Video 39 of 46
4 min 24 sec
English, Español
English, Español

Anyone who has experienced an asthma attack will tell you what a frightening situation it can be, as your airways tighten and no matter what you do, you simply cannot get enough oxygen into your lungs.

Pro Tip #1: Want to know what it feels like to have an asthma attack? Imagine only being able to breathe using a thin, plastic coffee stir straw. That would approximate how a severe asthmatic attack would feel.

In this lesson we'll discuss one of the best medications for acute and chronic asthma attacks (Albuterol) and how to use it correctly.

How to Treat a Patient with Asthma

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.

"Hi, my name's _____. I'm a paramedic. I'm going to help you."

Pro Tip #2: Albuterol comes in a small aerosol container with an actuator. Whether the patient's asthma is exercise induced or persistent, the effect should be the same regardless.

In this lesson, we're going to include the use of a spacer with the Albuterol dispenser. Spacers are really expensive, which probably contributes to many people not using one, and sort of resembles a small plastic sippy cup. The spacer goes between the patient's mouth and the Albuterol dispenser.

Warning: When not using a spacer, much of the medication, instead of going into the patient's lungs and bronchials where it should go, winds up sitting at the back of the throat and on the tongue. This obviously decreases the dosage and the effectiveness of that dose.

How to Administer Albuterol Using a Spacer

Pro Tip #3: Before using your Albuterol device, make sure it has actuations remaining. To find this information, look on the back of the dispenser. Most devices have a number there inside a little window that corresponds with the number of actuations remaining. And don't forget to check the expiration date!

  • Shake the Albuterol container just prior to using it. You don't have to shake for long. A few seconds will do the trick.
  • Insert the Albuterol mouthpiece into the end of the spacer where it fits. (It will be obvious.)
  • Place the other end of the spacer into the patients mouth. Make sure he or she completely exhales first.
  • Push down on the Albuterol dispenser one time and instruct the patient to hold his or her breath for 10 seconds.
  • Instruct the patient to exhale.

Pro Tip #4: A normal dosage of Albuterol for most adults is two inhalations and children may be one or two doses. So we need to always ask the patient about their specific dosage.

  • Repeat – patient exhales out all air, puts spacer into their mouth, dispense Albuterol, hold for 10 seconds, and exhale.

If the patient doesn't get relief from two injections, ask them what their prescribed amount of time is between injections and doses. If the patient is still having trouble breathing, call 911 and activate EMS.

They could be suffering from a persistent asthma attack that cannot be stopped with a simple rescue inhaler of Albuterol. Get help on the way immediately, in case the patient begins having a true respiratory emergency.

It's important to avoid assumptions that the patient will get better after administering a dosage of Albuterol. Always be prepared for anything.

A Word About Asthma Triggers

Asthma is an illness in which the airways swell. An asthma attack happens when an asthma trigger, such as exercise, cold air, allergens, or other irritants, causes the airways to suddenly swell and narrow. This makes breathing difficult, which can be very frightening.

The Centers for Disease Control and Prevention (CDC) estimates that approximately 24 million Americans are diagnosed with asthma in their lifetimes. Asthma is more common in children and young adults than in older adults, but its frequency and severity are increasing in all age groups.

You can often tell when a person is having an asthma attack by the hoarse, whistling sound the person makes while inhaling and/or exhaling. This sound, known as wheezing, occurs because air becomes trapped in the lungs.

But what exactly triggers an asthma attack?

A trigger is simply anything that sets off an attack. And they can be very different for different people. Common asthma triggers include:

  • Dust, smoke, and air pollution
  • Exercise
  • Plants
  • Molds
  • Perfume
  • Medications
  • Animal dander
  • Temperature extremes and changes in the weather
  • Strong emotions, such as anger, fear, or anxiety
  • Infections, such as colds or other respiratory infections

Usually, people diagnosed with asthma control their attacks by controlling environmental variables (exposure to those triggers) and through medication and other forms of treatment.

Related Q&A

What are asthma symptoms?

Symptoms that indicate you may be experiencing an asthma attack include:

  • Severe wheezing while breathing in and out
  • Difficulty talking
  • Repeated coughing that doesn’t stop
  • Rapid breathing
  • Chest pain
  • Tightened neck and chest muscles
  • Pale and sweaty face
  • Blue lips or fingernails
  • Feelings of panic or anxiety

What triggers or causes asthma?

Common asthma triggers include:

  • Dust, smoke, & air pollution
  • Exercise
  • Plants
  • Molds
  • Perfume
  • Medications
  • Animal dander
  • Temperature extremes and changes in the weather
  • Strong emotions, such as anger, fear, or anxiety
  • Infections, such as colds or other respiratory infections