How To Help Someone Having An Asthma Attack

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What is asthma?

After years of helping a younger sister through these frightening episodes, it's easy to forget how distressing it can be for the person trying to help the asthma sufferer especially if they have never dealt with it before. I hope this guide will give some useful information about asthma and how to assist someone having an asthma attack.

What is asthma?

This is a condition that affects one of the smaller units in the lung called the bronchioles - these are tiny air passages. They end in bulb like, elastic sacks, called the aveoli. When someone has asthma the bronchioles constrict, leading to the main symptoms of asthma. This usually happens due to these passages becoming inflamed. Why this inflammation occurs is not yet fully understood. However, when this happens, muscles and the linings of the air-ways constrict causing apertures to narrow significantly. In addition, the inflammation also causes excess mucus to be secreted, blocking the air passages further. This makes breathing difficult and you can also often hear a wheezing sound. However, as we shall see later, the signs and symptoms can vary depending on the severity of the asthma.

Asthma is a fairly common condition affecting both adults and children. It can first appear in adulthood, but it's most often a childhood development. According to NHS (National Health Service) UK Patient Information, about 1 in 20 adults have the condition and about 1 in 10 children. Asthma may also run in families but this is not always the case.

Most people have a treatment plan that is agreed with their doctor and often a specialist asthma nurse. The most common form of treatment is by inhalers that deliver a small dose of medicine into the lungs. Inhalers - for the majority of the time - do control the symptoms of asthma.

There are three different types of inhalers:

  • Reliever inhaler - to stop symptoms of asthma
  • Preventative - aims to prevent asthma symptoms developing
  • Bronchodilator - this inhaler helps to increase the spaces of the airways so allowing more air to get through and works much longer than the other inhalers. However, they are not always required by people suffering from asthma.
  • Tablets/liquid medication - these can be prescribed, especially for young children, where the inhalers are not effective enough to control all symptoms.
  • Steroids - although steroids are present in the inhalers, occasionally additional steroids - such as prednisolone - are required in a severe flare up and/or when an a person with asthma develops a chest infection or cold.

Lets look now at what triggers asthma and the signs and symptoms.

How to use an asthma inhaler

Symptoms of an asthma attack.

The signs and symptoms can vary depending on the severity of the asthma and also if the asthma is treated or untreated. NHS UK gives the following guidelines for what to look for and/or what might be experienced by people:

Asthma - untreated:

The symptoms range from very mild to severe. Even within an individual person the range can be quite extensive and may last anything from an hour to a number of weeks:

  • Cough
  • Wheeze
  • Breathless
  • Tightness in chest

In addition, with mild untreated asthma the symptoms may appear more frequently when the person suffers from a cold, chest infection or in the hay fever season. However, for the majority of the time there are no symptoms at all. In children, there could be a persistent cough at night, generally clearing during the day when the child is up and about.

Astham untreated - moderate to severe

the following symptoms may occur:

  • Although there will be periods with no symptoms, there will be more frequency than with mild asthma. It is also common with moderate to severe to have at least some symptoms on a daily basis when asthma is untreated.
  • The symptoms are the same as with mild asthma but will appear often at night and first thing in the morning for prolonged spells. In addition, people will often wake up during the night with a coughing spell and feelings of tightness in the chest. With children, it can be very difficult to tell the difference between recurring chest infections and the symptoms of asthma, so have them checked out by a doctor to establish the cause of any symptoms.
  • With a severe asthma attack it's very obvious what is going on - breathing is sounds harsh and laboured. The person's chest is rising and falling deeply and rapidly as they try to get more air into their lungs. They often lean forward, shoulders hunched and head forward and down as they try to take in more air. Their colour is anything from white, grey to bluish. They are unable to speak and many are even unable to gesticulate with their hands or head. There is an unmistakable look of distress/fear on their faces.

A person who suffers from asthma will get to know the signs of a severe attack coming on. Often they will experience:

  • The usual symptoms such as tightness, breathless, cough. However, the reliever inhaler does not help the symptoms or the effect wears off very quickly, so they have to use it more frequently.
  • Despite using the reliever inhaler, symptoms continue to get worse.
  • People often become too breathless to sleep, eat or speak.


If this happens then what should you do to help?

The lungs - showing the bronchioles that are most often affected by asthma
The lungs - showing the bronchioles that are most often affected by asthma | Source
With severe asthma attacks people are often given powerful medication via a nebuliser to help them to breath.
With severe asthma attacks people are often given powerful medication via a nebuliser to help them to breath. | Source

How to help with an asthma attack

When an attack happens take the following steps:

  • Stay calm and determine what type of attack is happening - mild, moderate or severe.
  • With mild to moderate the person is having difficulty breathing but can still usually speak and indicate with their hands and head.
  • In severe attacks, as stated previously, they will not usually be able to speak and may not even be able to indicate with hands or head. It is possible that unless they have a spacer - a device that helps the medicine to get into the lungs more easily - they may not be able to take their medicine using their normal inhaler.
  • With a severe attack, don't waste any time, your first action is to call for emergency medical back up.
  • Keep calm and reassure the person, get them into a position that is comfortable for them usually in an upright, sitting position - they may also be able to breath more easily if they are sitting slightly forward as this opens up airways.
  • Loosen any tight clothing, buttons around the neck and chest area.
  • Direct the person to take even deep breaths and try to relax their muscles. An asthma attack is terrifying and can lead onto panic attacks, so deep breathing can help to stop the escalation of the asthma attack and panic building up. Having said this, and I'm very grateful to fellow hubbers LucidDreams and Rosemay50, for raising this important point - when a person is having a severe asthma attack, it's sometimes just not possible for them to deep breath and relax, basically because of the struggle they are having to breath and the fear this causes. If you're the person looking after them, you need to be aware of this but it's also essential that you stay calm and just be with them until help arrives.
  • In a mild or moderate attack, ask the person if they have medication with them. If they have get it for them and help them to inhale the medicine - as with a severe attack, if they have a spacer, then use this. Normal directions are usually for the person to take one or two puffs, every two minutes - up to 10 puffs. Alternatively, they may have a regime already agreed with their doctor or nurse. If they still don't feel things are improving - usually within 5 to 10 minutes - then call for medical assistance. They will usually give further instructions over the telephone until they arrive.
  • If a person suffering an asthma attack doesn't have medicine with them, then call immediately for medical assistance whether the attack is severe or not and explain that the person has no medication.
  • Stay with them until you and the patient are sure the medicine is working or until medical help arrives.
  • If at any time with mild or moderate attacks, you are in doubt about the effectiveness of the medicine or the person indicates it's not working, call for immediate medical assistance.

For a person who has asthma and they are on their own, Asthma UK recommend you take the following steps:

  1. Take one to two puffs of your reliever inhaler (usually blue), immediately.
  2. Sit down and try to take slow, steady breaths.
  3. If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
  4. If you do not feel better after taking your inhaler as above, or if you are worried at any time, call 999.
  5. If an ambulance does not arrive within 10 minutes and you are still feeling unwell, repeat step 3. See the website - Asthma UK - for further information. For other countries see the links at the end of this hub.

To finish off I've collected a list of triggers that can lead to asthma attacks developing. If you have any others to add to the list, then feel free to let us all know through the comments section.

A simple breathing exercise for people with asthma

Air pollution is one of the most common triggers for asthma attacks.
Air pollution is one of the most common triggers for asthma attacks. | Source

Have you ever had to help someone who has had an asthma attack?

  • I have asthma and have experienced my own attacks.
  • I have asthma and have experienced my own attacks but have also helped someone else.
  • I have helped someone who has had an asthma attack.
  • I haven't had this experience either personally or by helping someone else.
See results without voting

Common triggers for asthma

There are a number of triggers that have been identified that can start an asthma attack. The triggers are different in each person and most asthmatics learn to avoid the ones whenever they can, that are harmful to them. It's also known that some triggers can cause a reaction immediately while others only cause irritation some time after contact with the trigger was made. Again every person is different.

This list is compiled from both Asthma UK and NHS UK Patient Information. However, if you have a trigger that's not listed, then let us know about it in the comments section.

Common Triggers:


Triggers found mostly indoors:

  • Smoking
  • Dust mites
  • Pets - especially fur and feathers
  • Perfumes
  • Household chemicals
  • Mould and fungi
  • Workplace substances and chemicals

Triggers found mostly outdoors:

  • Air pollution
  • Exercising
  • Weather - such as sudden changes in the weather, humid conditions. windy, cold and poor air quality are all known to be triggers for asthma.

Other triggers:

  • Chest infections, flu, colds can trigger an asthma attack
  • Medicines - medicines such as non-steroidal anti-inflammatory are known to be triggers, for example ibuprofen and aspirin.
  • Foods - some foods can be triggers for asthma, such as food containing sulphides and some wines. In addition, other people are allergic to foods such as nuts and can experience a reaction called an 'anaphylactic reaction' which also leads to an asthma attack.
  • Emotional state - anxiety and distress can also cause an asthma attack to develop. In addition it's also known that laughing can trigger an attack.

I hope this hub has been useful in giving you at least some ideas on how to help someone who is having an asthma attack and the basics of what asthma is. Thankfully most inhalers do stop attacks from happening often and these medicines - combined with increasing medical knowledge - will hopefully continue to improve conditions for people with asthma.

© 2013 Helen Murphy Howell

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Comments 22 comments

LucidDreams profile image

LucidDreams 3 years ago from St Petersburg, Florida

Nicely done. Unfortunately what most people do not clearly understand about asthma attacks is, taking deep breaths is nearly impossible. Of course emergency services will always ask the patient to do exactly that. Good hub!


AliciaC profile image

AliciaC 3 years ago from British Columbia, Canada

Thank you very much for this important and very useful hub, Seeker7. I have asthma, and while my symptoms are usually kept under control by taking my corticosteroid inhaler every day I do sometimes experience an asthma attack. A severe attack is very scary for the sufferer, and I'm sure it is for an observer too. All my personal triggers are covered in your list. This excellent hub will be very helpful for anyone who knows someone with asthma!


catgypsy profile image

catgypsy 3 years ago from the South

Great hub. Very thorough and useful information. Thanks.


Gypsy Rose Lee profile image

Gypsy Rose Lee 3 years ago from Riga, Latvia

Anoter very useful and informative hub. My ex-husbands niece has asthma and I know how difficult and scary it can be. Passing this on.


Eiddwen profile image

Eiddwen 3 years ago from Wales

So very interesting and also useful.

Both my sons had mild asthma when they were small and I am vote this one up,across and share all around.

Eddy.


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi LucidDreams,

Many thanks for stopping by and for taking the time to leave a comment.

I agree with you up to a point about the deep breathing. Certainly with my sister when she has a severe attack, there is no way she would be able to either relax or take deep breaths. When the attack is mild and at times even with moderate attacks, she can and does do deep breathing and she finds this helps quite a bit. I guess this might be different from person to person, but that's an important point you've brought up and I'll get something added into the article about this.


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi AliciaC, many thanks for stopping by always lovely to hear from you!

It is very frightening watching someone having an attack, so lord knows what it must feel like for the person themselves?? My sister has tried to explain it and it sounds gross, but even then it probably doesn't come close to what she is actually feeling.

I hope the hub can help in some ways so that people can manage this terrifying situation in the best way possible.


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi catgypsy, many thanks for stopping by and glad that you enjoyed the hub!


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi Rasma, always great to hear from you!!

Yes, it is a difficult thing and very, very scary. When I was a child and my sister had an attack, I would either go and hide in the bathroom or go to this big cupboard at the end of the hall until I heard Mum say that things were alright. Luckily enough my Mum was a nurse and was great at keeping calm when my sister was about passing out with fear!!


Rosemay50 profile image

Rosemay50 3 years ago from Hawkes Bay - NewZealand

Hi Helen this is an awesome hub everyone needs to know what happens and what to do if someone is having an attack.

I suffer from Asthma too but luckily don't have too many bad attacks,only in severe distress. You said above that is difficult to relax, You have to really concentrate on getting the panic under control and the feeling that your going to passout, before you can attempt to relax and try to breath deeply.

The fact is someone who doesn't know what to do can make things worse. My ex-husband would say "Go get a drink" He was so lucky that I couldn't speak, but that added frustration just intensified the attack.

I am sharing this as it is an important topic for everyone.


teaches12345 profile image

teaches12345 3 years ago

Thank you for writing this post. My sister has asthma and has to use an inhaler. Glad she has it, but it does make me a bit concerned to hear her when she has an attack. This hub will be useful to many.


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi teaches12345, lovely to hear from you and many thanks for leaving a comment. It is a worry when you hear the wheezing and then the attack comes on - very scary to watch!! Here's hoping the hub will help even if just with some issues!


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi Rosemay - 'go get a drink'?? For heaven's sake!! That would be enough to make anyone's asthma go from mild to severe in seconds! Yes, if you have someone who doesn't know and especially if they are getting distressed themselves, it does make the attack much worse! One of our cousins - who has to be one of the nicest people on the planet - but panics if my sister has an attack - does then get my sister all distressed and so her breathing becomes even more laboured! So she's glad when the cousin isn't around during one.

I was glad when LucidDreams made the point about deep breathing especially when it's a severe attack and also as you say trying to control the panic. My sister has ended up in A&E a couple of times for nebuliser treatment and so when a severe attack comes on, she automatically worries that it's going to escalate to 'A&E' levels and she can feel herself tighten up and her breathing go haywire. She has often said that it's a constant battle to try to keep the lid on the panic. I don't know how any of you guys manage it at all! I know that on at least one of the occasions when my sister ended up at the hospital the doctor gave her 5mg of diazepam(valium) not only to relace the muscles but the panic feelings were reduced within a couple of minutes. I'm not saying asthmatics should carry diazepam around, all I mean is that this shows people like me who don't have asthma, just how stressful and terrifying it can be.

Rosemay thanks so much for your very helpful comment and the share - greatly appreciated!!


LucidDreams profile image

LucidDreams 3 years ago from St Petersburg, Florida

Great comment, I can't remember being treated with diazepam but that is interesting. I have to admit, having an attack is about the scariest thing ever, you never really know that you will make it through until you do hopefully. It's almost impossible not to panic, but having someone around with a cool head, making good decisions for you is a great thing.


Rosemay50 profile image

Rosemay50 3 years ago from Hawkes Bay - NewZealand

I feel for your sister Helen. We spent a year in Sydney Australia and we seemed to spend most of thet year at A&E with my 6 yr old son, he lost so much weight because his asthma would play up as soon as he started eating. I was worried sick and dare not sleep. But within 6 months of leaving Sydney it had cleared up, no more asthma since. It must have just been something in that particular area causing it. With people like your sister it is just a vicious circle, the more she stresses the worse it gets, and yes her cousin wouldn't help by panicking too. It is a frightning thing both to watch and to go through.


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Oh Rosemay, bless his heart!! It's bad enough seeing an adult struggling to breath but seeing a child - especially your own - must be awful!!

LOL!! Yes, even the nicest people in the world can have their down sides and we basically send her off to the kitchen to make tea or coffee or take the dogs out the back garden - anthing to get her away from the scene!!


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi LucidDreams, thank you for the compliment!!

Yes, that was on one occasion - the only one as I recall - when she was given diazepam. She also had quite a bad chest infection at that time as well, that made it even more difficult for her to breath, and no doubt added to the panic - understandably - but when the doctor first came in to check on her, he told the nurse right away to get the diazepam. Anyway, whatever his reasons were, it worked!!


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi Eddy, many thanks for stopping by. Oh that's always sad when you hear about wee kids having asthma, as I was saying to Rosemay, bad enough for adults to have this, but to see a young kid trying to breath is awful!!


LA Elsen profile image

LA Elsen 3 years ago from Chicago, IL

What a great and thorough hub. I always need a reference when my husband starts to cough. I will mark this for those times.


Seeker7 profile image

Seeker7 3 years ago from Fife, Scotland Author

Hi LA Elsen, many thanks for stopping by and glad that the hub will be useful to you!


CallumCharles profile image

CallumCharles 14 months ago from Edinburgh, Scotland

Fantastic hub. As an asthmatic myself and having to take two inhalers daily. It's great to see so much understanding for what it's like for us, if we have an attack. This hub is brilliant and will be a great help and comfort to many.


Seeker7 profile image

Seeker7 13 months ago from Fife, Scotland Author

Hi Callum, most of my experience actually comes from my sister who is, like you, asthmatic. She is very good at explaining exactly how it feels and I've also seen her very distressed and to be honest scared when she has a bad attack. So I'm glad that you found this hub useful as I would particularly like to hear from asthma sufferers or their families to get in touch to keep on improving the hub. Many thanks for your comment.

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