How to Help Someone Having a Seizure in a Crowded, Noisy Subway Train

Summary

Safety first

• Stop and move away if your own safety is at risk (e.g., sudden train movement, threat from crowds).
• Do not attempt risky maneuvers or lift the person if space is extremely limited.
• Never put objects near the person’s mouth.
• If the person has fluid or vomit in their mouth and you cannot position them on their side, clear the area as best as possible and get help.
• If at any point the person does not regain consciousness, breathing stops, or you feel overwhelmed and unsafe, call for professional medical assistance immediately.

Tools you’ll need

• Smartphone (for calling emergency services)
• Notepad and pen (for recording details)

Materials

• Jacket, sweater, or soft item (to cushion the person's head, if possible)
• Backpack or scarf (as additional cushioning or protection)

Step-by-step

• Stay calm and quickly assess the scene for immediate dangers (e.g., moving parts, doors).
• Use a clear, loud voice and hand gestures to get people's attention and ask them to step back and give space.
• Guide the person gently to the floor if they're standing, or clear surrounding objects if they're already on the ground.
• Cushion their head with a soft item, like a jacket or backpack, to prevent injury if possible.
• Do not restrain their movements or put anything in their mouth.
• Time the seizure if you can safely do so and observe its duration.
• After the seizure, turn the person onto their side in the recovery position, if space allows.
• Reassure bystanders the seizure will usually end on its own, and ask someone to call emergency services if the seizure lasts longer than 5 minutes, injury occurs, or this is their first seizure.
• Stay with the person until they are fully alert and help them recover.

Troubleshooting

• If bystanders interfere or panic, calmly explain the situation and delegate specific roles (e.g., "You—call 911! You—help me give space!").
• If the train is too crowded to create a safe space, do your best to shield the person from injury using your body or belongings.
• If the train is about to stop, notify the conductor/driver for assistance and possible emergency response.
• If the person becomes aggressive/confused after the seizure, maintain a safe distance and reassure them.

Common mistakes

• Trying to hold the person down or restrain their movements.
• Attempting to force objects (like wallets or fingers) into their mouth.
• Panicking or leaving the person unattended before they are fully alert.
• Failing to communicate clearly with other passengers to create enough space.
• Delaying calling emergency services when needed.

When to call a pro

• Seizure lasts more than 5 minutes.
• Another seizure begins before full recovery.
• The person is injured, pregnant, has breathing difficulties, or this is their first seizure.
• You are unsure what to do or feel in danger at any point.

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