Zac Kennett still remembers the day when his grandmother found him having an asthma attack. He was supposed to be waiting for her in the foyer, but when she saw that he wasn’t there, she came inside and saw him gasping for breath in his bedroom.
Kennett’s grandmother knew that he had asthma and allergies — but she’d never seen him having an asthma attack before.
“It feels almost as if you’re being choked, but it’s prolonged,” says Kennett, of St. Peters, Missouri. Although he doesn’t know what triggered his asthma attack that day, he said that “without proper medicine and medical care, it wasn’t going to fix itself.”
If you see someone having an asthma attack, follow these steps.
Understanding an Asthma Attack
Difficulty breathing is usually the first sign of an asthma attack. This is caused by inflammation in the airways that then stimulates a tightening of the surrounding muscles. When this occurs, a person can experience coughing spells, wheezing, a tightening of the chest, or an inability to move air out of the chest.
Many people mistakenly think asthma attacks always go hand-in-hand with wheezing, but “this is not always the case,” says Ernesto Ruiz-Huidobro, MD, an allergist at Allergy and Asthma Healthcare in Lake St. Louis, Missouri. “To wheeze, you have to move air, so if they are really obstructed, they may not be moving air."
Other symptoms may include a blue or gray tinge to the fingers or lips, difficulty speaking, or difficulty doing simple chores or other activities, according to the American Academy of Family Physicians (AAFP).
"Asthma is extremely variable," Dr. Ruiz-Huidobro says. And there’s no average time for an asthma attack to last. While some are mild and can be managed at home, others require treatment at a hospital.
What to Do During an Asthma Attack
Thanks to advances in treatment options, asthma attacks are rarer than they once were. But unfortunately, some people still experience them. Here’s what to do in an emergency:
- Keep calm. That goes for you and who you’re trying to help. Reassure the person that you’re there for them, says Ruiz-Huidobro. People who are panicked can have difficulty breathing, so you don’t want to worsen an already stressful event by seeming panicked yourself, he explains.
- Help them sit up. If the person is sitting in an upright position, his or her breathing will be as unobstructed as possible.
- Eliminate the trigger. If you know the person’s history of asthma attacks, get them away from the trigger or remove the trigger, if possible, says Ruiz-Huidobro. (Example: If you’re near people who are smoking, move away from them.) The list of potential asthma triggers is lengthy — pollen, dust mites, mold, feathers, animal dander, certain foods, smoke, dirt, gases, illness, exercise, stress, cold weather or windy weather, and even acetaminophen — so if you don’t know the person’s triggers, ask them directly, if possible.
- Follow the emergency plan. If the person has an emergency plan on them — and this may include rescue inhalers (albuterol, in most cases), bronchodilators, and other anti-inflammatory agents — follow the directions. Read the label to determine the appropriate doses of medication and make sure the person follows through with the instructions. Then, ask about his or her action plan for worsening symptoms — whether you should help them use rescue inhalers or breathing treatments, or if you should call an ambulance at the first signs of chest tightening.
- Assess the severity of the attack. Look for any signs that this is a severe attack — i.e., one that warrants a trip to the emergency room or at least a call to the physician. Signs include skin that looks sucked in between the ribs and on the neck, a bluish discoloration of the lips, and a continuing struggle to breathe several minutes after using a rescue inhaler.
Even if symptoms improve after these steps, encourage the person to call his or her doctor to discuss additional treatments or changes to the current treatment regimen, the AAFP suggests.
Finally, recognize when your actions aren’t enough. If the steps in the emergency plan aren’t working, or if there is no plan, consider going to an urgent care center or calling an ambulance immediately. “The sooner, the better,” Ruiz-Huidobro says. “You have no way of treating it, and asthma attacks usually don’t just go away on their own.”