In an emergency try to stay calm. It helps to remember the six asthma steps:






All OK





Mild symptoms indicating that asthma is worsening can include:

A slight wheeze

Mild cough

Coughing or wheezing when excited or running

Moderate symptoms indicating that asthma is worrying can include:

Obvious breathing difficulties

Persistent cough

Difficulty speaking a complete sentence

Severe symptoms indicating an asthma emergency can include:


Gasping for breath

Difficulty speaking more than one or two words

Looking pale and sounding quiet

Complaining that the reliever medicine is not working

Unresponsive – doesn’t answer when spoke to

DIAL 111 for an ambulance.


Sit your child upright and stay with them. Lean them forward slightly and support their arms either on their knees or on a table.


Treat mild asthma symptoms with two puffs of a reliever inhaler. Treat moderate or severe symptoms with six puffs of the inhaler. If the reliever medicine comes in a metered dose inhaler, use a spacer. Put the spacer into the child’s mouth. Puff the inhaler once into the spacer and have the child breathe in and out six times.

Encourage your child to breathe as normally as possible.


If your child’s asthma does not start to get better after six minutes, or if you or your child are frightened, call an ambulance. Continue giving your child six puffs of their reliever inhaler every six minutes until help arrives. Make sure they take six slow breathes for each puff. Keep doing this until they get better, or the ambulance arrives.

Remember: Six puffs … six breaths for each puff … and repeat every six minutes


Stay with your child and watch carefully, even if they seem to get better. If your child is not finding it easier to breathe, give repeat doses of the reliever inhaler and call an ambulance.

All OK

Your child can return to quiet activities when they no longer wheeze, cough or feel breathless. Keep monitoring their symptoms and take action if required, following the steps in their action plan. If your child’s attacks are becoming more frequent or worrying, see your doctor as soon as possible.

You can find ‘What should I do in an emergency’ on pages 23 and 24 of our Managing Your Asthma booklet. (You may like to cut this page out of the booklet and put it somewhere you can easily find it, such as on the fridge).