As temperatures fall, people with asthma often face more severe symptoms. A sudden asthma attack can be frightening and may escalate quickly. If you or someone near you develops intense breathlessness and wheezing during winter and there is no inhaler to hand, acting decisively can be lifesaving.
Responding to an asthma attack in winter
First, assess the situation. If the person is struggling to speak in full sentences, has blue lips or face, is becoming drowsy or confused, or if breathing is extremely shallow or rapid, call emergency services without delay. These are signs of a life-threatening attack and require immediate professional help.
If the attack appears less severe but the person is clearly breathless and distressed, help them to sit upright. Sitting forward slightly with elbows resting on the knees or on a chair arm can make breathing easier than lying down. Keep the person calm; panic raises heart rate and worsens breathlessness.
Encourage slow, controlled breathing. A recognised technique is to inhale through the nose if possible and exhale slowly through pursed lips, as if gently blowing out a candle. This approach can reduce the sensation of breathlessness and prevent hyperventilation.
If a quick-relief (short-acting beta-agonist) inhaler is available for the patient, use it immediately. The standard emergency routine is to give one to two puffs via a spacer if one is available, or as the inhaler instructs, and repeat every few minutes up to the recommended limit while monitoring response. If the person’s regular inhaler is not available but another person nearby has a reliever inhaler, using that inhaler in an emergency is preferable to waiting. Clean the mouthpiece where possible and use a spacer or hold it slightly away from the mouth if no spacer is present.
If no inhaler is available at all, do not delay contacting emergency services. While waiting, keep the person warm but avoid overheating, as heavy bedding can restrict chest movement. Offer small sips of warm water if they can swallow safely; do not give anything by mouth if there is severe breathlessness, altered consciousness, or risk of choking.
Do not attempt to administer oral steroids or other medications unless prescribed and the person can take them safely and is able to follow instructions. Oxygen should only be given by trained personnel; if an ambulance is on the way, paramedics will assess and provide oxygen or nebulised bronchodilators as required.
After an attack, even if symptoms settle, the person should be reviewed by a healthcare professional. A settled attack can flare again within hours. Winter months often bring respiratory infections and cold air that aggravate asthma, so consider an updated action plan with a GP or chest specialist and ensure a working reliever inhaler and spacer are always accessible.
Preparation is key. Patients should keep an inhaler and spacer at home, in the car and at work if possible, and carry a written asthma action plan. Close contacts should know how to help and when to call for emergency assistance. Prompt, calm action can prevent a severe asthma attack from becoming fatal.
Key Takeaways:
- Winter can trigger an asthma attack; stay calm and sit upright to ease breathing.
- Try controlled breathing and a quick-relief inhaler; if none is available, call emergency services immediately.
- Use a spacer or share a reliever inhaler only as a last resort; seek hospital care for persistent or worsening symptoms.
