Doctor shares the signs and first-aid steps for immediate care after asthma attack

If you or a loved one is experiencing an asthma attack, it can feel overwhelming. It can turn any moment into a serious medical emergency. During an attack, it's vital to follow the right steps, not just to manage the high stress of the situation, but most importantly, to reduce the life-threatening risks associated with asthma. Timely intervention can make all the difference, sometimes between life and death.

In an interview with HT Lifestyle, Dr Ravi Shekhar Jha, Director of Pulmonology at Fortis Escorts Hospital, Faridabad, shared the first effective ways to address the situation.

He gave a glimpse of the large number of people in India affected by asthma, making it all the more important to know first aid, as it could be either a loved one or someone stranger in need in your immediate vicinity.

Dr Ravi Shekhar said, “For over 34 million Indians with asthma, the fear of a sudden attack is a constant reality. While many live symptom-free for long periods, an asthma exacerbation, triggered by allergens, infections, or pollution, can escalate within minutes. In such moments, knowing what to do at home can mean the difference between recovery and crisis.”

Dr Ravi Shekhar provided this detailed guide that covers, from identifying the early signs of when an asthma attack is about to happen to first aid steps:

How to recognise the signs of an asthma attack?

• An asthma attack doesn’t always start with dramatic symptoms.
• Often, it begins subtly: a persistent cough, mild chest tightness, or increasing breathlessness during regular activity. These early warning signs are easy to overlook, but responding quickly can prevent escalation.
• Most of the asthma attacks happen at night.
• More serious symptoms include rapid breathing, difficulty speaking in full sentences, visible chest retractions (especially in children), and bluish lips or fingernails. If these signs appear, it is already a medical emergency.

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First-aid steps

Step 1: Use a reliever inhaler immediately

• The first line of defence in any asthma emergency is a short-acting beta-agonist (SABA) inhaler, such as salbutamol (commonly known as asthalin or levolin or duolin or ventorlin).
• The “rule of 4” is widely recommended: 4 puffs, via a spacer, every 4 minutes for up to 4 cycles.
• Spacers, often overlooked, help deliver medication more effectively and are especially useful in children or the elderly.
• If the person has been prescribed a different rescue medication, it should be used as directed.

Step 2: Sit upright and stay calm

• Positioning can help ease breathing.
• Sit upright with shoulders relaxed and avoid lying down, which may worsen breathlessness.
• Anxiety can exacerbate symptoms, so reassuring the person and encouraging slow, steady breaths is crucial.

Step 3: Avoid triggers

If the trigger is known—smoke, dust, pollen, or strong odors—remove the person from that environment immediately. In many urban Indian homes, incense, mosquito coils, and cooking fumes can act as potent irritants. Good ventilation matters.

Step 4: Monitor response

• If the inhaler brings no relief after 10–15 minutes or if symptoms worsen, do not delay calling emergency services.
• One of the most dangerous myths in asthma care is the belief that all attacks can be handled at home.
• In fact, many asthma-related deaths result from delaying medical help.

Step 5: Prepare for the next time

• An asthma action plan, created with a healthcare provider, can be life-saving.
• This should outline daily medications, early warning signs, and steps to take during an attack.
• Every asthmatic household should have this plan visible, with rescue inhalers always accessible and unexpired. Emergency management of asthma at home is not a substitute for medical care, it is a bridge until help arrives.
• The rising pollution levels in cities, seasonal allergens, and increasing rates of respiratory illness mean that preparedness is no longer optional.

How to keep your home protected for asthma patients?

Homes need to be well-cleaned, as they can trigger asthma attacks, whether it’s due to dust mites or poor air quality caused by rising pollution in urban areas. Managing indoor air quality is just as important.

Dalila El Zein, Dyson Senior Research Engineer, shared some effective ways you can keep your indoors clean:

• Many people don’t realise that traditional cleaning methods, like using a broom and cloth, often stir up dust particles, releasing them into the air and making allergies worse. Instead of eliminating allergens, these methods may end up spreading them further. Vacuuming with devices equipped with advanced filtration systems is far more effective. HEPA filtration technology ensures that allergens are removed from floors, upholstery, and mattresses rather than floating back into the air.
• This makes it important to vacuum regularly. Don’t limit vacuuming to the floors; prioritise overlooked areas like sofas, cushions, and mattresses to tackle allergen hotspots.
• While opening windows may seem like a natural choice to freshen your space, it can also welcome outdoor allergens inside. Invest in an air purifier instead.

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Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.