Call 911
- Symptoms of acute attack include difficulty talking or walking because of shortness of breath or lips or fingernails turning blue.
1. Follow the Person’s Asthma Plan, if Possible
- Find out if the person has an individualized asthma action plan from a health care provider.
- If so, follow its directions for giving asthma medication and seeking medical help for acute asthma attack.
2. Give Asthma First Aid
If the person doesn't have an asthma plan:
- Sit the person upright comfortably and loosen tight clothing.
- If the person has asthma medication, such as an inhaler, assist in using it.
- If the person doesn’t have an inhaler, use one from a first aid kit. Do not borrow someone else’s. The medicine in it may be different than the needed rescue medicine. Also, using someone else's inhaler has a slight risk of passing on an infection.
3. Use Inhaler With a Spacer, if Possible
- Remove cap and shake inhaler well.
- Insert inhaler into spacer.
- Have the person breathe out completely and put mouth tightly around spacer mouthpiece.
- Press inhaler once to deliver a puff.
- Have the person breathe in slowly through the mouth and then hold breath for 10 seconds.
- Give a total of four puffs, waiting about a minute between each puff.
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4. Use Inhaler Without a Spacer, if Necessary
- Remove the inhaler cap and shake well.
- Have the person breathe out all the way and seal lips tightly around inhaler mouthpiece.
- As the person starts to breathe in slowly, press down on inhaler one time.
- The person should keep breathing in as slowly and deeply as possible (about five to seven seconds) and then hold breath for 10 seconds.
- Give a total of four puffs, waiting about one minute between each puff.
5. Continue Using Inhaler if Breathing Is Still a Problem
- After four puffs, wait four minutes. If the person still has trouble breathing, give another set of four puffs.
- If there’s still little or no improvement, give 4 to 8 puffs every 20 minutes until the ambulance arrives for up to 4 hours. If you are still waiting for help after 4 hours, the recommended dose is 4 to 8 puffs as needed every 1 to 4 hours..
6. Monitor the Person Until Help Arrives
- Do not mistake drowsiness as a sign of improvement; it could mean asthma is worsening.
- Do not assume the person’s asthma is improving if you no longer hear wheezing.
7. Follow Up
- An emergency room doctor will check the severity of the attack and provide treatment, including medications.
- The person may be discharged home or hospitalized for further care, depending on response to treatment.
