Asthma Attack First Aid: What to Do and When to Get Emergency Help

Short answer: During an asthma attack, sit upright, stay calm and take your reliever inhaler exactly as your asthma action plan or clinician has instructed, using a spacer if you have one. If you are not improving, are too breathless to speak in full sentences, your lips look blue or grey, or the reliever isn't helping, call 999 or 112 or get to a 24-hour facility immediately.

It's evening, the jiko is lit for supper and smoke drifts through the house. A schoolchild who has had "a bit of a cough" all week starts to wheeze, then struggles to finish a sentence. The family hunts for the inhaler. It's in a school bag, and nearly empty. Knowing what to do in those first minutes, and being prepared before they come, makes a real difference.

What does an asthma attack look like?

Asthma makes the airways in the lungs swell and tighten, so less air gets through. Signs that an attack is starting:

• Wheezing (a whistling sound) when breathing
• A cough that won't stop, often worse at night
• A tight chest
• Shortness of breath or fast breathing
• Needing your reliever more often than usual, or it not working as well

In children, look for fast breathing, skin sucking in between or under the ribs, and being too breathless to talk, feed or play.

First aid: what to do during an attack

1. Sit upright. Don't lie down. Leaning slightly forward can help.
2. Stay calm. Panic makes breathing harder. Speak slowly and reassure the person.
3. Take the reliever inhaler as your asthma action plan or clinician has instructed. A spacer helps more medicine reach the lungs, especially for children.
4. Move away from the trigger, such as smoke or dust, into fresh air. Loosen tight clothing.
5. Watch closely. If breathing settles, rest, and see a clinician within a day or two. An attack means your asthma needs a review.
6. Get emergency help if there is no improvement after following your plan, or things get worse at any point. Keep following your plan while you wait.

Don't rely on home remedies instead of your inhaler, and don't wait to see if the attack passes.

When to call 999 or 112, or come in immediately

Get emergency help straight away if the person:

• Is too breathless to speak in full sentences, eat or sleep
• Has lips or fingertips that look blue or grey
• Is getting little or no relief from the reliever
• Is drowsy, confused, exhausted or collapses
• Has ribs, neck muscles or nostrils pulling in with each breath
• Is a child who is too breathless to cry, feed or talk

Don't drive yourself during a severe attack. Ask someone to take you, or call for an ambulance.

What triggers asthma at home?

• Smoke from the jiko, charcoal, firewood or kerosene. Cook in a well-ventilated place and keep children away from smoke.
• Cigarette smoke. Keep your home and car smoke-free.
• Dust and dust mites. Damp-dust surfaces, and air bedding and mattresses in the sun.
• Damp and mould on walls and ceilings.
• Colds and flu, which often set off attacks.
• Cold air, dusty roads and pollen from grass and crops.
• Strong smells such as perfume, insect sprays and cleaning products.
• Some medicines, including certain painkillers in some people. Check with your clinician or pharmacist.

Do you have an asthma action plan?

An asthma action plan is a written plan from your clinician that tells you which medicines to take every day, how to recognise when asthma is getting worse, and what to do in an emergency.

If you don't have a plan, ask for one at your next visit. Give a copy to your child's school.

Never run out of your inhaler

• Check how many doses are left and the expiry date.
• Get a refill before it runs out, not after.
• Keep a reliever with you at work, school and when travelling.
• Tell teachers and carers about your child's asthma and where the inhaler is kept.
• Ask a clinician to check your inhaler technique. Many people use their inhaler in a way that delivers less medicine than it should.
• Keep taking your preventer as prescribed, even when you feel well.

How Primegala can help

Primegala Medical Centre is open 24 hours at Maili Sita on the Nakuru–Nyahururu Road. Our 24-hour urgent care team provides first-line care for asthma and breathing difficulty, and stabilises and refers patients who need a higher-level hospital. For an asthma review, inhaler technique check or action plan, book a visit. Know what to do in an emergency before you need it.