An asthma attack can escalate fast — learn the lifesaving steps: sit upright, use your blue reliever (one puff every 30–60s, up to 10 puffs via spacer), and call 999 if there’s no improvement or severe signs. Get an urgent GP/asthma‑nurse review after any attack to update your action plan.
Key Takeaways
- For an asthma attack, sit upright and use your blue reliever inhaler; take one puff every 30–60 seconds, up to 10 puffs with a spacer.
- Call 999 if there’s no improvement after 10 puffs or if you see severe symptoms like confusion or blue lips.
- After an attack, seek urgent review within 48 hours to update your asthma action plan and medications.
- Always carry your reliever inhaler and know your personal asthma action plan to prevent emergencies.
- Contact NHS 111 or your GP for advice if unsure, and call 999 in emergencies.
Introduction
An asthma attack can be frightening. Follow these nationally recommended steps and seek urgent help if symptoms don’t improve. It can be triggers by something that you are sensitive to eg cats.
Immediate steps
- Stay calm and sit upright — do not lie down.
- Give the reliever inhaler (short‑acting beta2‑agonist, e.g. blue salbutamol) via a spacer if available. One puff every 30–60 seconds, up to 10 puffs.
- If using a spacer, give each puff slowly and allow the patient to take several normal breaths after each puff.
When to call 999 / seek emergency care
- No improvement after 10 puffs and continued breathlessness.
- Severe signs: difficulty speaking, drowsiness or confusion, cyanosis (blue lips/face), collapse, or exhaustion.
- For children, seek urgent help sooner if they are very distressed, drowsy, or have poor feeding.
What emergency services/ED may provide
- Nebulised bronchodilators, oxygen and monitoring.
- A short course of oral corticosteroids (e.g. prednisolone) may be given if clinically indicated.
- In rare severe cases, parenteral treatments and advanced support are available.
After an asthma attack
- Arrange an urgent review with your GP or asthma clinic (ideally within 48 hours) to review control, inhaler technique and medications.
- You should be offered or updated with a written asthma attack action plan outlining current medications, how to recognise worsening control, and emergency steps.
- Discuss whether changes to preventer therapy, rescue plans (including MART or rescue packs), or specialist referral are needed.
Prevention and preparedness
- Always carry your reliever inhaler and spacer if prescribed.
- Know your personal asthma action plan and peak flow thresholds if you use a peak flow diary.
- Get regular asthma reviews and annual flu vaccination as recommended.
If you’re concerned about any of the points mentioned, please reach out to your GP.