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+First Aid Pocket GuideAustralian quick-reference

First-aid guides Asthma attack

Australian quick reference

Asthma attack

How to help someone having asthma symptoms in Australia.

Serious or worsening symptoms? Call Triple Zero (000).

The short answer

Sit the person upright and follow their written asthma action plan. If there is no plan and a blue/grey reliever is available, give 4 puffs through a spacer, one puff at a time with 4 breaths after each, then wait 4 minutes. Call 000 immediately for severe or rapidly worsening symptoms.

Use the person’s plan first

Asthma first aid in the next four minutes

Sit the person upright, stay with them and follow their written asthma action plan. Call Triple Zero (000) immediately for severe or rapidly worsening symptoms.

Asthma first aid decisions
What you findDo next
Mild or moderate symptomsSit upright and help with the person’s prescribed reliever and spacer, following their written asthma action plan.
No plan, blue/grey reliever availableGive 4 separate puffs through a spacer, one puff at a time with 4 breaths after each puff. Wait 4 minutes.
Not back to normal after 4 minutesRepeat the reliever sequence and call 000 if there is little or no improvement. Keep repeating as directed while waiting.
Severe, sudden or uncertain symptomsCall 000 immediately. This includes inability to speak, blue lips, exhaustion, not breathing, sudden worsening or a reliever not helping. If sudden breathing difficulty follows a known allergy, give adrenaline first if available, then the asthma reliever.

Four things to remember

See the next decision

These visual cues are a memory aid. In a real emergency, call Triple Zero (000) and follow the call-taker's instructions.

DO THIS FIRSTStart here

Sit the person upright, stay calm and keep them with you.

RECOGNISELook for this

Coughing, wheeze, chest tightness or shortness of breath may be mild at first.

DO NOTAvoid this

Do not lie the person flat.

CALL 000Escalate when needed

Severe breathing difficulty, blue lips, exhaustion, inability to speak, sudden worsening or little/no relief from the reliever requires 000.

Illustrated field notes

These original illustrations support recall. They are not a substitute for the written steps, a current first-aid course or the Triple Zero (000) call-taker.

Illustration of a person with asthma symptoms sitting upright while a helper brings a reliever and prepares to call for help.
Sit uprightHelp them follow their plan

Sit upright, stay calm and use the person’s own asthma action plan.

Educational illustration of a child using a generic reliever puffer with a spacer while a caregiver supports them.
Use the relieverUse a spacer if available

Follow the person’s prescribed plan and device instructions.

Illustration of a person with severe breathing difficulty while a helper calls Triple Zero and keeps them upright.
Call 000Escalate severe symptoms

Call 000 for severe difficulty, exhaustion, inability to speak or little relief.

Illustration of a helper showing an asthma action plan and reliever information to ambulance responders.
After the attackShare the action plan

Tell responders what was used and arrange medical review after the attack.

Visual memory cue

See the pattern before you practise

Use this simple visual reminder alongside the written steps. In a real emergency, call Triple Zero (000) and follow the call-taker's instructions.

  1. 01Sit uprightStay calm and stay with them.
  2. 02Give relieverFollow the action plan or 4 x 4 fallback.
  3. 03Wait 4 minutesRepeat if breathing is not normal.
  4. 04Call 000Call immediately for severe symptoms.

01

What to do first

  • Sit the person upright, stay calm and keep them with you.
  • Follow their written asthma action plan and help with their prescribed reliever and spacer.
  • If there is no plan and a blue/grey reliever is available, give 4 separate puffs through a spacer, taking 4 breaths after each puff.
  • Wait 4 minutes, then repeat the reliever sequence if breathing has not returned to normal. Call 000 immediately if symptoms are severe or rapidly worsening.
  • Keep giving reliever medication as instructed by the 000 call-taker while waiting. If they become unresponsive and are not breathing normally, start CPR.

02

What to avoid

  • Do not lie the person flat.
  • Do not leave them alone.
  • Do not delay 000 for severe symptoms.
  • Do not guess a device-specific dose when the person has a written action plan.

03

When to call 000

  • Severe breathing difficulty, blue lips, exhaustion, inability to speak, sudden worsening or little/no relief from the reliever requires 000.

04

What to monitor

  • Keep watching breathing, colour, speech and response.

Recognition cues

What you may notice

  • Coughing, wheeze, chest tightness or shortness of breath may be mild at first.
  • A severe attack can include difficulty speaking, gasping, exhaustion, drowsiness or blue lips.
  • Little or no relief from the reliever is an emergency warning.

Avoid these traps

Common mistakes

  • Lying the person flat or leaving them alone.
  • Delaying 000 when breathing is severe or the reliever is not helping.
  • Using someone else's written action plan instead of the person's own plan and call-taker advice.
  • Guessing a device-specific dose when the person has a written plan.
Children and babies

Sit the child upright, stay calm and use their written asthma action plan where available. Give the prescribed reliever through the child’s spacer and mask or mouthpiece as instructed; repeat the 4-breath cycle for each puff. Call 000 immediately for a severe attack, sudden worsening, exhaustion, blue lips or little/no improvement, and follow the call-taker.

When help is on the way

Keep the handover useful

  • Keep the person upright, calm and supervised while following the asthma action plan and 000 instructions.
  • Arrange medical review after an attack, even if symptoms improve, and update the written plan with the doctor.

Common questions

Quick answers

What if I am not sure whether it is asthma or anaphylaxis?

If there is a known allergy and sudden breathing difficulty, use the adrenaline autoinjector first if available, then give the asthma reliever and call 000.

What if there is no spacer?

Follow the person’s action plan or device instructions. If a spacer is unavailable in an emergency, give the reliever as directed while arranging emergency help.

Should they drink water?

Focus on the asthma action plan, reliever medication and emergency help rather than drinks.

What if I am unsure whether it is asthma or anaphylaxis?

If there is a known allergy and sudden breathing difficulty, give the adrenaline autoinjector first if available, then the asthma reliever and call 000.

Does everyone use the 4 x 4 fallback?

No. Follow the person’s written asthma action plan and medicine-specific instructions first. The 4-puff, 4-breath, 4-minute fallback is for a blue/grey reliever when no plan is available; other devices have different instructions.

When should I call 000?

Call immediately for severe or rapidly worsening breathing difficulty, blue lips, exhaustion, inability to speak, not breathing, a reliever that is not helping, or when you are unsure what is happening.

When should I call 000 for asthma?

Call 000 for severe breathing difficulty, blue lips, exhaustion, difficulty speaking, drowsiness or little or no relief from the reliever.

Should the person lie down?

No. Sit them upright and help them follow their own asthma action plan.

What if I am not sure whether it is asthma or anaphylaxis?

If there is a known allergy and sudden breathing difficulty, give the adrenaline autoinjector first if available, then give the asthma reliever and call 000.

Keep it close

Print the reminder

Asthma action guide
References and update notesAugust 2026

Expanded recognition cues, action-plan-first dosing boundaries, severe-attack escalation, spacer context and asthma/anaphylaxis distinction against current Healthdirect and Asthma Australia guidance.