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Asthma attack
If your child’s asthma suddenly gets worse (asthma attack), they will need urgent treatment. Signs of an asthma attack include:
- Being very wheezy
- Coughing
- 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.
A child asthma action plan will help you and your child to manage their asthma. If your child does not have one yet you can download a child asthma plan for free.
When should you worry?
Call 999 if your child’s:
- Reliever inhaler is not helping their symptoms
- If they do not have their reliever inhaler or if you’re worried at any time.
- Too breathless to talk / eat or drink
- Has blue lips
- Having symptoms of cough/wheeze or breathlessness which are getting worse despite 10 puffs blue (salbutamol) inhaler every 4 hours
- Confused and drowsy
Ring 999 for immediate help.
Give one puff of your reliever inhaler every 30 to 60 seconds up to a total of 10 puffs. If you don’t have your reliever inhaler or it’s not helping, call 999 straightaway.
Whilst waiting for an ambulance, you can use your reliever inhaler every 30 to 60 seconds (up to 10 puffs every 10 minutes
Keep child in upright position and reassure them.
If your child is:
- Wheezing and breathless and blue (salbutamol) reliever inhaler is not lasting 4 hours
- Having a cough or wheeze/tight chest during the day and night
- Too breathless to run / play / do normal activities
- Needing to use their reliever inhaler three or more times a week
- Waking up at night coughing or wheezing
- Needing time off school or nursery because of their asthma.
Immediately contact your GP and make an appointment for your child to be seen that day face to face
Give up to 6 puffs of your reliever inhaler every four hours. If this is not working, or the symptoms return within four hours, or you are worried about your child, arrange for urgent review by a health professional.
If your child is not improving after 24 hours arrange for same day review by a health professional.
If you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency Department
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 Asthma action plan while seeking advice.
Your child has mild cough and wheeze, but is able to continue their normal day to day activities.
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 our other pathways.
Self care
Give 2 puffs of your reliever inhaler up to every four hours as needed until symptoms improve.
This guidance was last reviewed 20/12/2024.
What can you do to reduce the risk of your child having another asthma attack?
Make sure your child takes their medicines
Your child will usually have a preventer inhaler and a reliever inhaler. Make sure:
• they take their preventer inhaler every day as prescribed.
• your child always has their reliever inhaler with them.
• your child uses a spacer if their inhaler is a pMDI (pressurised metered dose inhaler).
Find out more about your child’s asthma medicines. If your child has been diagnosed with severe asthma, they might have a slightly different treatment. Find out more about caring for a child with severe asthma.
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.
To watch a video on encouraging children to use their inhalers effectively please click here.
Check your child’s inhaler technique
Your child’s GP or nurse will check your child’s inhaler technique at their yearly asthma review. But you can also make sure their inhaler technique is correct day-to-day. Our inhaler technique videos can help you.
Your child’s asthma will not be controlled if their medicines are not getting into their lungs.
See your practice nurse or doctor if you are not sure whether your child is using their inhaler properly.
Avoid triggers where possible:
It can be helpful to monitor your child’s asthma symptoms over time to work out what their triggers might be, or if their asthma is getting worse.
Although it is extremely difficult to avoid your child getting a viral infection or experiencing changes in the weather, you can reduce exposure to common irritants such as cigarette smoke. Even where adults smoke away from their children, smoke on their clothes and hair is likely to make their child’s asthma worse.
If needed visit the your local stop smoking site.
Your child will be eligible for the influenza (Flu) immunisation every autumn.
Not only can flu trigger an asthma attack in your child, your child is more likely to experience severe influenza if they have asthma. Protect them by having them vaccinated every year.
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.