Seizure Response for NDIS Support Workers: What to Do When a Participant Has an Epileptic Episode

Epilepsy affects approximately 250,000 Australians, and people living with epilepsy are significantly represented among NDIS participants. For support workers, witnessing a seizure — whether expected or not — can be confronting. The difference between a calm, informed response and a panicked one can directly affect the participant’s safety and dignity.

This article explains what NDIS support workers need to know about seizure response: what to do, what not to do, how to document it correctly, and what your duty of care requires under Australian frameworks.

Understanding Seizures in a Disability Support Context

Epilepsy is a neurological condition characterised by recurring, unprovoked seizures caused by abnormal electrical activity in the brain. Seizures can present in many ways — from brief absence episodes where a person stares blankly and becomes unresponsive, to generalised tonic-clonic seizures involving convulsions, muscle stiffening, and loss of consciousness.

Many NDIS participants with epilepsy will have an existing Seizure Management Plan developed with their neurologist or GP. Before working with any participant who has a history of seizures, support workers should read this plan carefully, know where it is kept, and understand the specific instructions it contains for that individual. Not all seizures are managed the same way — what applies to one participant may not apply to another.

Your Duty of Care as an NDIS Support Worker

Under the NDIS Practice Standards and the NDIS Code of Conduct, registered NDIS providers have a clear duty of care to protect participants from harm. Support workers — as agents of their providers — are expected to respond competently to medical emergencies, including seizures.

The NDIS Commission’s Worker Orientation Module, “Quality, Safety and You,” outlines that support workers must act to prevent harm and respond appropriately when incidents occur. Failing to respond adequately to a seizure — or responding in a way that causes additional harm — can constitute a breach of duty of care and may result in a reportable incident under the NDIS (Reportable Incidents) Rules 2018.

Holding a current first aid qualification is increasingly expected for support workers in many roles, particularly those providing supports to participants with complex health needs. Check your provider’s requirements and your participant’s support plan to confirm what level of certification is needed.

What to Do During a Seizure

If a participant has a Seizure Management Plan, follow it. If not, or if you are unsure of any steps, follow standard first aid guidelines from the Australian Resuscitation Council (ARC).

Stay calm and stay with the person. Note the time the seizure begins — duration matters, and you will need to record it. Protect the person from injury by removing hard or sharp objects from the surrounding area. If possible and safe to do so, cushion their head with something soft, such as a folded jumper. Do not restrain the person or hold their limbs down — this can cause injury to both of you. Do not put anything in their mouth. Contrary to an old myth, people cannot swallow their tongue during a seizure, and placing objects in the mouth risks broken teeth, bitten fingers, or airway obstruction.

If the person is convulsing on the ground, gently guide them onto their side — into the recovery position — once the convulsions have stopped, to keep the airway clear and allow any saliva to drain.

When to Call 000

Call 000 immediately if the seizure lasts longer than five minutes; if the person does not regain consciousness after the seizure ends; if another seizure begins shortly after the first; if the person is injured during the seizure; if you are unsure whether the person has epilepsy; or if this is their first known seizure. These are medical emergencies that require paramedic attendance.

After the Seizure Ends

Most seizures stop on their own within one to three minutes. After it ends, the participant may be confused, drowsy, or distressed — this is known as the postictal phase and can last from minutes to hours. Stay with them, speak calmly, and give them time to recover. Do not offer food or drink until they are fully alert and able to swallow safely.

Gently reorient them — remind them where they are and what happened. Many people feel embarrassed or frightened after a seizure, and how you respond in the moments after matters enormously for their dignity and sense of safety.

If the participant uses rescue medication such as midazolam, this will be specified in their Seizure Management Plan, often with instructions on when and how to administer it. Only administer rescue medication if you have been specifically trained and authorised to do so for that participant.

Documenting and Reporting

Documentation is a critical part of your duty of care. After any seizure incident, record the following in your progress notes or incident report: the date, time, and location; how long the seizure lasted; what the seizure looked like (type of movements, whether the person was conscious); any first aid provided; any injuries sustained; whether 000 was called and the outcome; and how the participant was after the seizure ended.

Under the NDIS (Reportable Incidents) Rules 2018, certain incidents must be notified to the NDIS Quality and Safeguards Commission. These include serious injury or unexpected deterioration in a participant’s health. Your provider will guide you on what needs to be formally reported and within what timeframe. Accurate documentation from you is essential to this process.

Being Prepared Before an Emergency Happens

The best outcomes come from preparation. Before supporting any participant with epilepsy, make sure you have read and understood their Seizure Management Plan; know where any rescue medication is stored and whether you are authorised to administer it; have completed first aid training that includes seizure management; and know the location of the nearest hospital or medical centre relative to where you will be working.

If your participant does not yet have a Seizure Management Plan and has a history of seizures, raise this with your supervisor. Every participant with epilepsy should have one in place before their supports begin.

Epilepsy Australia recommends that anyone caring for a person with epilepsy understand their individual seizure pattern — because what is normal for one person can help you identify when something is outside the ordinary and action is needed sooner rather than later.

Get the Training That Prepares You for the Real Thing

AB First Aid in Tullamarine offers nationally recognised first aid training designed for real-world situations, including the scenarios support workers actually face. Our courses cover seizure response, CPR, choking, anaphylaxis, and more — delivered in a practical, no-jargon style that stays with you when it matters.

Whether you need a first aid certificate for the first time or it is time to renew, our public courses run regularly and are easy to book online. View the current schedule or get in touch with the team at AB First Aid in Tullamarine to find a date that works for you.

References

• NDIS Quality and Safeguards Commission. NDIS Code of Conduct. ndiscommission.gov.au
• NDIS Quality and Safeguards Commission. NDIS Practice Standards. ndiscommission.gov.au
• NDIS Quality and Safeguards Commission. NDIS (Reportable Incidents) Rules 2018. ndiscommission.gov.au
• Australian Resuscitation Council. ARC Guideline 9.2.9 — Epilepsy and Seizures. resus.org.au
• Epilepsy Australia. First Aid for Seizures. epilepsy.org.au
• Epilepsy Foundation of Victoria. About Epilepsy and Seizure First Aid. epilepsyfoundation.org.au