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Asthma Emergency

Start Asthma First Aid and continue until emergency services arrive. Blue-grey reliever medication is unlikely to harm, even if the person does not have asthma.


Sit the person upright 
 - Be calm and reassuring
 - Do not leave them alone


Give 4 separate puffs of blue/grey reliever puffer 
 - Shake puffer
 - Put 1 puff into spacer
 - Take 4 breaths from spacer
Repeat until 4 puffs have been taken
Remember: Shake, 1 puff, 4 breaths
OR Give 2 separate does of a Bricanyl inhaler (age 6 & over) or a Symbicort inhaler (over 12).


Wait 4 minutes 
- If there is no improvement, give 4 more separate puffs of blue/grey reliever as above
(OR give 1 more dose of Bricanyl or Symbicort inhaler)


If there is still no improvement call emergency assistance (DIAL 000)
 - Say 'ambulance' and that someone is having an asthma attack
 - Keep giving 4 separate puffs every 4 minutes until emergency assistance arrives
(OR 1 dose of Bricanyl or Symbicort every 4 minutes - up to 3 more doses of Symbicort)

 Call emergency assistance immediately (DIAL 000)
 - If the person is not breathing
 - If the person's asthma suddenly becomes worse, or is not improving
 - If the person is having an asthma attack and a reliever is not available
 - If you are not sure if it's asthma
 - If the person is known to have Anaphylaxis - follow their Anaphylaxis Action Plan, then give Asthma First Aid.
 Blue/grey reliever medication is unlikely to harm, even if the person does not have asthma


You may be having an asthma flare-up or attack if:

  • You have asthma symptoms that are getting worse
  • Your reliever puffer isn’t helping or is lasting less than four hours
  • Your symptoms are making it difficult to eat, speak or sleep
  • You feel like you can’t get your breath in properly
  • Children may complain of a sore tummy or chest, or be more restless

Start Asthma First Aid as soon as possible (see instructions at top of page).

Download your own asthma first aid poster ready for printing by clicking on the size you would like:


If you are using Symbicort as a reliever and preventer, you need to use the Symbicort SMART first aid procedure

After asthma first aid

If your symptoms improve you still need to make an appointment to see your doctor, preferably the same day.

If you’re not sure, or if you get worse again before you see your doctor, go straight to hospital or call Triple Zero (000) for an ambulance.

How an asthma flare-up happens

Any person with asthma can have a flare-up or worsening of asthma symptoms at any time. A sudden or severe flare-up is often called an asthma attack. An asthma flare-up or attack may develop very rapidly over a few minutes, or it may take a few hours or even days to happen. Having good control of your asthma means this is less likely, but it can still happen.

Reduce your risk of a flare-up by:

  • Taking your asthma medicine as advised
  • Being aware of your symptoms and responding quickly when they get worse
  • Following a written asthma action plan
  • Having regular reviews with your nurse or doctor, and asking them to check you’re using your inhaler well


If you are using Symbicort SMART (Symbicort as both reliever and preventer), a special first aid plan exists that does not use a blue reliever.

Symbicort SMART First Aid

If you are finding it extremely difficult to breathe or speak, or there is little or no improvement after using your Symbicort, dial 000 for an ambulance immediately and start Symbicort first aid:

  • Sit upright and stay calm.
  • Take 1 inhalation of Symbicort.  Wait 1-3 minutes.
  • If there is no improvement take another inhalation of Symbicort (up to a maximum of 6 inhalations).
  • If Symbicort is unavailable use a blue reliever and follow the standard Asthma First Aid plan.
  • Start a course of prednisolone tablets (if your doctor has advised you to do this) while waiting for an ambulance

See your doctor immediately after a serious attack, even if the symptoms settle quickly.

If you are on the SMART treatment program and have asthma symptoms, you should take 1 inhalation of your Symbicort whenever you need to.

If you need to take more than 6 Symbicort inhalations a day, you should check your asthma action plan for information on what to do, or see your doctor.

If you need more than 12 Symbicort inhalations in a day, you should see your doctor immediately or go to hospital the same day. 

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