Asthma Attack: What to do?

Uncontrolled asthma has four key symptoms: chest tightness, feeling short of breath, a cough or a wheeze (a high-pitched sound when you breathe out). An attack brings on severe chest tightness and a feeling that you can’t get enough air into your lungs. Others may notice that you’re taking rapid, shallow breaths and struggling to speak normally, or you may be clutching your chest or throat.

First things first, make sure you’re seated – on the floor if necessary. Don’t try to keep talking, but focus on deep slow breaths in and out, as far as you are able. If you’re the person helping, try to give an air of calm.

Your blue asthma inhaler – salbutamol, known as the reliever – is effectively your liferaft. You should take up to 10 puffs of this. Try to use your usual technique to get the maximal benefit: exhale, click, then inhale fully and slowly for each puff – take 30 to 60 seconds between puffs.

Use a spacer if you have one handy – it can help to deliver the medication to your lungs.

If you feel better after this, get a same-day assessment with your doctor or emergency department, and they may suggest starting steroid tablets, which act as an anti-inflammatory, and they may advise to increase your preventer inhaler.

If you are witnessing an asthma attack, call 999 immediately if someone has collapsed and stopped breathing. If they are breathing and awake, but unable to speak or they look pale or blue around the lips, you should call 999.

If the 10 puffs of salbutamol inhaler have not helped, this is also reason to call for urgent help. You can repeat the sequence of 10 puffs after 15 minutes, while waiting for the ambulance.

An ambulance crew will be able to administer oxygen and nebulisers, which are inhaled droplets of targeted medication to help the airways open up. They will administer life-saving medication and have equipment to take over ventilation, if necessary. Asthma causes three deaths per day in the UK, two of which are usually preventable. It’s important to take attacks seriously and not hesitate to get help.

After the emergency has passed, the hospital team may wish for you to stay in for nebulisers and steroid tablets. In milder cases not requiring hospital admission, your doctor can start steroid tablets, and will review you a couple of days later.

If you notice your asthma symptoms are gradually worsening, seek a review with your doctor sooner rather than later – this may prevent an attack. Ensure you are taking your preventer inhaler every day as prescribed, and make sure you order more before running out.

Being prepared is key, so make sure you have enough blue inhalers that you can keep one to hand – if you regularly stay between two homes, keep one at your partner’s, and if you are regularly out and about, keep one in your pocket or bag. If you don’t have it while outside your home and you’re having an attack, a nearby pharmacy can help.

Knowing your triggers can help to predict attacks, and you can take your blue inhaler as a precaution if you know you may be at risk. It is also important to understand the importance of inhaler technique and managing asthma via an spacer.