Asthma Emergency First Aid

Overview

Asthma is a lifelong condition that affects your lungs. It makes the airways swell and narrow, so it becomes harder to breathe. An asthma emergency (also called a severe asthma attack) happens when these symptoms get worse suddenly and do not improve with your usual reliever medication.

Yes. Asthma is one of the most common long-term lung conditions worldwide. It is estimated that more than 260 million people have asthma.

Asthma can appear at any age, but it often starts in childhood. It is more common in people who have allergies, a family history of asthma, or who were exposed to tobacco smoke early in life.

Symptoms

Common symptoms

• Wheezing (a whistling sound when you breathe)
• Coughing, especially at night or early morning
• Shortness of breath
• Tightness, pain, or pressure in the chest

Symptoms in children

• Coughing or wheezing during play or at night
• Feeding slowly or working hard to breathe
• Tiredness or avoiding activity
• Tummy pain (in younger children)

Symptoms in older adults

• Breathing faster than usual
• Feeling confused or very drowsy (when severe)
• Tight chest or a pounding heart
• Worsening fatigue with daily tasks

Causes

Main causes

• The exact cause of asthma is not fully understood, but it involves an overreaction of the immune system in the lungs.
• Common triggers are viral infections, allergies, smoke, cold air, exercise, and strong smells.
• Some people only have symptoms when they exercise or catch a cold.

Risk factors

• Allergies (such as hay fever or dust mites)
• A close relative with asthma
• Being born early or exposure to tobacco smoke before birth
• Living in urban areas with high air pollution

When to see a doctor

See a doctor urgently if:

• If you have had an asthma emergency, get a same-day follow-up appointment.
• If your symptoms are not controlled and you are using a reliever inhaler more than twice a week.

Book a routine appointment if:

• If you do not have a written asthma action plan, ask for one at a routine appointment.
• If you notice a change in your symptoms or triggers.

Diagnosis

Your doctor will talk with you about your symptoms and examine you. They will also use breathing tests that measure how well air moves out of your lungs.

Tests that may be done

• Spirometry: you take a deep breath and blow hard into a tube.
• Peak flow test: you blow into a small handheld meter.
• FeNO test: you breathe into a device that measures airway inflammation.

What to expect at your appointment

If the tests show variation in the strength of your breathing, your doctor may confirm asthma. They will ask you to monitor your breathing at home and usually give you an asthma action plan.

Treatment

Asthma treatment falls into two categories: long-term preventer medication to keep airway swelling down, and quick-acting reliever medication to use when symptoms appear. There is no cure, but good treatment prevents most symptoms and attacks.

Self-care at home

• Always keep your reliever inhaler within reach, and if prescribed, use your preventer inhaler every day.
• Learn to recognise your early warning signs of an attack.
• Make a written action plan with your doctor and follow it.
• Practice how to use your inhaler correctly with your pharmacist or practice nurse.

Medical treatments

Treatment usually involves inhalers. Preventer inhalers contain medicine that reduces swelling in the airways and should be used regularly as prescribed. Reliever inhalers provide quick symptom relief when you start to feel breathless. Depending on your needs, a doctor may also recommend a spacer device with the inhaler, a short course of oral corticosteroid tablets, or newer injection therapies for severe asthma. All options should be discussed with your asthma nurse or GP.

When is surgery considered?

Surgery is not used to treat asthma itself. Most people with asthma are treated with inhalers and other non-surgical methods.

Living with this condition

Living with asthma means following your action plan, taking your preventer medication as prescribed, and noticing any changes in your breathing, especially at night or early morning.

Lifestyle tips

• Stay physically active – ask your doctor which activities suit you best.
• Get support to quit smoking and avoid other people’s smoke.
• Keep your home free from dust and mould as much as possible.
• Use allergy-proof covers on pillows and mattresses if you are allergic to dust mites.

Diet and exercise

Eat a balanced diet with plenty of fruit and vegetables to support your immune system. Exercise like walking, cycling, or swimming can improve your fitness, but warm up first and keep your reliever inhaler nearby. If exercise triggers symptoms, talk to your doctor before the next session.

Mental health and emotional wellbeing

Asthma can sometimes cause worry and stress, and stress can in turn make asthma harder to control. It’s okay to ask for help. Counselling, support groups, or simply speaking with your GP can help you feel more in control.

Prevention

You cannot always prevent the first development of asthma, but you can prevent most asthma attacks by taking the right medication, avoiding triggers, and acting quickly when symptoms appear.

Vaccines

Keep your vaccinations up to date. The annual flu vaccine and the COVID-19 vaccine protect you and can reduce the chance of your asthma becoming worse from these infections. A pneumonia vaccine may also be advised – ask your healthcare team.

Screening programmes

There is no routine screening test for asthma in the general population. However, regular asthma reviews with your GP or nurse are a form of screening for poor control.

Complications

If left untreated

• Severe attacks that need emergency treatment in hospital
• Permanent loss of lung function over time
• Poor sleep, low energy, and missed school or work
• Rarely, a life-threatening attack

Long-term outlook

With the right treatment and a plan you trust, most people with asthma live full, active lives. The key is to take your medication as prescribed and to get help early if your symptoms are getting worse.

Find support

International organisations

• Global Initiative for Asthma (GINA) ↗

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