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Working with your local Asthma Foundation

Asthma Emergency

RECOGNISE signs of an asthma flare-up or attack

If you are experiencing any of these signs, start asthma first aid. Do not wait until asthma is severe.

Mild/moderate

  • Minor difficulty breathing
  • Able to talk in full sentences
  • Able to walk/move around
  • May have cough or wheeze

Commence Asthma First Aid

Severe

  • Obvious difficulty breathing
  • Cannot speak a full sentence in one breath
  • Tugging in of the skin between ribs or at base of neck
  • May have cough or wheeze
  • Reliever medication not lasting as long as usual 

Call Ambulance on 000
Commence Asthma First Aid

Life threatening

  • Gasping for breath
  • Unable to speak or 1-2 words per breath 
  • Confused or exhausted
  • Turning blue
  • Collapsing
  • May no longer have wheeze or cough
  • Not responding to reliever medication

Call Ambulance on 000
Commence Asthma First Aid


In children:

  • Signs of worsening asthma can be difficult to recognise
  • Asthma can worsen quickly over short period of time
  • They may complain of sore tummy or chest and be more restless
  • DO NOT DELAY in starting asthma first aid 

How to respond

If you are experiencing a severe or life-threatening asthma attack, call an ambulance - Dial Triple Zero (000) and then start asthma first aid.

If you are experiencing a mild to moderate asthma attack, start asthma first aid.

 1

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

 2

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).
person-taking-medication-icon 
 

 3

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)
Clock-icon 
 

 4 

If there is still no improvement call emergency assistance. Dial Triple Zero (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)
Triple-0 

 Call emergency assistance immediately. Dial Triple Zero (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

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

Or download Asthma Australia's Asthma App to access the asthma first aid steps wherever you are. Head to the iTunes app store and search for Asthma Australia or click on the App Store link below:

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Symbicort SMART First Aid

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.

If showing signs of severe or life-threatening asthma attack (in table above), dial 000 for an ambulance and start asthma first aid for your type of Symbicort below:

Rapihaler (50/3 mcg or 100/3 mcg) 
Symbicort Rapihaler image
 Turbuhaler (100/6 mcg or 200/6 mcg) 
Symbicort turbuhaler
1. Sit upright and stay calm   1. Sit upright and stay calm 
2. Take 2 inhalations of Symbicort. Then wait 1-3 minutes   2. Take 1 inhalation of Symbicort. Then wait 1-3 minutes.
3. If there is no improvement, take another 2 inhalations of Symbicort (up to a maximum of 12 inhalations)  3. 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 steps  If Symbicort is unavailable, use a blue reliever and follow the standard Asthma First Aid steps
Start a course of prednisone tablets (if your doctor has advised you to do this) whilst waiting for an ambulance  Start a course of prednisone tablets (if your doctor has advised you to do this) whilst waiting for an ambulance

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.

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