Asthma Attack First Aid: What to Do for Kids and Adults
Asthma affects millions of Canadians, including a large share of children. Knowing the sitting position, how to help with a reliever inhaler, and the signs of a severe attack can save a life.
An asthma attack happens when the airways in the lungs tighten, swell, and fill with mucus, making it hard to breathe. For someone in the middle of one, it can feel like breathing through a narrowing straw. Most attacks can be managed quickly with a reliever inhaler — but some become life-threatening, and bystanders who know what to do make all the difference.
This guide covers how to help both children and adults during an asthma attack, the position that eases breathing, how to assist with an inhaler, and the warning signs that mean you must call 911.
Recognizing an Asthma Attack
During an asthma attack, a person may have:
- Wheezing — a whistling sound, usually when breathing out
- Coughing, often persistent
- Shortness of breath and a feeling of tightness in the chest
- Difficulty speaking in full sentences
- Rapid breathing and a fast heartbeat
- Anxiety or panic — which makes breathing harder still
In children, also watch for the skin sucking in around the ribs and neck, a tummy that moves more than usual with breathing, and the child becoming quiet, still, or floppy — a worrying sign of tiredness.
Step-by-Step: How to Help During an Asthma Attack
1Sit them upright — do not let them lie down
Help the person sit up straight, leaning slightly forward. Resting their arms on a table or the back of a chair can help. Lying flat makes breathing harder. An upright, slightly forward position opens the airways and lets the breathing muscles work better.
2Stay calm and keep them calm
Panic tightens the chest and speeds up breathing, making an attack worse. Speak in a calm, reassuring voice. Encourage slow, steady breaths. Your composure helps them regain control.
3Help them use their reliever (blue) inhaler
Find their blue reliever inhaler (the rescue medication, not the preventer). Help them take one puff every 30 to 60 seconds, up to the number on their personal asthma action plan — commonly up to 10 puffs. If a spacer device is available, use it: it delivers the medication far more effectively, especially for children.
4Reassess after the inhaler
If their breathing improves and they feel better, they should still follow up with their doctor — an attack that needed the reliever is worth reviewing. If there is no improvement, if symptoms are getting worse, or if you used the full number of puffs without relief, call 911.
5Keep giving puffs while you wait for the ambulance
If you have called 911, continue helping them take one puff of the reliever every 30 to 60 seconds (up to a further 10 puffs) until paramedics arrive, unless they tell you otherwise. Keep them upright and calm.
6If they become unresponsive and stop breathing — begin CPR
In a severe, untreated attack a person can collapse. If they are unresponsive and not breathing normally, start CPR and continue until help arrives. This is a core skill taught in every Life Safe CPR course.
The Signs of a Life-Threatening Attack
Call 911 without hesitation if you see any of these:
- The reliever inhaler is not working or symptoms keep returning quickly
- The person is too breathless to speak, eat, or sleep
- Blue or grey lips, tongue, or fingertips
- Deep sucking-in of the skin around the ribs and neck (especially in children)
- The person is exhausted, agitated, drowsy, or confused
- A silent chest — the wheeze disappears because too little air is moving
- The person has no inhaler available
Helping a Child With Asthma
Children can deteriorate faster than adults and may not be able to describe what they feel. Stay especially alert to the skin pulling in around the ribs, a child going quiet and still, and any blue colour. Always use a spacer for a child’s reliever inhaler if one is available — it makes a real difference. And do not wait too long: with children, when in doubt, call 911.
Common Asthma Triggers to Know
Recognizing triggers helps prevent attacks. Common ones include respiratory infections (colds and flu), allergens like pollen, dust mites, and pet dander, cold air, exercise, smoke and air pollution, and strong emotions or stress. If you know what set off an attack, remove the person from the trigger where you can — for example, move them away from smoke or out of the cold.
Be Ready Before It Happens
If you live with, care for, teach, or coach someone with asthma — or have a child with asthma yourself — the time to learn these steps is now, not in the middle of an attack. A Life Safe first aid course gives you hands-on practice with positioning, inhaler and spacer technique, and CPR, so you can respond calmly and effectively when breathing becomes a struggle.
Frequently Asked Questions
What should you do during an asthma attack?
Sit the person upright — never let them lie down — and keep them calm. Help them use their blue reliever inhaler: one puff every 30 to 60 seconds, up to the number on their action plan (often up to 10 puffs), ideally with a spacer. If there is no improvement, no inhaler, or the attack is severe, call 911 and keep giving puffs while you wait.
What are the signs of a severe asthma attack?
The reliever not helping, being too breathless to speak in full sentences, blue or grey lips or fingertips, skin sucking in around the ribs and neck, exhaustion, a silent chest (no wheeze because little air is moving), and agitation or drowsiness. Any of these means call 911 immediately.
Should someone sit or lie down during an asthma attack?
Sit up — never lie down. Lying flat makes breathing harder. The best position is upright and slightly forward, perhaps leaning on a table or chair back, which opens the airways and helps the breathing muscles. Encourage slow, steady breaths.
Can you have an asthma attack without an inhaler?
Yes, and it is frightening. If someone is attacking and has no inhaler or it is empty, call 911 right away. Keep them sitting upright, calm, and breathing slowly. If you can find any blue reliever inhaler, it may help in a genuine emergency, but calling 911 is the priority.
Learn to Help When Every Breath Counts
An asthma attack can escalate fast. Life Safe’s hands-on first aid and CPR courses teach you to recognize a severe attack, assist with reliever inhalers and spacers, and respond if someone collapses — skills every parent, teacher, and coach should have.
Find a class near you: Toronto • Downtown Toronto • East York • Hamilton • Welland • Guelph