Asthma – first aid

In young children asthma symptoms may become worse very quickly. With some children, a change of behaviour may be an indication their asthma's getting worse. 

If they are young, a formal diagnosis of asthma may not have been made yet so it's important to know the signs (see above) so you can recognise it if it happens.

What to do

If a salbutamol inhaler (eg, blue Ventolin inhaler or white SalAir inhaler) is available, use 1 puff with a spacer at one time and repeat this as required up to 6 times. If there's no improvement, contact your healthcare provider or call Healthline 0800 611 116. Arrange a review as soon as possible, as more treatment may be needed. 

If no inhaler is available and your child is having trouble breathing don't delay in calling your healthcare provider or Healthline 0800611 116. If they are having a lot of trouble breathing call 111 for an ambulance. 

Learn more about an asthma emergency action plan for children 5 years of age and under(external link).

If someone is having an asthma attack, follow the ASTHMA acronym

A =  Assess

Assess how severe the asthma attack is:

• Mild – the person is short of breath, wheezing and coughing and has chest tightness.
• Moderate – the person may have loud wheeze, breathing difficulty and can only speak in short sentences.
• Severe – the person is distressed, gasping for breath, having difficulty speaking two words and is blue around the mouth. 

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

Treat with reliver inhalers – Symbicort, Vannair, DuoResp Spiromax, Ventolin (salbutamol), SalAir or Bricanyl. Use a spacer at all times if you're relying on an aerosol inhaler (eg, Ventolin or SalAir).

Image credit: Healthify He Puna Waiora adapted from Asthma and Respiratory Foundation, NZ

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. 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 medication is part of the treatment. This is crucial to reduce the chance of this type of attack happening again. This may mean a separate preventer inhaler is needed unless a combined reliever and preventer inhaler is already being used.

Ensure an asthma action plan is written up for possible 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.