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Lifeguard Response to Seizures in the Water
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The lifeguard response to seizures in the water is one of the few situations where the correct action is mostly to support and wait, and where the instinctive actions are actively harmful.
- Get to them and support the head. Keep the face and airway above the surface. That is the whole priority during the seizure.
- Do not restrain the limbs. You cannot stop a seizure and holding against it causes injury.
- Do not put anything in the mouth. Nothing, ever. People do not swallow their tongue, and objects in the mouth break teeth and obstruct the airway.
- Do not try to remove them mid-seizure unless staying is more dangerous, because moving a convulsing casualty through water risks both of you.
- Call emergency services. A seizure in water is always a 911 call.
- Once it ends, remove them from the water and treat as a submersion casualty.
- Place in the recovery position and monitor breathing continuously. Be ready for CPR.
Why it is treated as a drowning
A casualty who seized in water has very likely aspirated. They may look fine in the minutes afterwards and deteriorate later, which is why removal, oxygen where available, and medical assessment are not optional even for a casualty who recovers fully at the poolside.
The post-seizure period
Expect confusion, drowsiness and disorientation for some minutes. Keep them warm, keep them still, keep talking calmly, and do not let them re-enter the water under any circumstances.
Prevention and facility policy
Facilities often ask swimmers with a seizure history to swim with a companion and to inform staff. That is a reasonable control and it depends on guards knowing the policy exists. The lifeguard response to seizures in the water is far better when a guard already knew that swimmer needed extra attention.
Lifeguard response to seizures in the water: frequently asked questions
What is the lifeguard response to seizures in the water?
Support the head and keep the airway clear of the water, do not restrain the limbs or put anything in the mouth, call emergency services, and once the seizure ends remove the casualty, place them in the recovery position and treat them as a submersion casualty.
Should you pull someone out mid-seizure?
Not unless staying is more dangerous. Moving a convulsing casualty through water risks both of you, so support the head where they are until the seizure ends.
Why is medical assessment always needed?
Because a casualty who seized in water has very likely aspirated. They can look fine immediately afterwards and deteriorate later.
Reviewed by Jackie Stern, Lifeguard Instructor, Firefighter and EMT. Jackie Stern has taught lifeguarding for more than 20 years and works as a firefighter, EMT and swim instructor. She reviews course content, prerequisites and rescue standards against current certification requirements.
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