Asthma Attack
If your child’s asthma suddenly gets worse, they need urgent treatment. Signs of an asthma attack include:
- Sounding very wheezy
- Having a tight chest
- Finding it hard to breath
- Being too breathless to talk or walk
Sometimes there is no obvious cause for your child’s asthma attack. The most common triggers are viral infections (coughs, colds and chest infections), emotional anxiety and exposure to airway irritants such as cigarette smoke.
What should I do if my child is having an asthma attack?
1. Sit your child upright
2. Keep them calm and reassure them
3. Refer to your child’s action plan and follow the instructions. If your child does not yet have their own plan see here.
Please see Red-Amber-Green tables for advice on when and where to seek care for your child.
When should you worry?
If your child has any of the following:
- Not improving despite using their inhaler according to their action plan
- Breathing very fast, too breathless to talk, eat or drink
- Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
- Breathing that stops or pauses
- A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Has a fit (seizure)
- Has a rash that does not go away with pressure (the glass test)
You need urgent help
Go to the nearest Hospital Emergency (A&E) Department or call 999 - dial 999.
Keep your child upright and reassure them.
Get your child’s inhaler and follow your action plan.
If your child has any of the following:
- They need increased doses of their inhaler for more than 2-3 days
- Breathing a bit faster than normal or working a bit harder to breathe
- A harsh noise as they breathe in (stridor) only when upset
- Dry skin, lips or tongue
- Not had a wee in last 8 hours
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please contact your GP surgery or NHS 111 – dial 111.
Continue to follow your child’s action plan while seeking advice.
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If none of the above features are present
Watch them closely for any change and look out for any red or amber symptoms.
Continue to follow your child’s action plan while seeking advice.
If your child has other symptoms associated with their asthma attack, you might want to look at our information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways.
Self care
If you are still worried, please see your local pharmacist or call NHS 111 - call 111.
Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
Self care and Prevention
Asthma attack prevention
The most common triggers are viral infections, emotional disturbance and exposure to airway irritants such as cigarette smoke.
Things you can do to reduce the chance of your child having an asthma attack.
1. Get your child’s asthma under control
Children with poorly controlled asthma are much more likely to have an asthma attack. Make sure your child follows their action plan.
Signs of poorly controlled asthma:
- Needing additional doses of inhaler 3 or more times a week
- Wheezy after exercise
- Persistent night-time cough
If your child has symptoms of poorly controlled asthma they should be reviewed. Make an appointment with their GP or asthma nurse.
It is important to have a yearly asthma review with your asthma nurse or GP. Everyone with asthma should have an action plan.
2. Get the inhaler technique right
Watch these Beat Asthma videos on how to help your child use their inhaler.
Your child’s asthma will not be controlled if their medicines are not getting into their lungs.
If your child has been given a spacer:
- Check the inhaler contains medicine and shake. Reliever inhalers have a maximum of 200 doses but will continue to fire when empty.
- Remove the cap
- Fit the inhaler into the end of the spacer
- For spacer with mask, place the mask over the nose and mouth and ensure a good seal. For spacer and mouthpiece, place teeth around the mouthpiece and seal with lips. Most children over 3 years can use a mouthpiece
- Press the inhaler once and encourage the child to take 5 slow breaths or count to 10 slowly whilst they breath normally through the spacer
- Shake the inhaler and repeat steps 4 and 5 if more puffs are needed
See your practice nurse or doctor if you are not sure whether your child is using their inhaler properly.
3. Avoid triggers where possible
Even when adults smoke away from their children, smoke on their clothes and hair can make their child’s asthma worse.
If needed visit the Healthier Together page on how to stop smoking.
4. Your child should have an influenza immunisation every autumn (the flu jab)
Flu viruses can trigger asthma symptoms. Current guidelines in the UK recommend that high-risk groups such as people with severe asthma should have a flu jab each winter.
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