This publication was downloaded from the National Aging and Disability Transportation Center’s website (www.nadtc.org). It was developed by Easter Seals Project ACTION, a technical assistance center operated by Easter Seals, Inc. through a cooperative agreement with the U.S. Department of Transportation, Federal Transit Administration.

Seizure Disorder Awareness for Transportation Operators & Customers 

Note: This is an accessible version provided for those using screen readers.

This guide will help you understand the signs of epilepsy and what you should
do in case a passenger experiences a seizure on public transportation.

Logos: Epilepsy Foundation, Epilepsy Therapy Project, Easter Seals Project ACTION, Easter Seals, and U.S. Department of Transportation 

Introduction
In the U.S., over 10 billion trips are taken on public transportation each year. People of all ages and abilities travel by bus, rail, ferry, and taxi for work, school, personal appointments, and recreational activities. Approximately 1 in 26 Americans will develop epilepsy at some point in their lives, and as a result, may not be able to drive or may have restricted licenses.

The availability of public transportation and paratransit services are important for people
who have epilepsy and need to remain active in the community. It is possible that a passenger may experience a seizure while using public transportation. It is important to know the warning signs of seizure and understand what should be done in response. This is particularly important if you are the driver of a public transportation vehicle.

What is Epilepsy?
Epilepsy, also called a seizure disorder, is a neurological, medical condition. When epilepsy is not controlled, people have seizures. Seizures can be thought of as electrical overloads in the brain. Seizures can take many forms. Some types are brief and hardly noticeable whereas others present as convulsions that can be upsetting to those who see them.
Some common behaviors that occur during a seizure include:
●	Staring ahead without response to verbal commands or conversation
●	Losing awareness, losing consciousness, or becoming confused
●	Experiencing stiffness of limbs and/or shaking of limbs—this is also called a convulsion
●	Experiencing a change in emotional state
●	Picking and fiddling with items in a purposeless way
●	Using inappropriate language or
●	Agitated aggressive behavior
●	Falling

Important Epilepsy Facts & Tips
Never put anything in a person’s mouth when he is having a seizure. Objects like
pens or wallets can cause injury to teeth and gums. It is not true that a person can
swallow his tongue during a seizure. 
●	You cannot catch epilepsy or give it to someone else. Epilepsy is not contagious.
●	Through medication, surgery, diet, or a combination of approaches, about
	85 percent of people with epilepsy can achieve full or partial control of seizures.
●	Epilepsy is a medical condition and seizures are the outward sign. Seizures are caused by brief disturbances in the brain’s electrical activity. Epilepsy has a physical—not spiritual—cause.
●	People who experience seizures on public transportation should not be asked to leave the vehicle or be denied a ride. If you are an operator, refer to U.S. Department of Transportation ADA regulations and your agency’s service policies for more information.

What to Do in Case of Seizure

●	As a vehicle operator, stop the vehicle, and pull the vehicle out of traffic. Call 911
	or call dispatch and request emergency assistance. Follow your agency’s policy
	about calling 911.
●	Remain calm and ask those around you to remain calm. If the person experiencing
	the seizure is conscious, maintain open communication with him.
●	Check for epilepsy or seizure disorder I.D. The I.D may be around the passenger’s
	neck or carried in a purse or wallet.
●	Time the seizure. Seizures that last longer than five minutes are an emergency and
	require calling 911.
●	Some people can be agitated and combative during and after seizures. They are not aware of what they are doing. Agitation happens when a person becomes confused during or after a seizure.
●	Do not forcibly restrain the person having the seizure. Just gently guide them and
	keep them safe.
●	Never put anything in the person’s mouth.
●	Remove any objects (e.g., packages, strollers) from the area that could cause harm.
●	Cushion the passenger’s head, remove his glasses, and loosen tight clothing.

A seizure on a bus—If the person is having a convulsive seizure, and seats are available
on a bus or train, ease the person across a double or triple seat. It is best to turn the
person having a convulsive seizure on his side to decrease the chance of breathing in saliva.
However, do not risk injury to the person if it is difficult to turn him. Leave the person on his
side following the seizure. Once the person is fully aware and awake, help him into a resting
position in a single reclining seat.

●	A person recovering from a seizure should be fully conscious and aware before being
	left on her own.
●	As the seizure ends, offer help. Make sure the person knows the day, where she is, and
	where she’s going next. Ask the person if she would like you to contact a friend or relative.
	There is no reason why a person who has fully recovered from a seizure cannot stay on
	the bus until he arrives at his destination. If the person is traveling with a service animal,
the service animal should remain with the individual and is protected under the Americans with Disabilities Act.

You should call 911 or seek medical assistance if: 
●	The seizure lasts more than five minutes.
●	A second seizure starts shortly after the first seizure has ended.
●	The person has difficulty breathing after coming out of the seizure.
●	The person injures himself during the seizure.
●	Consciousness does not return after the physical shaking has stopped.
●	The person is not carrying a medical I.D. card, and there is no way of knowing whether the
	seizure is caused by epilepsy (i.e., you believe this may be a first time seizure).
●	The person has another medical condition such as:
 Diabetes
 Pregnancy
 Hypoglycemia
 Head injury
 Heat exhaustion
 Poisoning
 High fever

Epilepsy & Public Transportation 
●	Take your medication—on time, every day—as prescribed by your physician.
●	Carry your medical I.D. with you or wear a medic alert bracelet.
●	Medical alert IDs or bracelets are available through your physician’s
	office, pharmacies, or may be ordered online.
●	Consider traveling with someone who is aware of your medical condition and can help you
	if needed.
●	Know your seizure triggers, and be aware of how you feel before you take public transportation. Not getting enough sleep, drinking too much alcohol, or feeling stressed can cause seizures.

Easter Seals Project ACTION (ESPA) is funded through a cooperative agreement with the U.S. Department of Transportation, Federal Transit Administration, and is administered
by Easter Seals, Inc. This information is disseminated by ESPA in the interest of information exchange. 

Easter Seals, U.S. DOT, FTA, and the Epilepsy Foundation do not assume liability for its contents or use. 

For more information:
Epilepsy Foundation
www.epilepsy.com
(800) 332-1000
Easter Seals Project ACTION
1425 K Street NW, Suite 200
Washington, D.C. 20005
(800) 659-6428
www.projectaction.org
projectaction@easterseals.com

June 2014
Interior photos: OmniTrans—San Bernardino & NYC Dept. of Education