Asthma attack first aid

Overview

An asthma attack is a sudden worsening of asthma symptoms caused by tightening of the muscles around the airways, swelling of the lining, and increased mucus. This makes breathing difficult and can be frightening. First aid steps can help someone during an attack until medical help arrives.

Asthma is a common long-term condition that affects people of all ages. Asthma attacks are also common, especially when triggers are present or when asthma is not well controlled.

Asthma can affect anyone, but it often starts in childhood. Adults can also develop asthma. People with a family history of asthma, allergies, or eczema are more likely to have it.

Symptoms

Common symptoms

• Shortness of breath or difficulty breathing
• Wheezing (a whistling sound when breathing out)
• Coughing, which may be worse at night or early morning
• Chest tightness or pain
• Feeling tired or weak

Symptoms in children

• Rapid or shallow breathing
• Trouble feeding or sucking (in infants)
• Pale or sweaty skin
• Tugging in of the skin between ribs or at the base of the neck (retractions)
• Coughing or wheezing that interrupts play or sleep

Symptoms in older adults

• Shortness of breath that may be mistaken for normal aging
• Fatigue or difficulty with daily activities
• Increased coughing or wheezing, especially with colds
• Confusion or drowsiness due to low oxygen

Causes

Main causes

• Allergens like pollen, dust mites, pet dander, or mold
• Respiratory infections such as colds or flu
• Irritants like tobacco smoke, strong fumes, or air pollution
• Exercise, especially in cold or dry air
• Weather changes – cold air, storms, or humidity
• Emotions such as stress, laughing, or crying

Risk factors

• Having poorly controlled asthma or not using inhalers as prescribed
• Having had a previous severe asthma attack
• Smoking or being around second-hand smoke
• Exposure to known triggers at home, work, or school
• Being overweight or obese

When to see a doctor

See a doctor urgently if:

• If you or someone else has symptoms of a severe asthma attack (see emergency symptoms) – call your local emergency number immediately.
• If symptoms do not improve after using a quick-relief inhaler, seek urgent medical help.

Book a routine appointment if:

• If you have asthma symptoms that wake you up at night or limit your activities, make an appointment with your healthcare provider.
• If you need to use your quick-relief inhaler more than twice a week, see your doctor to review your asthma action plan.

Diagnosis

A healthcare provider will diagnose asthma based on your symptoms, medical history, and breathing tests. They may also do a physical exam and ask about triggers and how often symptoms occur.

Tests that may be done

• Spirometry – a test where you blow into a machine to measure how much air you can breathe out and how fast
• Peak flow measurement – a simple handheld device to check your lung function at home
• Allergy tests – to identify triggers like pollen or dust mites
• Chest X-ray – sometimes ordered to rule out other conditions

What to expect at your appointment

Diagnosis usually involves a few visits to your healthcare provider. They will work with you to create a personalized asthma action plan. This plan includes daily medicines, quick-relief inhaler use, and steps to manage an attack.

Treatment

Asthma treatment focuses on controlling symptoms, preventing attacks, and managing attacks when they happen. Treatment usually includes daily control inhalers to reduce airway swelling and quick-relief inhalers (short-acting bronchodilators) to relax airway muscles during an attack.

Self-care at home

• Learn your triggers and try to avoid them.
• Use your inhalers exactly as prescribed – even if you feel well.
• Keep your quick-relief inhaler with you at all times.
• Follow your written asthma action plan.
• Check your peak flow regularly if advised by your doctor.

Medical treatments

Medical treatment for asthma includes prescription inhalers. There are two main types: a daily controller inhaler (usually a corticosteroid) that reduces airway inflammation, and a quick-relief inhaler (a bronchodilator) for immediate symptom relief during attacks. In some cases, a combination inhaler or additional medications may be prescribed by your healthcare provider. For severe attacks, emergency treatment may involve oxygen, nebulized bronchodilator therapy, and oral or intravenous corticosteroids. Always follow the advice of your healthcare provider.

When is surgery considered?

Surgery is not a treatment for asthma. In very rare cases, a procedure called bronchial thermoplasty may be considered for severe asthma that does not respond to other treatments. This is only done after careful evaluation by a specialist.

Living with this condition

Living with asthma means taking your prescribed medicines regularly, avoiding triggers, and knowing what to do if symptoms worsen. Many people with asthma have a normal, active life by following their asthma action plan.

Lifestyle tips

• Quit smoking if you smoke – and avoid second-hand smoke.
• Use dust-proof covers on pillows and mattresses to reduce dust mites.
• Keep your home well-ventilated and clean to reduce mold and allergens.
• Check air quality warnings and stay indoors when pollution or pollen levels are high.
• Keep a diary of symptoms and triggers to share with your doctor.

Diet and exercise

A healthy diet rich in fruits, vegetables, and whole grains supports overall health but does not cure asthma. Regular exercise is good for lung function, but talk to your doctor about warming up and using your inhaler before exercise if needed. Avoid exercise during asthma attacks or when you feel unwell.

Mental health and emotional wellbeing

Living with asthma can cause anxiety or stress, especially if attacks are frightening. It is important to talk to your healthcare provider or a counselor if you feel overwhelmed. Managing stress can also help reduce the risk of asthma attacks triggered by emotions.

Prevention

Asthma itself cannot be prevented, but asthma attacks can often be prevented by good asthma control: taking daily controller medicines, avoiding known triggers, and having an asthma action plan. Regular check-ups help keep your treatment on track.

Vaccines

Getting vaccinated against the flu (influenza) and pneumonia is recommended for people with asthma, as respiratory infections can trigger attacks. Ask your healthcare provider about recommended vaccines.

Screening programmes

There is no routine screening test for asthma in the general population. If you have symptoms like wheezing, coughing, or shortness of breath, see your healthcare provider for evaluation. Children with a family history of asthma may be monitored more closely.

Complications

If left untreated

• Severe asthma attacks that require emergency hospital care
• Permanent airway damage (airway remodeling)
• Reduced lung function over time
• Increased risk of respiratory infections
• Sleep disturbances and reduced quality of life

Long-term outlook

With proper treatment and management, most people with asthma can control their symptoms and prevent attacks. Even severe asthma can be managed with modern medicines and a good asthma action plan. It is important to work with your healthcare team and follow your plan. Many people with asthma live long, active, and full lives.

Find support

International organisations

• Global Initiative for Asthma (GINA) ↗

Local organisations

• Asthma UK / British Lung Foundation ↗ · UK

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