Which of the following is an appropriate safety measure during a seizure?

• A. Keep airway open, clear harmful objects, assess respirations and pulse; do not restrain; do not suction until movement stops
• B. Restrain the patient to prevent injury
• C. Immediately suction the oropharynx
• D. Move the patient by lifting under the arms

Answer: (A)

During a seizure, the priority is to protect the airway and prevent injury while allowing the event to run its course. The safest approach is to keep the airway open and clear any nearby objects that could cause harm, so the person can breathe more easily and not be obstructed. Calmly monitor respirations and pulse to assess oxygenation and circulation, which helps determine if urgent intervention is needed.

Avoid restraining the person. Holding them down or trying to pin their limbs can cause physical injury to both the patient and caregiver and may prolong distress without improving the seizure. Likewise, avoid suctioning during the seizure; mouth or oropharyngeal suctioning should wait until movement has stopped, because attempting to suction during active convulsions can injure tissues and is generally ineffective at preventing aspiration during the seizure.

If safe to do so, once the shaking ceases, place the person on their side to help maintain a clear airway and prevent aspiration. Stay with them, provide reassurance, and remove any dangerous objects from the surroundings. Seek emergency help if the seizure lasts longer than about five minutes, if another seizure follows immediately, or if the person has never had a seizure before.