When to Call 999: Clear Criteria for Emergency Response

In an emergency, hesitation costs time. When someone has a seizure, the people around them often face a moment of uncertainty. Should they call 999? Should they wait? Is this serious enough? That uncertainty is understandable, but it is also avoidable. Clear criteria exist for when emergency services should be contacted during or after a seizure. Knowing them removes the guesswork and supports a faster, safer response.

This article sets out those criteria in plain terms. It is intended for anyone who may witness a seizure, including care providers, support workers, school staff, employers, and members of the public.

The default position: most seizures do not require 999

Most seizures end on their own within a few minutes and do not require emergency medical intervention. For someone with a known epilepsy diagnosis, a typical seizure may be part of a pattern their healthcare team is already managing. Calling 999 for every seizure would not be appropriate and could place unnecessary strain on emergency services.

The starting point, therefore, is this: a seizure alone is not automatically an emergency. What matters is whether specific criteria are met.

When to call 999

Emergency services should be called immediately if any of the following apply.

The seizure lasts longer than five minutes. A convulsive seizure that does not stop within five minutes is treated as a medical emergency. This is the threshold for what may be developing into status epilepticus, a prolonged seizure state that requires urgent medical treatment.

One seizure follows another without recovery in between. If a person has a second seizure before regaining consciousness or awareness from the first, this is also treated as a medical emergency.

The person is injured during the seizure. Head injuries, suspected fractures, burns, or any significant injury sustained during the seizure require medical assessment.

The person has difficulty breathing after the seizure ends. Some difficulty catching breath immediately after a convulsive seizure can be normal, but persistent breathing problems require emergency care.

The seizure happens in water. Even if the person appears to recover quickly, anyone who has had a seizure in water should be assessed by medical professionals due to the risk of inhaled water and secondary complications.

This is the person’s first known seizure. A first seizure should always be medically assessed, even if it appears to end normally.

The person does not regain consciousness or normal awareness after the seizure ends. Recovery times vary, but a prolonged failure to come round requires urgent medical attention.

The person has another health concern that may be relevant. Pregnancy, diabetes, recent head injury, or other significant health factors raise the threshold for emergency response.

When 999 is not normally required

If a person has a known epilepsy diagnosis and the seizure follows their usual pattern, ends within a normal timeframe, and recovery proceeds as expected, emergency services are not normally required. The individual’s own care plan may set out specific guidance, and that plan should be followed.

This is why person-specific support plans matter. They remove ambiguity by defining what a typical seizure looks like for that individual and what response is appropriate.

What to do while waiting for emergency services

If 999 has been called, the following steps support the person until help arrives.

• Stay with them and keep them safe from further injury.
• If they are convulsing, place something soft under their head and move nearby objects out of the way.
• Do not restrain them or put anything in their mouth.
• Once the convulsion ends, place them in the recovery position if they are not already breathing comfortably on their side.
• Time the seizure if you have not already done so.
• Note what you observe, including any injuries, changes in breathing, and how long recovery takes.
• Be ready to share this information with paramedics on arrival.

Removing ambiguity through training

Knowing the criteria is one thing. Acting on them confidently in a real situation is another. Structured training builds the confidence to recognise when each criterion applies, communicate clearly with emergency services, and provide effective support until help arrives. For staff in care, education, or public-facing roles, this training is not optional. It is a core part of safe practice.

Get in touch

National Epilepsy Training delivers focused, practical training on seizure recognition and emergency response. Our Epilepsy Awareness Training course covers the criteria for calling 999 in detail, alongside seizure first aid and safe response procedures. For staff who administer rescue medication, our Buccal Midazolam Training with Epilepsy Awareness and Rectal Diazepam Training and Epilepsy Awareness courses provide the additional skills required.

To discuss training for your team, please complete the contact form below and a member of our team will be in touch.