Asthma first aid | Health Navigator NZ

Even with the best efforts to manage asthma well, there are sometimes situations that need urgent first aid for asthma symptoms. Here’s what to do when that happens.

Key points

An asthma attack can take anything from a few minutes to a few days to develop.
During an asthma attack, a person gets short of breath and has tightness in their chest. They will also be coughing, wheezing or breathless.
Symptoms can quickly worsen so it's important to act quickly.
The treatment depends on whether the attack is mild, moderate or severe.
Steps to take follow the acronym ASTHMA: Assess, Sit, Treat, Help, Monitor, All OK.

What do I do if someone is having an asthma attack?

If you find yourself in a situation where someone is having an asthma emergency, here is a guide:

Children 5 years and under:

In young children asthma symptoms may become worse very quickly.
In some children, a change of behaviour may be an indication of worsening asthma.
Learn more about an asthma emergency action plan for children 5 years of age and under.

With children 5 years and older, teenagers and adults, you can use the acronym ASTHMA to help you remember what to do.

If someone is having an asthma attack, follow the 'ASTHMA' acronym
Assess Assess how severe the asthma attack is: Mild – the person is short of breath, wheezing and coughing and has chest tightness. Moderate – the person may have loud wheeze, breathing difficulty and can only speak in short sentences. Severe – the person is distressed, gasping for breath, having difficulty speaking two words and is blue around the mouth. If the person has severe asthma or is frightened, call an ambulance on 111.
Sit Sit the person upright and stay with them. Reassure them calmly.
Treat With reliever inhalers: Salbutamol (Respigen®, SalAir®, Ventolin®) or Terbutaline (Bricanyl®) Treatment depends on the type of attack. Mild symptoms – treat with 2 puffs of reliever inhaler. Moderate or severe symptoms – treat the attack with 6 doses of reliever inhaler. Note that this type of inhaler should be used with a spacer if the person has one with them. They need to have 1 puff of medicine at a time and use 6 breaths per puff. Use the salbutamol inhaler with a spacer if the person has one with them. Remember: 6 doses of medication 6 breaths per puff 6 minute wait. Call Healthline 0800 611 116 if you are unsure what you should do.
Help If the person is not improving after 6 minutes, call an ambulance on 111. Continue to use the reliever inhaler at the rate of 6 doses every 6 minutes until help arrives.
Monitor If the person is improving after 6 minutes, keep monitoring them. If necessary, repeat doses of the reliever inhaler.
All OK! When the person is free of wheeze, cough or breathlessness, they can return to quiet activity. If symptoms recur, repeat treatment and rest. It is important to always see a doctor after an asthma attack.

If someone is having an asthma attack, follow the 'ASTHMA' acronym

Assess

Assess how severe the asthma attack is:

Mild – the person is short of breath, wheezing and coughing and has chest tightness.
Moderate – the person may have loud wheeze, breathing difficulty and can only speak in short sentences.
Severe – the person is distressed, gasping for breath, having difficulty speaking two words and is blue around the mouth.

If the person has severe asthma or is frightened, call an ambulance on 111.

Sit

Sit the person upright and stay with them. Reassure them calmly.

Treat

With reliever inhalers: Salbutamol (Respigen®, SalAir®, Ventolin®) or Terbutaline (Bricanyl®)

Treatment depends on the type of attack.

Mild symptoms – treat with 2 puffs of reliever inhaler.

Moderate or severe symptoms – treat the attack with 6 doses of reliever inhaler. Note that this type of inhaler should be used with a spacer if the person has one with them. They need to have 1 puff of medicine at a time and use 6 breaths per puff.

Use the salbutamol inhaler with a spacer if the person has one with them.

Remember:

6 doses of medication
6 breaths per puff
6 minute wait.

Call Healthline 0800 611 116 if you are unsure what you should do.

Help

If the person is not improving after 6 minutes, call an ambulance on 111. Continue to use the reliever inhaler at the rate of 6 doses every 6 minutes until help arrives.

Monitor

If the person is improving after 6 minutes, keep monitoring them. If necessary, repeat doses of the reliever inhaler.

All OK!

When the person is free of wheeze, cough or breathlessness, they can return to quiet activity.

If symptoms recur, repeat treatment and rest. It is important to always see a doctor after an asthma attack.

How can I help someone having an asthma attack?

Learn more

The following links provide further information about asthma first aid. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Asthma action plans – adults Health Navigator, NZ, 2018
Asthma action plans – children Health Navigator, NZ, 2018
Asthma emergency action plan for children 5 years of age and under Asthma New Zealand and the Lung Association, NZ, 2016
Asthma St John, NZ

References

Asthma first aid Asthma and Respiratory Foundation, NZ
Asthma Ministry of Health, NZ, 2014
What to do in an asthma emergency Asthma New Zealand

Reviewed by

Teresa Demetriou is the head of education and research at the Asthma and Respiratory Foundation NZ and co-author of the Child and Adolescent Asthma Guidelines. As a registered nurse with a wide range of experience in primary health, respiratory healthcare and education, she is responsible for ensuring that evidence-based best practice is implemented into all of the Foundation’s training, guidelines and resources.

Credits: Health Navigator Editorial Team . Reviewed By: Teresa Demetriou, Asthma & Respiratory Foundation NZ Last reviewed: 03 Dec 2018 Page last updated: 14 May 2021

Asthma – first aid