Asthma attack: how to spot the signs and what to do

Last updated:
Reviewed by:
Dr Bryony Henderson, Lead GP at Livi
Woman taking her asthma inhaler
Asthma attacks can be frightening. Here’s what to do if you suspect you or someone else is having one and how you can prevent them in the first place

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Four people die each day in the UK due to an asthma attack. Recognising symptoms and knowing what to do for you or another person could potentially save a life.

First aid steps for an asthma attack

If you or someone else is having an asthma attack, follow this emergency advice.

Step 1

Sit them upright in a comfortable position. Reassure them, and try to keep them calm by asking them to breathe slowly and deeply.

Step 2

If they have a reliever inhaler, which is usually blue, help them take one puff of this inhaler every 30-60 seconds for up to 10 puffs.

If they have a spacer, ask them to use it with their inhaler. This helps the medicine reach their lungs more efficiently and quickly.

If they don't have an inhaler, call 999 straight away.

Step 3

If they don’t feel better after 10 puffs of their blue reliever inhaler, or if they are worsening, call 999 for an ambulance.

Step 4

If the ambulance doesn’t arrive after 10 minutes, and their symptoms aren’t improving, repeat step 2.

Step 5

If they don’t feel better, call 999 again. This advice isn’t for people who use a Maintenance and Reliever Therapy (MART) inhaler. You can find out more on this from Asthma UK.

Asthma inhalers explained

The two key types of asthma inhalers that help control symptoms:

  1. Blue reliever inhaler – used for quick relief

  2. Brown preventer inhaler – used to lower your risk of asthma symptoms and attacks

What are the signs of an asthma attack?

It’s important to know the signs of an asthma attack – you may have all of these symptoms or just some of them.

  • Worsening symptoms – breathlessness, coughing, wheezing or chest tightness
  • Breathing getting faster and feeling like you’re unable to catch your breath
  • Difficulty speaking – the ability to just whisper or use short sentences
  • Dizziness, drowsiness or confusion
  • Fingertips and lips going blue
  • Feeling of exhaustion
  • Collapsing

If a reliever inhaler doesn’t relieve symptoms, this is very likely an asthma attack.

What causes an asthma attack?

Flare-ups and asthma attacks are usually caused by triggers that irritate your airways and set off symptoms.

While many people with asthma are aware of their triggers, it’s not always possible to avoid them.

Common asthma triggers include:

  • Cold or flu viruses
  • Allergies, including dust mites, mould, pollen or pets and animals
  • Weather, including cold air, dry wind or sudden temperature changes
  • Exercise
  • Irritants in the air, including air pollution, smoke from cigarettes, strong fumes, dust or chemicals
  • Medication, particularly beta blockers or anti-inflammatory painkillers like ibuprofen
  • Strong emotions, including stress, fear, anger or laughing

How can I prevent future asthma attacks?

There are several things you can do to help you reduce your risk of an asthma attack.

1. Know your early warning signs

You can prevent an asthma attack before it happens by recognising your triggers and the early warning symptoms, like when your chest feels tighter or you begin wheezing more.

2. Listen to your body when exercising

If you have asthma, physical activity can be more challenging. The good news is that there’s evidence to suggest that getting your heart rate up can improve asthma symptoms and quality of life.

If your asthma is well-managed, you should be able to exercise without your symptoms being triggered. However sometimes, exercise can trigger asthma, particularly when you breathe in cold, dry air or encounter pollution or pollen.

So, listen to your body, and increase your fitness levels gradually. It’s also a good idea to let the people you’re exercising with know that you have asthma.

3. Keep stress levels as low as you can

It’s not always possible to reduce stress in life. But stress can make your asthma symptoms worse.

If stress is a trigger for you, talk to your doctor or asthma nurse. They can provide you with the right support, whether it’s signposting you to counselling or suggesting you take more of your asthma medicines to keep your asthma stable during these periods. The key thing is to reach out and get help when it’s needed.

A few simple ways to lower stress might include:

  • Planning ahead so you feel more in control
  • Connecting with others as often as you can
  • Being more active
  • Prioritising your sleep

4. Take all your medicines as prescribed

Preventer inhalers reduce your risk of having an asthma attack. They reduce inflammation building up in your airways, meaning your airways are less sensitive and you’re less likely to react to your triggers.

Remember to take your preventer medicines regularly as prescribed by a doctor or asthma nurse.

It’s also important to check your peak flow meter, because it can pick up changes in your airways before you have symptoms. A peak flow is a small hand-held device that measures how quickly you can blow air out of your lungs.

Speak to a doctor or asthma nurse about whether you need to monitor your peak flow.

5. Create an asthma action plan

Having an asthma action plan can help you manage and stay on top of your asthma. One recent review found that using an asthma action plan can reduce hospitalisations for asthma attacks as well as improve your symptoms and quality of life.

It tells you:

  • Your triggers
  • The medications you take each day to prevent symptoms and reduce your risk of an asthma attack
  • What you should do if you feel worse
  • Steps you should take during an asthma attack and when to get emergency help

If you haven’t already got an asthma action plan, speak to a doctor or asthma nurse who can help you to fill it in. It’s also a good idea to make copies of it and share it with friends and family.

When to speak to a doctor

If you experience any of the symptoms of an asthma attack, like difficulty breathing, go immediately to A&E or ring 999.

If you’ve had an asthma attack, and your symptoms improved with your reliever inhaler, you still need to make an urgent same-day appointment with a doctor or asthma nurse.

Also speak to a doctor or asthma nurse if:

  • You’re having regular asthma attacks
  • You want advice on better managing your asthma
  • You’re using your reliever inhaler more than usual
  • You’re not sleeping as well
  • Your asthma is stopping you from doing everyday things like going to work, playing with your children or doing housework

This article has been medically reviewed by Livi Lead GP, Dr Bryony Henderson.

Asthma attack: how to spot the signs and what to do 
| Livi UK

From worsening symptoms to experiencing dizziness, drowsiness or confusion, discover how to spot the signs of an asthma attack and find out what you should do

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