Asthma – first aid
What to do if someone's having an asthma attack
Key points about asthma first aid
- An asthma attack is an emergency – act fast.
- Anyone with asthma can have a severe asthma attack.
- Worsening asthma symptoms include being short of breath, wheezy, have tightness in your chest and you may also cough.
- Symptoms can get worse quickly so it's important to act fast.
- If you have an asthma action plan follow the instructions there.
An asthma attack is when your airways swell and narrow making you wheeze, possibly cough and find it difficult to breathe.
Image credit: Depositphotos
Note: The information on this page is for adults. See KidsHealth, NZ for information about asthma attacks in children(external link).
An asthma attack may be mild, moderate or severe
- Anyone with asthma can have a severe asthma attack.
- An asthma attack can take anything from a few minutes to a few days to develop.
- Symptoms may be mild or moderate and can quickly get worse so it's important to act fast.
- If you have an asthma action plan follow the instructions on there.
Mild asthma symptoms
Early signs that asthma may be getting worse can include mild cough, slight wheeze or coughing or wheezing when exercising or excited.
Moderate asthma symptoms
When asthma becomes more serious, symptoms may include:
- cough or wheeze are getting worse
- difficulty breathing
- difficulty talking; you can't complete a sentence without needing a few breaths.
Severe symptoms – call 111 if:
- you have worsening wheezing, cough, chest tightness
- you can't speak a full sentence in 1 breath
- you're breathless and have to put extra effort into breathing
- your nostrils are flaring with each breath
- the skin at your ribs, neck or throat sucks in with each breath
- your peak flow reading's getting worse (if checked)
- you've used a reliever inhaler but there's no improvement in your symptoms.
If someone is having an asthma attack, follow the ASTHMA acronym
A = Assess
Assess whether the person's asthma attack is mild, moderate or severe.
If the person has severe asthma or is frightened, call an ambulance on 111.
S = Sit
Sit the person upright and stay with them. Reassure them calmly.
T = Treat (with a reliever inhaler)
It's important to carry your reliever inhaler with you at all times.
- Symbicort or DuoResp Spiromax: Use 1 puff initially and repeat if needed, up to 12 puffs daily. These inhalers quickly reduce inflammation of your airways and help you to breathe more easily.
- Ventolin or SalAir: Always use a spacer with these inhalers. Inhale 1 puff through the spacer and take 6 breaths per puff through the spacer. Use 1 puff initially and repeat if needed, up to 6 puffs. For severe symptoms, use 6 puffs through the spacer, every 6 minutes until help arrives. Make sure to take 6 slow breaths for each puff.
- Bricanyl: Use 1 puff initially and repeat if needed, up to 6 puffs.
H = Help
If the person is not improving, call an ambulance immediately on 111. Continue to use the reliever inhaler every few minutes until help arrives.
M = Monitor
- If the person is improving, keep monitoring them for signs of improvement or worsening of symptoms. If necessary, repeat doses of the reliever inhaler.
- If the person is not improving, continue to use the reliever inhaler every few minutes until help arrives.
A = All OK!
When the person is free of wheeze, cough or breathlessness, they can return to quiet activity.
Ensure a preventer inhaler is part of your asthma management plan. This is important to reduce the chance of this type of attack happening. This may mean a separate preventer inhaler is needed or a combined reliever and preventer inhaler, if you don't have this already.
Ensure an asthma action plan is written up to guide you through asthma attacks in the future. Regular peak flow monitoring may be useful to reduce the chance of further asthma attacks. Read more about peak flow monitoring.
If symptoms come back, repeat the treatment and rest. It's important to always see your healthcare provider as soon as possible after an asthma attack.
Video: How to use a spacer
Action plans
4-stage asthma action plans(external link) Asthma Foundation, NZ, English(external link), te reo Māori(external link), Samoan(external link), Tongan(external link), Simplified Chinese(external link)
Child asthma action plans(external link) Asthma Foundation, NZ, English(external link), te reo Māori(external link), Samoan(external link), Tongan(external link)
Asthma emergency action plan for children 5 years of age and under(external link) Asthma NZ and the Lung Association, NZ
Brochures
Asthma – First aid poster (external link)Asthma and Respiratory Foundation NZ English(external link), te reo Māori(external link)
Asthma in school(external link) Asthma and Respiratory Foundation NZ
GINA patient guide for asthma – you can control your asthma(external link) Asthma Respiratory Foundation NZ
Summer holiday asthma and allergies checklist(external link) Asthma Respiratory Foundation NZ
Asthma checklist(external link) Asthma Respiratory Foundation NZ
Allergy and asthma fact sheet(external link) Asthma Respiratory Foundation NZ
Breathing and asthma(external link) Asthma Respiratory Foundation NZ
Apps
References
- Asthma first aid(external link) Asthma and Respiratory Foundation, NZ
- What to do in an asthma emergency(external link) Asthma NZ
Algorithm for management of acute severe asthma in adolescents and adults(external link) Asthma Foundation, NZ
NZ adult and adolescent asthma guidelines(external link) Asthma Foundation, NZ, 2020
See our page Asthma in adults for healthcare providers, Long-term conditions for healthcare providers
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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.
Reviewed by: Angela Lambie, Pharmacist, Auckland
Last reviewed:
