What to do in an asthma attack
Asthma is usually well-controlled with a preventer inhaler and occasional use of a reliever inhaler. From time to time, symptoms may flare up and cause an asthma attack – you might be able to identify a trigger or this may come out of the blue. Whether you are the one suffering the attack, or you are on hand to help someone else, this can feel frightening. Fore-warned is fore-armed, so it’s important to know what to do, as in some circumstances this can be life-threatening.
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How to recognise an attack
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.
What action to take
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 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.
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When to call for an ambulance
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.
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