Emergency advice

If someone is having an asthma attack:

  1. Reassure them, help them to use their reliever inhaler.
    • If no inhaler call 999/112.
  2. Ask them to breathe slowly and deeply.
  3. Sit them down.
  4. If the attack does not ease, advise one to two puffs every two minutes for up to 10 puffs.
  5. If they still don’t improve call 999 or 112.
    • Monitor breathing and level of response.
    • If unresponsive, prepare to give CPR.

What is an asthma attack?

During an asthma attack, the muscles of the air passages in the lungs go into spasm. As a result, the airways become narrowed, which makes breathing more difficult. Sometimes there is a recognised trigger for an attack, such as a cold, a drug, cigarette smoke or an allergy. At other times, there is no obvious trigger.

Signs and symptoms

Look for:

  • difficulty breathing
  • wheezing and coughing
  • a tight chest, it may feel like a band is tightening around it
  • distress and anxiety
  • difficulty speaking, shown through short sentences and whispering
  • signs of hypoxia such as grey-blue tinge to the lips, earlobes and nailbeds
  • exhaustion, in the case of a severe attack.

What to do

  1. Reassure the casualty and ask them to take their usual dose of their reliever inhaler (usually blue). Ask them to breathe slowly and deeply.

    • If they have a spacer available, ask them to use it with their inhaler. The inhaler is more effective with a spacer, especially when being used for young children.
    • If they have no inhaler call 999 or 112 for emergency help.
  2. Sit them down in a comfortable position.

  3. A mild attack will normally ease after a few minutes. However, if they don’t improve within a few minutes, it may be a severe attack. Ask them to take a puff every 30 to 60 seconds, until they have had 10 puffs. Help the casualty to use their inhaler if they need assistance.

  4. If the attack is severe, and they are getting worse, becoming exhausted, or if this is their first attack, call 999 or 112 for emergency help.

  5. Monitor their breathing and level of response. If the ambulance hasn't arrived within 15 minutes, repeat step 3.

    • If they become unresponsive at any point prepare to give CPR.
  6. If their symptoms improve and you do not need to call 999, advise the patient to get an urgent same-day appointment to see their GP or asthma nurse.

Important: This asthma attack information is not for patients on a Maintenance and Reliever Therapy (MART) plan; this may include a steroid preventer medicine and a certain type of long-acting bronchodilator medicine which can also be used as their emergency reliever. The patient will know which they should use in an emergency and may carry a written plan. 

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