An asthma attack is when something (such as dust, pollen, cigarette smoke) triggers a switch in the person that causes their air passages to constrict, tighten, and spasm causing the person to cough, wheeze and have difficulty breathing. They can also be caused by anxiety and tension. Most people who suffer attack on a rather regular basis will carry their medication with them.

If someone you are with is having an attack:

• Help them assume an upright position, this will make breathing easier than lying down. You may want to encourage the person to sit with their legs crossed and their elbows on their knees as this is a relaxing position and may ease breathing.
• Talk to the person calmly and try to get them to relax.
• Make sure they are in an area where there is a good supply of clean air (as opposed to a dusty room)
• As soon as the person is sitting down, have them take their medication. If they cannot then you will have to assist them. Shake the
   puffer and give them one puff of reliever (with or without a spacer), they should then hold that breath for 4 seconds then breathe in and out normally 4 times. Repeat this step four times.
• Wait 4 or so minutes. If there is no improvement repeat the previous step again.
• If there is still no improvement call an ambulance and continue repeating the process until help arrives.

Hyperventilation is rapid short breathing, and the symptoms usually last 15 minutes to half an hour, although to the person experiencing them it will seem much longer. It may be frightening but hyperventilation is usually harmless and can be triggered by things such as:

Anxiety (most commonly)

Extensive physical injuries

Severe stomach pains

Heart or lung disease

If you are hyperventilating:

• Loosely cover your nose and mouth with a small paper bag.
• Slowly breathe into the bag and re-breathe the air in the bag about 10 times.
• Put the bag down and breathe normally for a few minutes before picking up the bag and repeating the previous step again.
• Repeat these steps until the symptoms lessen or go away.
• Try to focus on your breathing and remain clam. Try to take one breath every 5 seconds.

If someone you are with is hyperventilating:

• Stay calm and speak to the person clearly and slowly, if possible make eye contact.

• Don’t crowd the person, give them space and make calming gestures and try to avoid making a scene. If they are not already sitting, have the person sit down.

•  Encourage them to breathe normally, and walk them through the breathing cycle “breathe...slowly...hold…release…slowly...rest…breathe…” and do the cycle with them. You’ll want to pause for 1-2 seconds while holding the breath, and before inhaling again.

• If they are doing it right, calmly encourage them to keep going while continuing to breathe evenly and slowly.

Panic attacks are brought on by social situation and activities that are perceived as a threat to the person experiencing them. They can happen to anyone, and are usually not a serious threat. They can however occur rapidly and repeatedly, and even after the attack the person may be highly anxious for many hours afterwards.  

Symptoms (not all will be present at once):

• Shortness of breath with rapid breathing, or hyperventilation
• Palpitations or accelerated heart rate (when you can ‘feel your heart pounding’)
• Trembling or shaking
• Choking
• Chills, or flushing
• Sweating
• Nausea
• Numbness, or pins and needles in the arms and legs
• Chest pain or discomfort in the chest region (if pains persist after attack see a doctor, it may be signs of a heart attack)
• Fear of dying
• Fear of going crazy or doing something crazy

You treat a panic attack the same way you would treat someone who is hyperventilating.

• Stay calm and speak to the person clearly and slowly, if possible make eye contact.

• Don’t crowd the person, give them space and make calming gestures and try to avoid making a scene. If they are not already sitting, have the person sit down.

• Encourage them to breathe normally, and walk them through the breathing cycle “breathe...slowly...hold…release…slowly...rest…breathe…” and do the cycle with them. You’ll want to pause for 1-2 seconds while holding the breath, and before inhaling again.

• If they are doing it right, calmly encourage them to keep going while continuing to breathe evenly and slowly.

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