Asthma and choking

What is an asthma attack?

During an asthma attack, the muscles of the air passages in the lungs go into spasm. As a result, the airways become narrowed, which makes breathing more difficult. Sometimes there is a recognised trigger for an attack, such as a cold, a drug, cigarette smoke or an allergy. At other times, there is no obvious trigger.

Signs and symptoms

Look for:

Difficulty breathing.

Wheezing and coughing.

A tight chest, it may feel like a band is tightening around it.

distress and anxiety.

Difficulty speaking, shown through short sentences and whispering.

Signs of hypoxia such as grey-blue tinge to the lips, earlobes and nail-beds.

Exhaustion, in the case of a severe attack.

What to do

Reassure the casualty and ask them to take their usual dose of their reliever inhaler (usually blue). Ask them to breathe slowly and deeply.

If they have a spacer available, ask them to use it with their inhaler. The inhaler is more effective with a spacer, especially when being used for young children.

If they have no inhaler call 999 or 112 for emergency help.

Sit them down in a comfortable position.

A mild attack will normally ease after a few minutes. However, if they don’t improve within a few minutes, it may be a severe attack. Ask them to take a puff every 30 to 60 seconds, until they have had 10 puffs. Help the casualty to use their inhaler if they need assistance.

If the attack is severe, and they are getting worse, becoming exhausted, or if this is their first attack, call 999 or 112 for emergency help.

Monitor their breathing and level of response. If the ambulance hasn't arrived within 15 minutes, repeat step 3.

If they become unresponsive at any point prepare to give CPR.

If their symptoms improve and you do not need to call 999, advise the patient to get an urgent same-day appointment to see their GP or asthma nurse.

Important: This asthma attack information is not for patients on a Maintenance and Reliever Therapy (MART) plan; this may include a steroid preventer medicine and a certain type of long-acting bronchodilator medicine which can also be used as their emergency reliever. The patient will know which they should use in an emergency and may carry a written plan. 

Choking

What is choking?

When someone is choking, their airway is partly or completely blocked, meaning they may be unable to breathe properly. They might be able to clear it by coughing, but if they can't you will need to help them straight away.

Signs and symptoms

Look for:

Difficulty breathing, speaking or coughing.

A red puffy face.

Signs of distress, and they may point to their throat or grasp their neck.

What to do

Adult choking first aid - if they cannot breathe, cough, or make any noise then they need your help straight away

1.If you think someone is choking, ask them ‘Are you choking?' If they can breathe, speak or cough then they might be able to clear their own throat. If they cannot breathe, cough, or make any noise, then they need your help straight away.

2. Cough it out. Encourage them to cough and remove any obvious obstruction from their mouth.

3. Slap it out. If coughing fails to work, you need to give five sharp back blows.

To do this, help them to lean forwards, supporting their upper body with one hand.

With the heel of your other hand give them five sharp back blows between their shoulder blades.

After each back blow, check to see if there’s anything in their mouth.

4. Squeeze it out. If back blows fail to clear the obstruction, give five abdominal thrusts.

To do this, stand behind them and put your arms around their waist.

Place one hand in a clenched fist between their belly button and the bottom of their chest.

With your other hand, grasp your fist and pull sharply inwards and upwards up to five times. Check their mouth again, each time.

5. If the blockage has not cleared, call 999 or 112 for emergency help straight away. Repeat five back blows and five abdominal thrusts until help arrives, re-checking their mouth each time. 

If they become unresponsive at any point, prepare to start adult CPR.