In an asthma attack the muscles of the air passages in the lungs go into spasm and the linings of the airways swell. As a result, the airways become narrowed and breathing becomes difficult.

Sometimes there is a specific trigger for an asthma attack such as:

  • an allergy
  • a cold
  • cigarette smoke
  • extremes of temperature
  • exercise.

People with asthma usually deal well with their own attacks by using a blue reliever inhaler, however you may be required to assist someone having an asthma attack or having an attack for the first time.

Recognition features

  • Difficulty in breathing.

There may also be:

  • wheezing as the casualty breathes out
  • difficulty speaking and whispering
  • distress and anxiety
  • coughing
  • features of hypoxia, such as a grey-blue tinge to the lips, earlobes and nailbeds (cyanosis).


Your aims during an asthma attack are to ease the breathing and if necessary get medical help.

  • Asthma - reassuring the casualtyYou need to keep the casualty calm and reassure them.
  • Asthma - taking inhalerIf they have a blue reliever inhaler then encourage them to use it. Children may have a spacer device and you should encourage them to use that with their inhaler also. It should relieve the attack within a few minutes.
  • Encourage the casualty to breathe slowly and deeply.
  • Asthma - sitting in a comfortable positionEncourage the casualty to sit in a position that they find most comfortable. Do not lie the casualty down.
  • A mild asthma attack should ease within a few minutes of them using their inhaler. If it doesn't then assist them to use their inhaler (one or two puffs) every two minutes until they have had 10 puffs.
  • Monitor their vital signs - breathing, level of response and pulse.


If this is the first attack, the attack is severe, the inhaler has no effect or the attack appears to be getting worse.

Dial 999 (or 112) for an ambulance.

If the patient becomes unconscious open the airway and check their breathing and be prepared to give emergency aid. Please listen to the tips on recovery position and CPR.

Related topics

Please note:

These hints are no substitute for thorough knowledge of first aid! St John Ambulance holds first aid courses throughout the country.

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