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There may be a time when you have to treat a patient having an Asthma attack who either does not have their inhaler with them or has an inhaler that is empty. it may be that their inhaler is empty.
In these cases where a replacement is not available, you would need to take other measures to control the attack before help arrives.

The first thing is to see if you can locate their replacement medication or maybe send someone for it if this is possible as the inhaler is the best treatment. Find out if there are any other medications their Doctor has prescribed for them to control their Asthma. Also make sure you call the EMS, as this advice will only usually help them control their breathing until the inhaler and professional help arrives.

The general advice is to first stop what they were doing to just concentrate on treating asthma and sit them upright as bending over or laying down can constrict the breathing even more. They will feel more comfortable if they are sat up but they may find a more comfortable way to position themselves.

Get them to take long and deep breaths which can slow down the breathing and prevent them from hyperventilating which will make the attack worse. Breathing in through the nose and out through the mouth also helps. Breathing out through the mouth slowly keeps the airways open for longer.

Moving the person to a steamy atmosphere such as a bathroom with the shower can increase the humidity in the air and this may help.

Keeping them calm is very important and although this may not be easy, do your best to calm the situation and take any worry from them. Stress causes the chest muscles to tighten which can make breathing more difficult.

If possible remove the person from the trigger that causes their Asthma. It may be their trigger is dust or smoke so move them to a place where the air is clear. Taking them to an air-conditioned area may help them.

Sometimes hot caffeinated drinks can help open up their airways, giving them some relief for an hour or two.

This advice can help them in the short term but you must get professional help as soon as possible.

It may be that the person has an inhaler but it is not working effectively, so there are a few things you can do to ensure that the inhaler is ready every time it is needed.

Ensure that the inhaler is always clean and that the cover is always put back on to avoid dirt and dust getting inside. Inhaling dust or dirt will make the situation worse.  You should also ensure that if a spacer is used, it is kept clean and dry. Also, change the mouthpiece when needed or every few months.

Ensure the inhaler actually has the drug inside and you are not just breathing propellant.

  • Make sure that a spare canister is carried when the level is low.
  • Make sure the latest prescription is collected from the chemist.
  • Make sure a spare inhaler is carried if going away on holiday or a work trip.

If you work in a school that holds inhalers, ensure the correct documentation is kept and that there are sufficient inhalers for the number of children in your care.

Make sure the correct inhaler is used at the right time. Using a preventative inhaler in an emergency will not have the same effect as the correct inhaler.

Ensure the inhaler is used correctly. Sometimes children blow instead of breathing in and make sure that subsequent doses are delivered at the right times.

Finally, ensure that the inhaler is in date as the medication may not be effective past its expiry date or the propellant may not deliver the correct amount of drug.