Acute Asthma Attack Treatment for Adults

Symptoms of acute attack include difficulty talking or walking because of shortness of breath or lips or fingernails turning blue.

1. Follow the Person’s Asthma Plan, if Possible

Find out if the person has an individualized asthma action plan from a health care provider.
If so, follow its directions for giving asthma medication and seeking medical help for acute asthma attack.

2. Give Asthma First Aid

If the person doesn’t have an asthma plan:

Sit the person upright comfortably and loosen tight clothing.
If the person has asthma medication, such as an inhaler, assist in using it.
If the person doesn’t have an inhaler, use one from a first aid kit. Do not borrow someone else’s. The medicine in it may be different than the needed rescue medicine. Also, using someone else’s inhaler has a slight risk of passing on an infection.

3. Use Inhaler With a Spacer, if Possible

Remove cap and shake inhaler well.
Insert inhaler into spacer.
Have the person breathe out completely and put mouth tightly around spacer mouthpiece.
Press inhaler once to deliver a puff.
Have the person breathe in slowly through the mouth and then hold breath for 10 seconds.
Give a total of four puffs, waiting about a minute between each puff.

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4. Use Inhaler Without a Spacer, if Necessary

Remove the inhaler cap and shake well.
Have the person breathe out all the way and seal lips tightly around inhaler mouthpiece.
As the person starts to breathe in slowly, press down on inhaler one time.
The person should keep breathing in as slowly and deeply as possible (about five to seven seconds) and then hold breath for 10 seconds.
Give a total of four puffs, waiting about one minute between each puff.
5. Continue Using Inhaler if Breathing Is Still a Problem

After four puffs, wait four minutes. If the person still has trouble breathing, give another set of four puffs.
If there’s still little or no improvement, give 4 to 8 puffs every 20 minutes until the ambulance arrives for up to 4 hours. If you are still waiting for help after 4 hours, the recommended dose is 4 to 8 puffs as needed every 1 to 4 hours..

6. Monitor the Person Until Help Arrives

Do not mistake drowsiness as a sign of improvement; it could mean asthma is worsening.
Do not assume the person’s asthma is improving if you no longer hear wheezing.
7. Follow Up

An emergency room doctor will check the severity of the attack and provide treatment, including medications.
The person may be discharged home or hospitalized for further care, depending on response to treatment.