Emergency asthma plan: what to do during an attack

An asthma attack can escalate fast. A clear, practiced plan keeps you calm and helps you act right away. Below are the practical steps most doctors recommend and the warning signs that mean you need urgent help.

During an asthma attack — immediate steps

1. Stop and sit up. Stay upright; try to breathe slowly. Panic makes breathing harder.

2. Use your reliever inhaler now. A common emergency approach is 4 puffs of a short-acting bronchodilator (for example, albuterol/salbutamol) using a spacer if you have one. Take one puff at a time and breathe in slowly. If you don’t have a spacer, follow your doctor’s inhaler technique instructions.

3. Wait and reassess. After the first set of puffs, wait about 4 minutes. If symptoms improve, keep monitoring. If there’s only partial relief, repeat the reliever dose as your action plan or doctor advises.

4. Call for help if things don’t improve. If breathing stays hard, you’re getting worse, your lips or face turn blue, you can’t speak full sentences, you’re very drowsy, or you don’t respond to reliever medicine — call emergency services immediately.

5. Use your written asthma action plan. If your doctor gave you a personalized plan with exact doses and steps, follow it. That plan should say when to increase reliever use, when to start a short steroid course (if prescribed), and when to seek emergency care.

Prepare and prevent — make your plan real

Write down a simple action plan and keep it somewhere obvious. Include: your usual reliever dose and device, emergency contact numbers, any steroid rescue instructions from your doctor, and the nearest emergency room.

Know your peak flow numbers. If you use a peak flow meter, learn your personal best and the zone cutoffs: green means 80–100% of your best (all clear), yellow is 50–80% (use reliever and contact your clinician), red is under 50% (seek urgent care now).

Keep a working spacer and an in-date inhaler handy at home, work, and school. Practice inhaler technique with a clinician — many attacks are worsened by poor technique. Teach family or coworkers how to help you and where your plan is stored.

After any attack, see your doctor even if you feel better. They’ll review what happened and adjust preventer meds if needed so the next attack is less likely.

Make the plan personal: write exact doses, get everyone to know it, and review it once a year or after each attack. Being ready reduces panic and gets you the right care fast.