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

If you work as an NDIS support worker, there’s a reasonable chance you’ll one day support a participant who has a seizure. Epilepsy affects around 250,000 Australians, and the rate is significantly higher in people with intellectual disability — with some studies suggesting prevalence rates of 20–30% in this group. Yet seizure response remains one of the most misunderstood areas of first aid in disability support.

This post covers what you actually need to know: how to recognise a seizure, what to do (and what not to do), when to call 000, and what your obligations are as an NDIS provider or support worker.

Understanding Seizures in a Disability Support Context

A seizure happens when there is a sudden burst of abnormal electrical activity in the brain. Seizures can look very different depending on the type. A tonic-clonic seizure (previously called a grand mal seizure) is the most recognisable — the person loses consciousness, their muscles stiffen, and they experience rhythmic jerking movements. But seizures can also appear as brief episodes of staring into space, sudden muscle twitches, or unusual repetitive behaviours like lip-smacking or fumbling with clothing.

Many participants you support may have a known seizure condition and an individual Seizure Management Plan. If they do, that plan should always be your first reference point — it will specify how to respond to their particular type of seizure, any rescue medication they’ve been prescribed, and when to call for help.

What to Do When a Seizure Occurs

The core principle of seizure first aid is simple: keep the person safe, stay calm, and let the seizure run its course. Here’s what to do, step by step.

Stay with the person. Do not leave them alone. Note the time the seizure started — duration matters for deciding whether to call 000.

Move hazards away. Clear away any hard or sharp objects nearby. If they’re standing, guide them gently to the ground if possible.

Protect their head. Place something soft under their head — a folded jacket or a cushion works well. Do not restrain their movements.

Roll them onto their side once the jerking stops. The recovery position helps keep their airway clear and allows any saliva or vomit to drain. This is important — do not attempt this during active convulsions.

Stay nearby and reassure them. After a tonic-clonic seizure, the person will often be confused, disoriented, or exhausted. This post-seizure phase is called the postictal period and can last from a few minutes to an hour. Speak to them calmly, stay close, and let them rest.

What You Should Never Do

Some common instincts during a seizure can actually cause harm. Do not put anything in the person’s mouth — this is dangerous for both the person and you, and the old idea that people can swallow their tongue during a seizure is a myth. Do not restrain the person or try to hold their limbs still. Do not give food or water until the person is fully alert and oriented.

If the person is prescribed a rescue medication such as midazolam (a benzodiazepine administered intranasally or buccally), only administer it if you have been specifically trained and authorised to do so and their Seizure Management Plan instructs it. This is not a decision to make on the spot without prior preparation.

When to Call 000

Call 000 immediately if any of the following apply:

• The seizure lasts longer than five minutes
• Another seizure follows shortly after without the person regaining consciousness
• The person does not regain consciousness or awareness after the seizure ends
• The person is injured during the seizure
• The person has difficulty breathing
• This is the person’s first known seizure, or the seizure is different from their usual pattern
• The seizure occurs in water

A prolonged seizure (over five minutes) or repeated seizures without recovery between them — a condition called status epilepticus — is a medical emergency requiring immediate intervention.

Your Obligations as an NDIS Provider

Under the NDIS Practice Standards, registered providers have a duty of care to ensure participants’ health and safety, including effective responses to medical emergencies. This extends to ensuring that workers supporting participants with known seizure conditions are trained, informed, and prepared.

In practice, this means:

• All support workers should hold a current first aid certificate that includes seizure response
• Any participant with a known seizure condition should have an up-to-date Seizure Management Plan on file and accessible to workers supporting them
• Workers should be briefed on the plan before providing support, not after an incident occurs
• All seizure incidents must be documented and reported in line with your organisation’s incident reporting procedures and NDIS reporting obligations

The NDIS Quality and Safeguards Commission expects providers to have systems in place that prevent harm and respond appropriately when incidents occur. A gap in worker training or a missing Seizure Management Plan is a compliance risk — and more importantly, it puts participants at risk.

Seizure Management Plans: What They Should Cover

If you’re a coordinator, team leader, or service manager, make sure every participant with epilepsy or a known seizure disorder has a current Seizure Management Plan developed with input from their treating neurologist or GP. A good plan will include:

• A description of the person’s usual seizure type(s) and what they look like
• Known seizure triggers to be aware of
• Step-by-step instructions for responding to their specific seizure type
• Details of any rescue medication, dosage, and who is authorised to administer it
• Clear criteria for when to call 000
• Emergency contact details

Plans should be reviewed at least annually or whenever there is a change in the participant’s condition or medication.

The Role of First Aid Training

General first aid training gives workers a foundation for seizure response, but if you’re regularly supporting participants with epilepsy, consider whether additional epilepsy-specific training is appropriate. Epilepsy Action Australia offers resources and training that go deeper than what’s covered in a standard first aid course.

At minimum, every support worker should hold a current Provide First Aid (HLTAID011) certificate — and if your team supports participants in community settings, CPR currency (HLTAID009) should be treated as non-negotiable. Certificates should be renewed every three years (first aid) and every 12 months (CPR).

Book Your NDIS Team’s First Aid Training

AB First Aid runs practical, scenario-based first aid and CPR training designed for the real situations disability support workers face — including seizure response, managing medical emergencies during community outings, and supporting participants with complex needs. Our courses are delivered at our Tullamarine training centre, with options to accommodate rostered staff and shift workers.

View our upcoming public course schedule or get in touch to arrange training for your team at abfirstaid.com.au. Group bookings and organisation-wide training packages are available.

References

• Epilepsy Action Australia — www.epilepsy.org.au
• Australian Institute of Health and Welfare (AIHW), Epilepsy in Australia — www.aihw.gov.au
• NDIS Quality and Safeguards Commission, NDIS Practice Standards — www.ndiscommission.gov.au
• Australian Resuscitation Council (ARC), Guideline 9.2.7 — Seizures — www.resus.org.au
• Healthdirect Australia, Seizures and epilepsy — www.healthdirect.gov.au