In an asthma attack the muscles of the air passages in the lungs go into spasm and the linings of the airways swell. As a result, the airways become narrowed and breathing becomes difficult.

Sometimes there is a specific trigger for an asthma attack such as:

  • an allergy
  • a cold
  • cigarette smoke
  • extremes of temperature
  • exercise.

People with asthma usually deal well with their own attacks by using a blue reliever inhaler, however you may be required to assist someone having an asthma attack or having an attack for the first time.

Recognition features

  • Difficulty in breathing.

There may also be:

  • wheezing as the casualty breathes out
  • difficulty speaking and whispering
  • distress and anxiety
  • coughing
  • features of hypoxia, such as a grey-blue tinge to the lips, earlobes and nailbeds (cyanosis).


Your aims during an asthma attack are to ease the breathing and if necessary get medical help.

  • You need to keep the casualty calm and reassure them.
  • If they have a blue reliever inhaler then encourage them to use it. Children may have a spacer device and you should encourage them to use that with their inhaler also. It should relieve the attack within a few minutes.
  • Encourage the casualty to breathe slowly and deeply.
  • Encourage the casualty to sit in a position that they find most comfortable. Do not lie the casualty down.
  • A mild asthma attack should ease within a few minutes of them using their inhaler. If it doesn't then assist them to use their inhaler (4x4x4) 4 puffs with a breath between every puff, wait 4 minutes and do 4 times
  • Monitor their vital signs - breathing, level of response and pulse.


If this is the first attack, the attack is severe, the inhaler has no effect or the attack appears to be getting worse.

Dial 000 for an ambulance.