Skip to content

Asthma attack: first aid

Emergency numbers differ by country. This page uses 911, the number for the United States and Canada. Many other countries use 112, 999, or another number. Find the number for your country.

An asthma attack happens when the airways in the lungs swell and narrow, making it hard to breathe. Prompt action helps restore normal breathing.

Do this now

  1. Sit the person upright comfortably. Do not let them lie down.
  2. Help them use their quick-relief inhaler (usually blue, containing albuterol or salbutamol).
  3. Give 1 puff every 30 to 60 seconds, up to 4 puffs, preferably using a spacer if available.
  4. Wait 4 minutes. If breathing does not improve, give 4 more puffs.
  5. If there is no improvement after 8 total puffs, or if the person has severe distress, call your local emergency number (911 in the United States, 112 in Europe, 999 in the United Kingdom) immediately.

Recognizing a severe asthma attack

An asthma emergency requires immediate medical care. Watch for these red flag symptoms:

  • Severe shortness of breath or rapid, shallow breathing.
  • Inability to speak more than a word or two without pausing for breath.
  • Chest muscles pulling in tightly under the ribs or at the neck when breathing in (retractions).
  • Blue or gray tint around the lips, tongue, or fingernails.
  • Extreme anxiety, drowsiness, or confusion.
  • The inhaler gives no relief.

Step by step inhaler instructions

If the person needs assistance using their rescue inhaler:

  1. Shake the inhaler well 4 to 5 times.
  2. Attach the inhaler to a spacer chamber if one is available.
  3. Have the person breathe out fully away from the inhaler.
  4. Place the mouthpiece between their teeth and seal their lips tightly around it.
  5. Press down on the canister once as the person begins a slow, deep breath in.
  6. Have them hold their breath for 10 seconds or as long as comfortable, then breathe out slowly.

Repeat 1 puff every 30 to 60 seconds as needed.

Staying calm and creating space

Anxiety can worsen breathing difficulty during an asthma flare-up. Keep your voice steady, calm, and reassuring.

  • Move away from known triggers like smoke, strong fumes, cold air, dust, or pet dander.
  • Loosen tight collars, ties, or waistbands to allow full chest expansion.

Asthma education

People with asthma should have a written Asthma Action Plan from their physician. First aid courses from the Red Cross and asthma foundations train responders on proper spacer and inhaler techniques.