Safety and Seizures
Many safety issues are similar among people living with epilepsy, but there are also individual issues. It is impossible to give a comprehensive list of safety tips that apply to everyone. Thus, this guide developed by the Epilepsy Foundation National Office and other resources should be used in consultation with your caregivers and doctor(s), as applicable.
We all live with risks in our daily lives. Having epilepsy (a seizure disorder) can increase the risk of injury, for some people more than others. A lot depends on the kind of seizures people have, how often they have them, and the kinds of activities that are important in their lives.
These safety tips to reduce injury risks will probably be most helpful for people whose seizures cause them to fall, lose consciousness, or make them briefly unaware of where they are or what they are doing.
In the Household
The following are tips on how to make different rooms in the house safer for people with epilepsy:
- Carpet the floors in your house or apartment with heavy pile and thick under padding.
- Pad sharp corners of tables and other furniture; look for rounded corners when you shop.
- Put guards around the fireplace or, preferably, close fireplace screens while a fire is burning.
- Don't smoke or light fires when you're by yourself.
- Don't carry hot fireplace ashes or lighted candles through the house.
- Avoid space heaters that can tip over.
- Use curling irons or clothing irons with automatic shut off switches to prevent burns.
- Select chairs with arms to prevent falling.
- Make sure motor-driven equipment, such as a lawn mower, has a "dead man's" handle that will stop the machine if your hand releases normal pressure.
- Hang bathroom doors so they open outwards instead of inwards (so that if someone falls against the door, it can still be opened).
- Put extra padding under carpeting in the bathroom.
- Hang an "Occupied" sign on the outside handle of the bathroom door, instead of locking it.
- Routinely check that the bathroom drain works properly before taking a bath or shower.
- If you fall frequently during seizures, consider using a shower or tub seat with a safety strap.
- Keep water levels in the tub low.
- Consider using a hand held shower nozzle while seated in tub or shower.
- Set water temperature low so that you won't be scalded if you lose consciousness while hot water is running.
- Avoid using electrical appliances, such as a hair dryer or electric razor, in the bathroom or near water.
- Slide containers of hot food along the counter instead of picking them up, or use a cart when taking hot foods or liquids from one room to another.
- Use plastic dishes and cups with lids (commuter cups) to prevent cuts or burns from spills.
- Use a microwave oven for cooking.
- When you use the stove, try to use the back burners as much as possible.
- Remove burner controls from gas or electric stoves when not in use.
- Use long, heavy duty oven mitts or holders when reaching into a hot oven.
- Wear rubber gloves when handling knives or washing dishes and glassware in the sink.
- Use plastic rather than glass containers as much as possible.
Kids Safety
The following tips are ways parents can help improve safety for children with epilepsy:
- A monitor in the child's bedroom may alert you to the sound of a typical seizure.
- Avoid top bunks. A lower bunk, a regular bed, a futon or even a mattress on the floor is a safer place to sleep for a child with seizures.
- A well fitting-helmet with a face guard may protect against head and facial injuries from severe drop seizures.
- Have the child wear a life vest when near water, including the backyard pool. [See also water safety]
- Closely supervise showers and tub baths.
- Put a list of first aid steps on the refrigerator or some other place where it's easy to find.
- When you have babysitters, go over first aid steps, write down the phone number where you or a relative can be reached; include the doctor's number and the one for the emergency squad on the same sheet.
- If your child is going to sleep at a friend's or relative's house overnight, make sure a copy of the list goes along too, and that an adult in the house knows what to expect and what to do if a seizure happens.
- Not every childhood injury is preventable, whether or not a child has seizures. Try to strike a balance between safety and overprotection.
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Recreation
The following tips are ways people with epilepsy can help improve their safety during recreational activities:
- When exercising, take frequent breaks, stay cool, and save your greatest exertion for the coolest part of the day.
- Exercise on soft surfaces if you can -- grass, mats, wood chips.
- Review the risks carefully before taking up sports which could put you in danger if you were suddenly unaware of what you were doing.
- Wearing a life vest is a good idea when you are on or close to water.
- Swimming can be safe and fun for everyone, but if you have seizures, avoid swimming alone.
- Tell lifeguards and friends you swim with what kind of seizures you have, how to recognize them, and what to do if you have one. Make sure they swim well enough to help if you need it.
- Wear head protection when playing contact sports or when there is an added risk of falling or head injuries.
- If you ski or hike, go with a buddy; you may need someone to get help if you have a seizure in remote areas.
- Consider use of a safety strap and hook when riding the ski lift.
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Kid-Friendly Tips for Recreation:
Unless your child's doctor recommends otherwise, sports activities and other exercise are as beneficial to a child with epilepsy as they are to any other child. In general, school sports activities and gym should be open to all children, including children with seizures. Safety measures such as harnesses, shock absorbing mats and adult supervision should reduce risks. Coaches and officials should be aware that a child has seizures, and how the parents want them to be managed. Wearing safety helmets when riding a bicycle or during sports where head injury is possible should reduce risk.
Transportation
The following are transportation safety tips for people with epilepsy:
- Don't drive unless you have a valid license and are not having seizures.
- If you can't drive because of epilepsy, explore local "Dial a Ride" services and public transportation options.
- When riding a bicycle, wear a helmet, knee pads and elbow pads.
- As much as possible, ride on side roads or bike paths.
- Stand well back from the road when waiting for a bus and from the platform edge when taking the subway or train.S
- If you wander during a seizure, try to take a friend along when you travel.
- If subway or other escalators or stairs are unusually steep, consider using elevators instead.
- If you're going to be outside in extremely cold weather, go with a friend.
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Water Safety
The following water safety tips for people with epilepsy is adapted from the July 26, 2006 Epilepsy USA article by Sylvia Blair as well as from the National Epilepsy Foundation website.
Water can be a hazard to children with seizures, whether it is in a swimming pool, at the beach, or in the bathtub. To help prevent drowning and other avoidable accidents in the water, the Epilepsy Foundation of Greater Los Angeles recommends the following safety measures around water for people who experience seizures:
- Discuss the matter of swimming with your doctor and review guidelines that are specific to you or your child.
- Before going out in the water, consider whether your seizures are under sufficient control to permit swimming.
- Wearing a floatation device that supports the head above water is a good idea. It's especially important for children and, in some cases, adults with seizure disorders.
- A child with epilepsy -- or any child -- should never swim alone, or be on a boat or close to water (including backyard wading pools) without a flotation device or life jacket.
- Adults with frequent seizures should never swim alone. Always swim with a buddy who's a good swimmer. This is good basic advise whether one has epilepsy or not!
- Inform adult nearby who knows your child has epilepsy and is a good enough swimmer to help if your child has a seizure in the water.
- Inform the lifeguards and swimming instructors that you/your child has epilepsy.
- Carefully supervise children near water.
- Don't get over-tired or too cold while in the water.
- Don't swim if you have forgotten to take your seizure medication.
- Don't let your seizure medications get wet. Several are known to lose their anticonvulsant effect when exposed to the water.
- If flashing lights bring on your seizures, wear polarized sunglasses to reduce the flicker effect of sunlight on the water and other reflective surfaces.
- If a child has a seizure in water, he or she should be checked by a lifeguard or parent. If there is any possibility that water has been swallowed or breathed into the lungs, get a medical check up.
- Supervise young children closely during tub baths.
- Have older children take showers, not tub baths.
- Set water temperature low so a child won't be scalded if consciousness is lost while hot water is running.
- Hang bathroom doors so they open outwards, and remove locks.
- Make sure shower and bath drains run quickly and are unobstructed.
It is important to know that, although a study of drowning accidents among people with epilepsy confirms that seizures in the water can be deadly, the Epilepsy Foundation says that most people with epilepsy can safely enjoy water activities if they take the above precautions. The study of drowning incidents, conducted in Fla., includes 2,381 drowning deaths reported in that state between 1992 and 1997 (Epilepsia, Vol. 40, Supplement 7, December 1999). Of these, 58 (2.4%) were reported as seizure-related. The highest number of seizure-related drowning fatalities were in people between 25 to 34 years old.
