Seizures and sudden neurological red flags, including stroke

Seizures and stroke can occur suddenly in the pharmacy. The response differs from airway or allergic emergencies, but the practical steps are familiar: keep the person safe, call 999 when indicated, monitor them closely, and avoid unsafe myths or delays.

Seizure first aid

• Protect from injury: remove dangerous objects and cushion the head if possible.
• Do not restrain: do not put anything in the mouth.
• Time the seizure: duration guides escalation.
• After convulsions stop: check breathing and, if normal, place the person in the recovery position.
• Stay until recovery: speak calmly; expect post-seizure confusion.

NHS advice is to call 999 if this is the person's first seizure, it lasts more than 5 minutes, it is longer than usual for them, seizures recur without full recovery between episodes, the person is injured, or they have breathing difficulties afterwards.

Stroke red flags and FAST

NHS guidance is clear: use FAST and call 999 immediately.

• Face: one side droops or the smile is uneven.
• Arms: they cannot lift both arms and keep them there.
• Speech: speech is slurred, confused, or absent.
• Time: call 999 immediately.

Do not ignore stroke signs that improve quickly. Symptoms that come and go may be a transient ischaemic attack or stroke and still need urgent ambulance assessment.

Do not give food, drink, or routine oral medicines to someone with suspected stroke while waiting for the ambulance. The priority is urgent assessment and safe handover.