There are few conditions that a first aider will come across that are scarier than a classic grand mal seizure. While you can bandage a wound, place someone in the recovery position, or administer CPR, the sight of someone shaking on the ground is extremely daunting if you are not use to it.

First, though, you should not panic. Your first priority is to remove any hazards that could be hit by the seizing person. These could include knives, scissors, and other sharp objects or electrical goods such as hair curlers, electric fires, and other hot items. If you cannot remove an item, such as a door or wardrobe corner, cushion it with either your body or a blanket. Ensure the head is cushioned if possible. Do not try to restrain the person or hold down the tongue as this may cause potentially severe injuries.

Your next priority is to dial 911. The operator will ask you for your location, the age of the casualty, and whether he or she is still breathing. Give as much information as you can. You may already know whether this is the casualty’s first seizure or not and how long they typically last. Alternatively, you can ask whoever is with the person.

Having made the area safe and called for help, you must consider the comfort and dignity of the person. A seizure always creates a lot of attention, and ideally the casualty’s dignity must be preserved. Set up screens if they are available or close the area off. Remove any bystanders who are just staring. If they refuse to leave the area, ask them to consider whether they would like to be stared at in a similar situation.

If the patient is still fitting when the paramedic arrives, a line will normally be placed in the casualty’s arm. Alternatively, a suppository may be administered if the fitting is too severe or a vein is hard to find. This will help the patient to recover from the procedure.

If the seizure abates before medical help arrives, put the patient in the recovery position. Keep the casualty warm by covering with a blanket. He or she may be very confused upon waking up from the seizure. Some may become frightened or momentarily aggressive. Explain what has happened and that help is on the way. Suggest the patient stays still until help arrives.

Whatever happens, when dealing with a seizure, you must keep calm. The vast majority of seizures will not cause any serious harm to the casualty. Staying focused and following your first-aid training is the best way to help an epileptic recover.