Not every seizure looks like the one most people picture. Some look like staring, confusion or a repeated word. Those are the ones that get missed, and they are seizures too. About 1 in 100 Australians has epilepsy, a lasting tendency to have seizures, diagnosed by a doctor usually after more than one. Many people control it well with medication and have few seizures or none. What a worker sees depends on which part of the brain is involved, and the person's own pattern, written in their seizure management plan, is the reference. It will rarely match a textbook exactly.
What are the different kinds of seizure a worker might see?
A tonic-clonic seizure is the kind most people picture: the body stiffens then jerks, the person is unconscious, and they may cry out, go blue around the lips, or wet themselves. A focal aware seizure leaves the person awake and knowing what's happening, sometimes with one part of the body twitching or a strange smell, taste or feeling. A focal impaired awareness seizure looks different again: the person looks awake but isn't really there, and may pluck at clothes, chew, wander or repeat a word, with no memory of it afterwards. An absence seizure is a few seconds of blank staring that can look like daydreaming, starting and stopping suddenly. Some people get a warning beforehand, called an aura, which is itself a focal seizure and can last seconds or minutes. If a person says one is coming, the thing to do is help them get somewhere safe.
What should a worker do while a seizure is happening?
For a convulsive seizure: look at the clock the moment it starts, since timing is the first thing done and a seizure always feels longer than it is. Cushion the head with a folded jumper, a cushion or hands. Clear the space of furniture and hard objects. Loosen anything tight at the neck if that can be done easily. Stay with the person and keep others back. A worker cannot stop a seizure and shouldn't try. The job is keeping the person safe while it runs, and calm is part of the care, since the person may hear a worker even when they can't answer.
What should a worker never do during a seizure?
Nothing goes in the mouth, no fingers, no spoon, no water, since it breaks teeth and blocks airways. The person is not held down: restraining someone mid-seizure causes injury and doesn't shorten it, and it can also count as a restrictive practice. And the person isn't moved unless they're in danger, such as near a road, water or a heater.
When does a seizure become a call-000 situation?
The rule is to check a list rather than judge it in the moment. Call 000 if the seizure has run five minutes, or longer than the person's own plan says; if another seizure starts before the person has recovered from the first, whatever the gap between them; if something else is wrong, a first-ever seizure, an unfamiliar pattern, no seizure plan in place, not knowing the person, an injury, trouble breathing, being in water, or being pregnant; or if afterwards the person is still not responding five minutes on, they ask for an ambulance, or the worker is simply out of their depth. Most convulsive seizures stop within two minutes. At five minutes, one is much less likely to stop on its own, which is why noting the start time is the first thing a worker does.
What happens after the jerking stops?
Roll the person onto their side once the jerking has stopped, not during it. Check they're breathing and that nothing is blocking the mouth. Note the time it stopped. Stay with them until they're fully back to themselves, talking calmly and telling them where they are. If breathing isn't normal after a seizure, that's treated the same as not breathing at all, and it means calling 000 and starting CPR if trained to. The period after a seizure is called the post-ictal phase: the person may not know where they are, may be exhausted, sore or upset, and most won't remember the seizure at all. Give them space, keep a low voice, don't restrain them, and don't take agitation personally, since a confused brain isn't an angry person.
What about a focal or absence seizure, where there's no convulsion?
Don't grab the person, since they may resist without knowing why. Guide rather than steer, a hand near the elbow if they're walking toward something hazardous. Time it anyway, since the clock matters just as much here. Speak calmly and simply, since they may hear without being able to answer. And stay until they're back, then tell them what happened.
Where emergency medication sits
Some people have emergency medication, usually midazolam given into the cheek or nose, prescribed for long seizures. Giving it requires three things to all be true: specific training for that medication, not general medication training; the provider's authorisation to give it; and a current plan naming the dose and when to give it. If any one of those is missing, the medication is not given. Follow your organisation's policy, and call 000. Midazolam slows breathing, and giving it without training, at the wrong time or the wrong dose, can cause serious harm.
What makes a seizure more likely, and what should get reported?
Triggers vary person to person, and some people have none they can identify. The most common and most preventable is missed medication. Others include not enough sleep, being unwell, alcohol, stress, and missed meals or dehydration. Supporting someone to take medication on time is itself seizure prevention. A good record carries the start and stop time from the clock, what was actually seen rather than a judgement, whether the person responded, what came before it, any injury, how long recovery took, and any medication given. A concern goes to a supervisor the same shift, and a change in pattern, more often, longer, or a new kind, gets flagged specifically, since some seizure events are reportable incidents under the NDIS rules.
Is this the same as first aid training?
No. This course covers recognising a seizure including the quiet kinds, keeping someone safe, knowing the 000 list, holding the medication line, and writing a record a specialist can act on. It is not an accredited first aid qualification and doesn't teach CPR. Accredited first aid training is separate, and still required.
How CORA's course fits into this
CORA's course Epilepsy & Seizure Support, part of the Disability Understanding & Daily Life stream in the course library, covers recognising seizures including the kinds that get missed, keeping a person safe in the moment, the 000 list, the medication line, and writing a record a specialist can act on. It is knowledge-only and does not replace accredited first aid training.
To map this alongside the rest of the Disability Understanding stream for a team, try the Free tools, free and no sign-up required, or enquire.
See how CORA covers epilepsy support and the rest of Disability Understanding
CORA includes the provider portal behind the library: pathways with per-course due dates, automatic due, overdue and renewal reminders, a credential and evidence register, and exportable audit records, a training register by name, a completion summary and the credential register. Browse the full library, or get in touch to talk through what your team's coverage looks like right now.
Try the Pathway Builder Book a demo Browse the course libraryCommon questions
What should a worker do while a seizure is happening?
Look at the clock the moment it starts, cushion the head, clear hard objects from the space, loosen anything tight at the neck if that can be done easily, and stay with the person while keeping others back. Nothing goes in the mouth, the person is not held down, and they are not moved unless they're in danger from something like a road, water or a heater.
When does a seizure become a call 000 situation?
Check the list rather than judging it in the moment: the seizure has run five minutes or longer than the person's plan says; a second seizure starts before they've recovered from the first; something else is wrong, such as a first-ever seizure, an unfamiliar pattern, no seizure plan, injury, or trouble breathing; or afterwards they're still not responding five minutes on, they ask for an ambulance, or the worker is out of their depth. Any one of these means calling 000.
Can a support worker give emergency seizure medication?
Only if three things are all true: the worker has specific training for that medication, the provider has authorised them to give it, and it's in the person's current plan with the dose and timing. If any one of those is missing, the medication is not given. The worker follows their organisation's policy and calls 000 instead.
Is epilepsy training the same as first aid training?
No. This kind of course covers recognising seizures, keeping someone safe, knowing when to call 000, and reporting properly. It is not an accredited first aid qualification and doesn't teach CPR. Accredited first aid training is separate and still required.
Sources and further reading
- Guideline 9.2.4, First Aid Management of a Seizure, Australian and New Zealand Committee on Resuscitation
- High intensity support skills in the NDIS, CORA Workforce
This page is general knowledge for support workers and providers, not clinical guidance. It does not qualify a worker to administer emergency seizure medication beyond what their organisation has specifically authorised and trained them for, and it is not a first aid qualification. Always follow the person's seizure management plan and your organisation's policies.
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