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Asthma Attack — First Aid
What to do
- Sit the person upright — do not lie them down. Stay calm and loosen tight clothing. Asthma attacks are frightening; a calm helper genuinely helps breathing.
- Help them use their own reliever inhaler (usually blue) as directed in their personal asthma action plan — a spacer, if they have one, makes it more effective, especially for children.
- Call 911 if symptoms do not improve after the initial reliever treatment, if the person is too breathless to speak in sentences, eat or sleep, if their lips or face look blue or pale, if the inhaler is not helping, or if you are in any doubt.
- While waiting, the reliever can be continued according to their action plan or dispatcher advice. Keep the person sitting up and warm.
- If the person becomes drowsy, exhausted or their breathing becomes quiet, treat as a dire emergency: call 911 again and be ready to start CPR if they become unresponsive and stop breathing normally.
- Even if the attack settles, arrange same-day medical review — asthma attacks that need emergency reliever use mean the asthma plan needs reassessment.
What NOT to do
- Do not use someone else's inhaler unless it is an emergency and no alternative exists — get emergency advice.
- Do not lie the person flat or leave them alone.
- Do not delay calling 911 because 'the inhaler might work' if the person is struggling to speak or worsening.
- Do not give food, drink or sedatives.
When to get medical care
Call 911 immediately if the reliever inhaler is not working, the person cannot speak in full sentences, breathing is rapid with visible effort (neck and rib muscles), lips look blue, they become drowsy or exhausted, or peak flow (if measured) is well below their best. Any asthma attack needing emergency treatment needs same-day follow-up.
Related conditions
Related procedures & tests
Related symptoms
Frequently asked questions
What are the signs an asthma attack is life-threatening?
Too breathless to talk, eat or sleep; a silent chest (little air moving); exhaustion, confusion or drowsiness; blue lips; and a reliever that is not working. These need 911 immediately — fatal asthma attacks often involve delayed help-seeking.
Why use a spacer with the inhaler?
A spacer holds the medication mist in a chamber so it can be breathed in slowly over several breaths, delivering more to the lungs and less to the mouth and throat. In an attack, a reliever via spacer is as effective as a nebuliser for most people.
In an emergency, call 911 (or your local emergency number) first — do not delay a call to read a guide. These pages are educational first-aid information in general terms; they are not a substitute for emergency services, first-aid training, or assessment by a qualified clinician.
