An asthma action plan can guide a person through an attack. But for anyone nearby, the hard part is judging whether to wait, fetch medicine, or call for help. The response to an asthma attack rests on a short sequence and a single common medicine, neither of which needs medical training, and a written plan slots into that sequence wherever one is on hand.
What Is A Written Asthma Action Plan
A written asthma action plan is a set of instructions a person works out with their doctor for managing their asthma. Doctors develop the plan with each patient, so it suits that person’s age, asthma severity, language, and reading level. The National Asthma Council Australia and Asthma Australia publish templates translated into community languages so more families can access the same clear instructions.
The plan lists their usual medicines by name and dose, carries their doctor’s contact details, and describes what their asthma looks like as it gets worse. It gives clear instructions for each stage: which medicine to take, when to start a short course of steroid tablets (oral corticosteroids such as prednisolone), and the point at which to call an ambulance. Some plans track breathing with a peak flow reading (PEF) measured against the person’s personal best.
Spotting The Symptoms Of An Asthma Attack
An asthma attack builds as the airways narrow and fill with thick mucus, which makes each breathing harder. Common asthma symptoms include wheezing, a whistling sound on the way out, a dry cough that will not ease, shortness of breath, and a tight feeling in the chest. Symptoms range from mild to severe, and some people have few signs at all until they are very unwell. Some signs mean breathing is failing and the person needs an ambulance without delay:
- speech broken into single words, or no speech at all
- lips or fingertips turning blue
- little or no relief from their reliever puffer
- symptoms getting worse fast
- skin sucking in at the neck or between the ribs
First Aid Guidelines for Asthma
Follow the steps in the person’s asthma action plan. Sit the person upright, leaning slightly forward if that helps them breathe, since lying flat makes the airways harder to open. Stay with them, keep calm, and speak quietly to settle them, since panic can make breathing harder. Loosen anything tight around their neck or waist. Send someone to find their reliever puffer while you stay put.
Reach for their reliever puffer, the asthma medication most people with asthma carry. Fit it to a spacer if one is on hand, because a spacer carries more of the medicine into the lungs. Shake the puffer, fire one puff into the spacer, and have the person take four slow breaths from it. Repeat until four puffs have been given, one puff and four breaths at a time.
Wait four minutes and watch how the person breathes, since the reliever needs a few minutes to open the airways. Breathing that eases back toward normal means the medicine is taking effect, though the person still needs to be seen by their doctor afterwards. Breathing that stays laboured, or worsens, means giving more reliever or calling for help.
If their breathing has not returned to normal after the wait, give four more puffs the same way, one puff and four breaths at a time. If there is still no normal breathing, call triple zero (000) for an ambulance and tell the operator it is an asthma emergency. Keep giving four puffs every four minutes until the ambulance arrives.
What To Do Once The Emergency Settles
Even when the attack eases, the person should see their doctor the same day, because the reliever wears off and the airways can tighten again within hours. A reliever used heavily during an attack also points to asthma that the GP needs to look at.
The follow-up review is when their asthma action plan, and their medicines, are checked and updated against what happened. A person without a written plan can ask their doctor to make one at this visit, so the next flare-up meets clear instructions rather than memory.
Learn Asthma First Aid Before You Need It
A written asthma action plan carries instructions a bystander can read and act on during an attack. Using a reliever and spacer for asthma management while someone fights for respiratory ease is something you’ll remember easier after practising it in a nationally recognised first aid course. The next time someone close to you cannot draw a breath, your hands will already know what to do if you enrol in first aid training now.
FAQs
What If There Is No Spacer Or Puffer Nearby?
With no spacer on hand, you can improvise one from a clean plastic drink bottle or a tightly rolled tube of paper, following the National Asthma Council’s method.
What Is Thunderstorm Asthma?
Thunderstorm asthma happens when a storm breaks grass pollen into pieces small enough to reach deep into the lungs. It can trigger severe attacks, including people who normally only get hay fever rather than asthma.
Can You Give Too Much Reliever During An Attack?
In an emergency the blue reliever is safe to keep repeating. Too much can leave the person with a faster heartbeat or shaky hands, though these ease off and are not a reason to stop. The risk of holding back the reliever during an attack is far greater than the risk of giving it.
