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Panic attacks: first aid and grounding

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.

A panic attack is a sudden surge of intense fear or severe anxiety that causes physical symptoms like heart racing and shortness of breath. While alarming, panic attacks are not life-threatening.

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  1. Reassure the person that they are safe and that the feeling will pass in a few minutes.
  2. Encourage them to take slow, steady breaths. Count out loud with them: inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds.
  3. Guide them through a grounding exercise (such as the 5-4-3-2-1 technique).
  4. Move them to a quiet, open space away from crowds, loud noise, or bright lights.
  5. If chest pain or shortness of breath is accompanied by arm numbness or pressure, treat it as a medical emergency.

Symptoms of a panic attack

Panic attacks hit quickly and typically peak within 10 minutes. Symptoms include:

  • Rapid, pounding heart rate or heart palpitations.
  • Chest tightness, shortness of breath, or feeling smothered.
  • Trembling, shaking, or feeling detached from reality.
  • Sweating, chills, or hot flashes.
  • Dizziness, lightheadedness, or nausea.
  • Fear of losing control or fear of dying.

Grounding techniques to calm anxiety

Grounding refocuses the brain away from fear and back to physical surroundings:

The 5-4-3-2-1 Sensory Method: Ask the person to name out loud: - 5 things they can see around them. - 4 things they can physically touch. - 3 things they can hear right now. - 2 things they can smell. - 1 thing they can taste.

Box Breathing: Guide the person to breathe slowly together: - Breathe in through the nose for 4 seconds. - Hold breath for 4 seconds. - Exhale through the mouth for 4 seconds. - Pause for 4 seconds before the next breath.

Panic attack vs. heart attack

Because chest pain and shortness of breath occur in both, it can be difficult to distinguish them:

  • Panic attack: Often triggered by stress, symptoms peak within 10 minutes, pain is sharp or localized, and grounding helps slow breathing.
  • Heart attack: Pain feels like heavy pressure, squeezing, or crushing in the chest, radiating to the jaw, neck, back, or arm, often accompanied by vomiting or cold sweat.

If you are ever in doubt, call emergency services (911 in the United States, 112 in Europe, 999 in the United Kingdom) immediately.

Managing anxiety

Professional therapy and mindfulness training help manage recurrent panic attacks. Learning first aid skills builds confidence during high-stress situations.