Asthma emergency first aid

Asthma first aid steps

To use asthma first aid with a blue/grey reliever puffer:

Step 1: Sit the person upright

• Be calm and reassuring.
• Do not leave them alone.

Step 2: Give 4 separate puffs of blue/grey reliever puffer

• Shake the puffer.
• Put 1 puff into the spacer.
• Get the person to take 4 breaths from the spacer.
• Repeat until 4 puffs have been taken. (If you don’t have a spacer, give 1 puff as they take 1 slow, deep breath and hold breath for as long as comfortable. Repeat until all puffs are taken.)
• Remember: Shake, 1 puff, 4 breaths.

Step 3: Wait 4 minutes

• If there is no improvement, give 4 more separate puffs of blue/grey reliever, as with Step 2.

Step 4: If breathing does not return to normal, call triple zero (000) for an ambulance

• Tell the operator that someone is having an asthma emergency.
• Keep giving the person 4 separate puffs, taking 4 breaths for each puff, every 4 minutes until emergency assistance arrives.

Learn how to use a puffer and spacer.

Asthma flare-up or attack

An asthma flare-up is a worsening of asthma symptoms and lung function compared to what you would usually experience day to day. An asthma flare-up can come on slowly (over hours, days or even weeks) or very quickly (over minutes).

A sudden or severe asthma flare-up is sometimes called an asthma attack. An asthma attack can quickly become an asthma emergency, but if you take quick action, you can reduce the risk of an asthma emergency.

If you or a family member have asthma, make sure you have an updated asthma action plan from your doctor and know asthma first aid.

Your doctor will:

• prescribe the correct medication
• help you to develop a plan to manage your asthma
• provide you with an action plan to manage your asthma and provide instructions in case of an asthma flare-up.

Follow your asthma action plan if the symptoms of an asthma attack appear.

Signs that you need to use asthma first aid

If you are experiencing any of the following signs, follow your asthma action plan. If you do not have an asthma action plan, or you are assisting someone who is experiencing an asthma attack, start asthma first aid. Do not wait until asthma is severe.

Mild to moderate asthma signs (commence asthma first aid):

• minor difficulty breathing
• able to talk in full sentences
• able to walk or move around
• may have a cough or wheeze.

Severe asthma signs (call triple zero [000] for an ambulance and commence asthma first aid):

• obvious difficulty breathing
• cannot speak a full sentence in one breath
• tugging of the skin between ribs or at base of neck
• may have cough or wheeze
• reliever medication not lasting as long as usual.

Life-threatening asthma signs (call triple zero [000] for an ambulance and commence asthma first aid):

• difficulty breathing (gasping for air)
• unable to speak one to 2 words per breath
• confused or exhausted
• lips are turning blue
• symptoms are getting worse very quickly
• collapsing
• getting little or no relief from reliever inhaler
• may no longer have wheeze or cough.

In asthma emergencies, follow your asthma action plan.

Know asthma first aid

It’s important for everyone in the community to know asthma first aid.

One of the most common reliever medications in Australia is salbutamol, often known as your ‘blue puffer’. These are available over the counter from a chemist.

If you are not sure if someone is having an asthma attack, you can still use blue reliever medication because it is unlikely to cause harm.

Call triple zero (000) immediately if:

• the person is not breathing
• their asthma suddenly becomes worse or is not improving
• the person is having an asthma attack and there’s no reliever medication available
• the person is unsure if it is asthma
• the person is known to have anaphylaxis. If this is the case, ALWAYS GIVE ADRENALINE AUTOINJECTOR FIRST, and then reliever, even if there are no skin symptoms.

Other asthma first aid directions

Not everyone with asthma uses the same reliever medication.

Some people use a different blue reliever called Bricanyl (terbutaline) which comes in a different type of inhaler called a Turbuhaler.

See the asthma first aid steps for those using Bricanyl.

Other people use a ‘dual-purpose’ reliever. A dual-purpose reliever contains budesonide and formoterol together, and is used ‘as-needed’.

The combination of budesonide and formoterol in the dual-purpose reliever, when used as-needed, relieves symptoms and reduces risk of experiencing serious asthma flare-ups. It does this by relaxing tight airway muscles and treating inflammation in the airways.

Note: you may also be prescribed these medicines as a ‘preventer’. Always follow your doctor’s instructions on your asthma action plan about what to use in an asthma flare-up or asthma attack.

See the asthma first aid steps for those using Symbicort Turbuhaler 100 or 200.

See the asthma first aid steps for those using DuoResp Spiromax 200/6.

See the asthma first aid steps for those using BiResp Spiromax 200/6.

See the asthma first aid steps for those using Symbicort Rapihaler 50/3 or 100/3.

Some people may use the same medicine for their reliever and preventer.

See the asthma first aid steps using Fostair 100/6.

Asthma symptoms in a severe allergic reaction (anaphylaxis)

People having a severe allergic reaction (anaphylaxis) can also have asthma-like symptoms. If the person has an anaphylaxis action plan, follow the instructions.

Always give adrenaline injector first, then asthma reliever if someone with known asthma and allergy to food, insects or medication has sudden breathing difficulty (including wheeze, persistent cough or hoarse voice) even if there are no skin symptoms.

In case of an emergency, call triple zero (000) and ask for an ambulance.

Thunderstorm asthma

People who have asthma or hay fever can get severe asthma symptoms during grass pollen season when high amounts of grass pollen in the air combine with a certain type of thunderstorm. Find out more about thunderstorm asthma.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• National Home Doctor Service Tel. 13 SICK (13 7425) – for after-hours home doctor visits (bulk billed)
• Asthma Australia Tel. 1800 ASTHMA (1800 278 462)
• National Asthma Council Australia
• Allergy and Anaphylaxis Australia
• The Royal Children's Hospital Melbourne – information about children's asthma