Proper first aid for acute asthma attacks to restore breathing and prevent respiratory failure.
The person has severe difficulty speaking, is struggling to breathe, looks pale/blue around the lips, or their reliever inhaler is not working. Call 911 / 112 immediately. Do not leave the person alone.
Help the person sit comfortably upright immediately. Do not allow them to lie down, as lying down restricts airway passage and makes breathing significantly harder.
Panic and anxiety can worsen asthma symptoms. Encourage them to take slow, steady breaths, breathing in through the nose and out through the mouth.
Give them 4 puffs of a blue/reliever inhaler (usually albuterol), ideally using a spacer device. Shake the inhaler, insert it into the spacer, place the mouthpiece, and deliver 1 puff at a time. Have the person take 4 deep breaths for each puff.
Wait 4 minutes. If they still have breathing difficulty, give another 4 puffs of the reliever inhaler in the same manner.
If there is no improvement after 8 puffs, or if the person is worsening, call 911 / 112 immediately. Tell the dispatcher it is a severe asthma attack.
Continue giving 4 puffs of the reliever inhaler every 4 minutes until professional medical help arrives. If they stop breathing, begin CPR immediately.