Asthma attack treatment: what to do

During an attack, muscles around the airways tighten and the airway lining may swell, making it harder to move air. A prescribed quick-relief inhaler helps relax tightened airway muscles. Some people use a spacer with an inhaler so the medicine is easier to breathe into the lungs. More serious attacks may require oxygen, repeated inhaled medicine, or anti-inflammatory medicine in an urgent-care setting.

A nebuliser turns liquid medicine into a mist, but it is not automatically stronger than correctly delivered inhaler treatment. The suitable device and medicine depend on the person's action plan, symptoms, and ability to use the device.

Sit upright, stay as calm as possible, and move away from smoke, dust, strong fragrances, or another obvious trigger. Use the prescribed reliever exactly as the personal asthma action plan directs. A caregiver can help assemble the inhaler and spacer, count doses according to that plan, and monitor whether breathing and speech improve.

Do not lie flat or rely on steam, caffeine, or someone else's inhaler. If there is no action plan, symptoms are worsening, or the reliever is unavailable, seek urgent medical help rather than improvising a dose. Continue prescribed controller treatment unless a clinician gives different instructions.

Call emergency services now if the person is struggling to breathe, cannot speak comfortably in sentences, becomes drowsy or confused, develops blue or grey lips, has marked pulling-in around the ribs or neck, collapses, or is getting worse despite following the action plan. Very quiet breathing in someone working hard to breathe can mean too little air is moving and is also an emergency sign.

Arrange prompt clinical review after an attack even when symptoms settle. A clinician can check inhaler technique, identify triggers, assess whether controller treatment needs adjustment, and update written instructions for a future episode.

Ask which changes in cough, chest tightness, sleep, activity, or reliever use should activate each part of your written plan. Confirm the correct inhaler and spacer technique, how to recognise an empty or expired device, which triggers may be relevant, and where to seek help if treatment does not work as expected.