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What to do in an asthma attack

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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Asthma is usually well-controlled with a preventer inhaler and the occasional use of a reliever inhaler like albuterol. 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.

Let us arm you with techniques to treat this and help you to recover.

Doctor’s advice

How to recognize an attack

Uncontrolled asthma has four key symptoms:

  • Chest tightness
  • Feeling short of breath
  • A cough
  • 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 rescue inhaler – albuterol, known as the reliever – is effectively your life-raft. 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 increasing your preventer inhaler use.

When to call for an ambulance

If you are witnessing an asthma attack, call 911 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 also call 911.

If the 10 puffs of albuterol 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 nebulizers, which are inhaled droplets of targeted medication to help the airways open up. If necessary, they will administer life-saving medication and have equipment to take over ventilation. Asthma attacks can cause death. It’s important to take them seriously and not hesitate to get help.

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

Is there anything to prevent future attacks?

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 rescue inhalers that you can keep one on hand – if you regularly stay between two homes, keep one at the other, 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 rescue inhaler as a precaution if you know you may be at risk.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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