Asthma is a condition in which the air passages of the respiratory system become narrowed due to muscle spasm, swollen mucous membranes and/or increased mucus production. This makes it difficult for the person to breathe, especially to exhale.
Common triggers for asthma include:
- allergens such as pollens or smoke
- cold air
- chest infections
- emotional factors
- exercise.
Signs and symptoms
- A dry, irritating, persistent cough
- Chest tightness
- Shortness of breath
- Wheezing
Severe, life-threatening asthma attack
- Blue discolouration around the lips
- Difficulty to speak a few words at a time or unable to speak
- Gasping for breath
- Feeling distressed and anxious
- Loud wheeze or no wheeze heard
- Pale and sweaty skin
- Reduced consciousness
- Severe chest tightness
- Sucking in of the throat and rib muscles
- Unable to move around
Note: Wheezing may or may not be audible depending on the severity of an asthma attack. In severe asthma attacks, the audible wheezing may subside as the condition worsens with very little air moving in and out of the lungs. This is an emergency situation. Never assume that a decreased audible wheeze is a sign of improvement unless the breathing also improves.
Management
- Seat the person comfortably upright while providing reassurance.
- Obtain and shake a blue/grey reliever inhaler (puffer), e.g., Ventolin.
- Give four separate puffs (one round) of the inhaler (through a spacer if available)
- shake the inhaler before delivering each puff one at a time
- ask the person to take four breaths after each puff (through a spacer if available)
- repeat until all four puffs have been taken.
- Send for help and request an ambulance.
- Keep giving four puffs every four minutes until the person’s condition improves or the paramedics arrive.
Note
- An easy way to remember the use of the inhaler is the 4×4×4 round rule—4 puffs, with 4 breaths after each puff, and waiting 4 minutes after the fourth puff before commencing another round.
- Send for help and request an ambulance immediately if the person is showing any signs of a severe asthma attack, no inhaler is available or their condition suddenly becomes worse.
- Use the person’s own inhaler if possible. If not, use the inhaler in the first aid kit or borrow one from someone else.
- Ask them if they have an individual asthma management plan you can follow.
- First responders qualified in advanced resuscitation may safely administer oxygen to persons showing the signs and symptoms of asthma. Refer to the SLS Pathways website or the appropriate person at your SLS club for more information on advanced resuscitation training.
- Refer to the latest ARC Guideline for Asthma to learn more.
