Give supportive care

Most seizures are brief (1 to 3 minutes) and do not require drug treatment.

Give supportive care to all patients. Position the patient on the left side, protect the airway and maintain oxygenation.

If the patient is in an emergency department or similar setting, connect monitoring equipment and check the blood glucose concentration. Obtain intravenous access if possible. Send blood samples to pathology for a full biochemical panel, full blood count, and antiepileptic drug concentration (if readily available, to check concordance with therapy). Venous blood gas measurements give a fast indication of the patient's acid-base status, ventilation and concentrations of sodium, glucose and haemoglobin. If alcohol withdrawal cannot be excluded, give intravenous thiamine (see advice for Wernicke encephalopathy).

If the seizure stops, see advice on immediate follow-up after a seizure.