Asthma Attacks:
Recognising the Symptoms and Providing First Aid

Asthma attacks can be frightening and life-threatening if not managed quickly. An asthma attack occurs when the muscles around the airways tighten, causing them to narrow and making it difficult to breathe. Understanding the signs of an asthma attack and knowing how to provide the right first aid can help prevent a serious medical emergency.

What is Asthma?

Asthma is a long-term lung condition that causes the airways to become inflamed and sensitive. When triggered by irritants, allergens, or other factors, the airways can narrow, leading to difficulty breathing. While asthma is often managed with medication, asthma attacks can still happen suddenly and unexpectedly.

Common Triggers of an Asthma Attack

Asthma attacks can be triggered by various factors, including:

• Allergens: Pollen, dust mites, pet dander, or mould.
• Irritants: Smoke, strong odours, pollution, or cold air.
• Exercise: Physical exertion, particularly in cold, dry air.
• Respiratory Infections: Colds, flu, or other infections.
• Stress: Emotional stress or anxiety.

Signs and Symptoms of an Asthma Attack

The severity of asthma symptoms can vary, but common signs of an asthma attack include:

• Wheezing: A whistling sound when breathing, particularly when exhaling.
• Shortness of Breath: Difficulty breathing or feeling like you cannot catch your breath.
• Tight Chest: A feeling of pressure or tightness in the chest.
• Coughing: Persistent coughing, especially at night or early in the morning.
• Difficulty Speaking: The person may struggle to talk or finish sentences due to shortness of breath.
• Pale or Bluish Skin: Particularly around the lips or fingernails (a sign of low oxygen levels).
• Anxiety: The person may appear panicked or anxious due to difficulty breathing.

If untreated, an asthma attack can worsen and lead to life-threatening complications, including respiratory failure. Recognising the early symptoms and responding quickly is critical.

First Aid for an Asthma Attack

1. Help the Person Sit Upright:

• Encourage the person to sit upright rather than lying down. Sitting upright helps open the airways, making it easier to breathe.
• Avoid having them lie flat, as this can make breathing more difficult.

2. Assist with Their Inhaler:

• Most people with asthma will carry a reliever inhaler (often a blue inhaler) containing medication such as salbutamol.
• Help the person use their inhaler by following these steps:
  1. Remove the cap and shake the inhaler.
  2. Ask them to breathe out fully.
  3. Place the mouthpiece in their mouth, sealing it with their lips.
  4. As they breathe in slowly, press down on the inhaler to release one puff of medication.
  5. They should hold their breath for 10 seconds if possible, then breathe out slowly.
• They can take up to 10 puffs from their reliever inhaler, waiting 30 seconds between each puff.

3. Stay Calm and Reassure the Person:

• Stay with the person and keep them calm. Panic and anxiety can worsen the symptoms of asthma.
• Reassure them that help is on the way and encourage slow, steady breathing.

4. Call 999 if There’s No Improvement:

• Call 999 for emergency help if:
  • The person’s symptoms do not improve after 10 puffs of their inhaler.
  • They are struggling to breathe, or their condition is worsening.
  • They cannot speak due to shortness of breath.
  • Their lips or fingernails are turning blue.
  • They are losing consciousness.
• While waiting for help, continue to help them use their inhaler as needed.

5. Use a Spacer if Available:

• If the person has a spacer device with their inhaler, use it. A spacer helps deliver the medication more effectively.
• Attach the spacer to the inhaler and follow the same steps as using the inhaler alone. The person can breathe in and out slowly through the spacer after each puff.

After the Attack

Even if the person’s symptoms improve after using their inhaler, they should still see a doctor or asthma nurse, especially if this is a severe attack or their first. Asthma attacks can be unpredictable, and they may need to adjust their asthma management plan.

When to Seek Medical Help

Seek emergency medical help by calling 999 if:

• The person’s inhaler does not relieve their symptoms after 10 puffs.
• They are finding it extremely difficult to breathe, talk, or walk.
• They become drowsy or unresponsive.
• Their lips, face, or fingernails are turning blue.
• The person is getting worse despite using their reliever inhaler.

Preventing Asthma Attacks

• Avoid Known Triggers: If possible, avoid allergens or irritants that trigger asthma attacks, such as smoke, pollen, or pollution.
• Carry Medication: Always carry a reliever inhaler and use it at the first sign of symptoms.
• Take Preventer Medication: If prescribed, use a preventer inhaler daily to reduce the risk of attacks.
• Regular Check-ups: Regular asthma check-ups with a healthcare professional can help monitor the condition and adjust treatments if necessary.

Key Points to Remember

• Help the person sit upright and assist them with their reliever inhaler.
• They can take up to 10 puffs of their inhaler, waiting 30 seconds between each puff.
• Call 999 if the person’s symptoms do not improve after using their inhaler or if they are struggling to breathe.
• Stay calm and reassure the person, as anxiety can worsen the attack