However, First Aid Classes explain how in an asthma attack, the muscles in the airways go into spasm, which causes the lining to swell. This narrows the airway, making it difficult for the patient to breathe.
- Difficulty in breathing – with prolonged breathing-out phase
- Wheezing as they exhale
- Difficulty speaking and whispering
- Features of hypoxia – grey-blue colour to lips, earlobes and nail-beds
- Distress and anxiety
- In severe attacks, exhaustion. It is very rare that the patient will lose consciousness or stop breathing
There are various causes for an asthma attack. Sometimes the patient will know their triggers and try to avoid them. These can include an allergy, a cold, a particular drug or cigarette smoke. Nonetheless, there are many instances where there is no clear trigger. For example, a lot of asthma sufferers can experience a sudden attack during the night.
Asthma sufferers normally carry a reliever pump, (usually blue) to inhale when they feel an attack coming on. Sometimes the patient uses an additional piece to the inhaler pump called a ‘spacer’ to diffuse the medication and help them breathe the drug in more effectively.
Patients will usually have ‘preventer’ inhalers that they use regularly to help their condition. However, the St Mark James First Aid manual states that these are no use in the event of an asthma attack, only the reliever inhalers should be taken.
The aims of a first aider in this situation is to help to relieve and ease the patients breathing, and to get medical assistance if needed.
First Aid Classes teach you to always keep calm and reassure the patient. Tell them or assist them to take a puff of their reliever inhaler. This should be effective within a few minutes. In the meantime, encourage the patient to control their breathing by taking slow deep breaths.
Allow the patient to make themselves comfortable, usually this is a sitting position. Do not make the patient lay down as laying flat can aggravate their breathing and make it more difficult.
If the reliever inhaler does not help in 3 minutes, then the patient should take another dose. In a severe asthma attack, the reliever may not have an effect. If after 5 minutes there is no improvement, call the emergency services.
It is always essential to obtain medical assistance if this is the first episode of an asthma attack, if the reliever pump is not effective within 5 minutes, if the patient gets any worse, if their breathlessness is so severe that they find it difficult to speak or if the patient is becoming exhausted.
Whilst waiting for specialist help, continue to comfort and reassure
the patient, and assist them to take their reliever inhaler every 5 to 10 minutes. Continually monitor her breathing and pulse.
If there is any loss of consciousness, open the patients airway and check the breathing. You may need to give chest compressions and rescue breaths if needed. If the patient is unconscious but still breathing, put them into the recovery position and continue to monitor responsiveness, pulse and breathing until assistance arrives.
First Aid Manual (The Authorised Manual of St. John Ambulance, St Andrew’s Ambulance Association and the British St Mark James), 2006.