I have seen more than one bitten tongue from a Seizure. I have never seen a bitten tongue cause more than a bleeding problem. I have seen a few tongue tips bitten off, but again it is never more than a bleeding issue.

The absolute best thing to do for a patient that is seizing is protect them from doing any more harm to themselves from their surroundings. Don't put anything in their mouth while they are seizing... if you need to secure an airway while they are postictal then manual airway management (head tilt) is usually all you need.

Bee, an NPA would probably not hurt a seizing patient if you could actually get one in safely… but you would be wasting your time. It isn’t an airway issue that causes seizing patients to become hypoxic. Placing anything in a seizing patient’s airway is more likely to cause a foreign body airway obstruction then it is to do any good.

As OBG stated, “swallowing the tongue” isn’t actually that. It refers to the tongue relaxing a causing it to occlude the airway. Normally our gag-reflex prevents this, but an unconscious person’s gag reflex can be compromised. An OPA does help prevent this, but a proper head-tilt or modified jaw thrust method or manual airway management is the most effective basic airway management with an OPA or NPA as an adjunct after one of those airway maneuvers has been performed. OPAs and NPAs do require special training but are very simple and many area’s are including their training in first responder classes (a 40-60 hour course) if someone is interested in gaining that additional training.

As for tearing the lingual frenulum, it is very rare in adults… and usually the least of their worries.

OH, I do currently both work in the field on a busy paramedic unit and am the lead instructor of a paramedic training program.