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Asthma is a disorder of the small airways of the lungs. People with asthma have sensitive airways which can narrow when exposed to certain ‘triggers’, leading to difficulty in breathing.

Three main factors cause the airways to narrow:

1. The muscle around the airway tightens (bronchoconstriction).

2. The inside lining of the airways becomes swollen (inflammation).

3. Extra mucus (sticky fluid) may be produced.

Trigger factors for asthma include:

Colds and flu.

Cigarette smoke.


Inhaled allergens e.g. pollen, mould, dust mites.

Environmental factors e.g. dust, pollution, smoke.

Changes in temperature and weather.

Certain medications e.g. aspirin, beta-blockers.

Chemicals and strong smells e.g. perfume, cleaning products.

Emotional factors e.g. stress, laughter.

Foods e.g. nuts, seafood.

Food additives e.g. preservatives, flavourings.

The onset of an asthma attack can be recognised by one or more of the following signs and symptoms:

Shortness of breath.

Wheezing when exhaling, remember not all asthma sufferers wheeze.

Dry or moist persistent cough, particularly at night, early morning and with exercise.

Tightness of the chest.

Signs of a severe asthma attack include:

Gasping for breath.

Severe chest tightness.

Inability to speak more than one or two words per breath.

Thirst due to loss of water vapour from the lungs.

Feeling distressed and anxious.

Increasing pulse rate.

Pale, sweaty skin.

Drawing in of the spaces between the ribs and above the collarbones with the effort of breathing.

Blue colour around the lips.

Little or no improvement after using reliever medication.

Collapse, leading to respiratory arrest.



If you know the casualty’s asthma management plan, follow its guidelines. Assist the casualty to:

Follow the DRSABCD emergency action plan

Sit in a comfortable upright position.

Be calm and reassure the casualty.

With a Spacer

Shake the inhaler and insert the mouthpiece into the spacer.

Place spacer’s mouthpiece in the casualty’s mouth and give four separate puffs of a blue/grey reliever puffer.

Ask the casualty to breathe in and out normally four times after each puff.

Wait four minutes, if there is little or no improvement, repeat the above sequence.

Without a Spacer

Shake inhaler.

Place the inhaler’s mouthpiece in the casualty’s mouth, deliver one puff as the person inhales slowly and steadily.

Ask the casualty to hold that breathe for four seconds, then take four normal breaths.

Repeat until four puffs have been given.

Wait four minutes, if there is little or no improvement, repeat the above sequence.

If still no improvement:

Call 000 for an ambulance.

Continuously repeat reliever medication every four minutes until the ambulance arrives.

Collapsed Casualty

Follow the DRSABCD emergency action plan.

If possible, assist four puffs of a reliever.

If little or no immediate improvement:

Repeat reliever medication every four minutes until the ambulance arrives.

Be calm and reassuring.

If the casualty is not breathing give rescue breaths. In severe asthma attacks, rescue breathes require much greater force to inflate the lungs.

Be prepared to commence CPR.

You will not harm the casualty by giving a reliever if they are not suffering an asthma attack.


For further information on asthma visit:

The National Asthma Council Australia

1800 032 495

Asthma Australia

1800 645 130

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