Asthma

Calm and reassure the casualty, get them comfortable
and ask them to use their 'reliever' inhaler.

During an asthma attack the muscles of the air passages in the lungs go into spasm and the linings of the airways swell. This results in the airway becoming narrow and breathing becoming more difficult. Sometimes an asthma attack is triggered by an allergy, cold, cigarette smoke or some other external stimulus. Sometimes there is no recognised trigger for the attack - some asthma sufferers have sudden attacks at night. People with asthma usually deal with their own attacks using a 'reliever' inhaler, usually coloured blue, at the first sign of an attack. Asthma sufferers may also have a second 'preventer' inhaler, coloured brown, that reduces the risk of having an attack. The preventer inhaler will not help when an asthma attack in progress.

The main priorities are to calm and reassure the casualty, treat the asthma attack and maintain the casualty's airway.

Recognition:

• Difficulty in breathing, with a very long breathing-out phase.
• Wheezing when the casualty breathes out.
• Difficulty speaking.
• Signs of hypoxia (low blood oxygen) such as grey-blue lips, earlobes and nailbeds.
• Distress and anxiety.
• Coughing.
• Eventually the casualty may become unconscious and stop breathing.

Treatment:

• Calm and reassure the casualty.
• Ask the casualty to take a puff of their reliever inhaler.
• Ask the casualty to breathe slowly and deeply.
• Let the casualty adopt the most comfortable position, usually sitting. Do not let the casualty lie down.
• A mild asthma attack should ease within 3 minutes - if not, ask the casualty to take a second dose from their inhaler.
• Ring for an ambulance if:

• this is the casualty's first ever asthma attack.
• the inhaler has no effect after 5 minutes.
• the casualty is getting worse.
• breathlessness makes talking difficult.
• the casualty is becoming exhausted.

• Be prepared to give resuscitation if the casualty stops breathing.