What is the best initial action by the nurse when a child starts experiencing a tonic-clonic seizure?

When a child begins to experience a tonic-clonic seizure, the best initial action is to ensure their safety by placing them on the floor. This approach helps prevent them from falling and sustaining injuries. The floor provides a flat, stable surface, which is crucial because during a tonic-clonic seizure, the child may lose consciousness and fall.

Additionally, placing the child on the side (often called the recovery position) is beneficial in preventing possible aspiration if they vomit during the seizure. This position can also help maintain an open airway. It is important to protect the child from potential harm due to the intense muscle contractions and jerking movements associated with the seizure.

While it might seem helpful to hold the child's head to prevent injury or to put a towel in their mouth, these actions can inadvertently cause more harm. For instance, trying to hold the child's head can restrict their movements, leading to increased risk of injury, and placing anything in the mouth can lead to choking or dental injuries. Calling for assistance is wise, but ensuring the child's immediate safety is the priority in such situations.