Asthma Attack Treatment for Adults

Call 911

• Symptoms of acute attack include difficulty talking or walking because of shortness of breath or lips or fingernails turning blue.

1. Follow the Person’s Asthma Plan, if Possible

• Find out if the person has an individualized asthma action plan from a health care provider.
• If so, follow its directions for giving asthma medication and seeking medical help for acute asthma attack.

2. Give Asthma First Aid

If the person doesn't have an asthma plan:

• Sit the person upright comfortably and loosen tight clothing.
• If the person has asthma medication, such as an inhaler, assist in using it.
• If the person doesn’t have an inhaler, use one from a first aid kit or borrow someone else’s.

3. Use Inhaler With a Spacer, if Possible

• Remove cap and shake inhaler well.
• Insert inhaler into spacer.
• Have the person breathe out completely and put mouth tightly around spacer mouthpiece.
• Press inhaler once to deliver a puff.
• Have the person breathe in slowly through the mouth and then hold breath for 10 seconds.
• Give a total of four puffs, waiting about a minute between each puff.

4. Use Inhaler Without a Spacer, if Necessary

• Remove the inhaler cap and shake well.
• Have the person breathe out all the way and seal lips tightly around inhaler mouthpiece.
• As the person starts to breathe in slowly, press down on inhaler one time.
• The person should keep breathing in as slowly and deeply as possible (about five to seven seconds) and then hold breath for 10 seconds.
• Give a total of four puffs, waiting about one minute between each puff.

5. Continue Using Inhaler if Breathing Is Still a Problem

• After four puffs, wait four minutes. If the person still has trouble breathing, give another set of four puffs.
• If there’s still little or no improvement, give four puffs every four minutes until ambulance arrives. If the person is having a severe attack, give up to six to eight puffs every five minutes.

6. Monitor the Person Until Help Arrives

• Do not mistake drowsiness as a sign of improvement; it could mean asthma is worsening.
• Do not assume the person’s asthma is improving if you no longer hear wheezing.

7. Follow Up

• An emergency room doctor will check the severity of the attack and provide treatment, including medications.
• The person may be discharged home or hospitalized for further care, depending on response to treatment.

SOURCES:

National Heart, Lung, and Blood Institute: “How Is Asthma Treated and Controlled?”

Handal, K. The American Red Cross First Aid and Safety Handbook, Little, Brown and Company, 1992.

National Asthma Council Australia: “First Aid for Asthma.”

Cleveland Clinic: “How to Use a Metered Dose Inhaler.”

Institute for Clinical Systems Improvement: “Emergency and Inpatient Management of Asthma Emergency Room Management.”

eMedicineHealth: “Asthma.”