Asthma Puffer Use In First Aid

Let’s talk about Asthma and why it is a concern. It’s on the increase in our community and appearing more and more in our children.  There are many theories is about why this happens. But if someone panics during an attack, as first aiders we can assist them to use an Asthma Puffer. Here’s how …

With an Asthmatic there are three mechanisms that occur.  The first one is whatever the reason that causes it to happen; the muscles in the airway actually go into spasm. 

The second thing is that because the airways are being irritated, the tissue responds by swelling up.  So not only are the muscles going into spasm and closing up but they are now also swelling up as well.  And also because it is the lungs, the way that they defend against irritants is that they produce mucus.

So now the poor asthmatic not only has to breathe through an airway that’s in spasm and it’s narrower than normal, they also have to breathe through this excess mucus.

Symptoms Of Asthma Attacks

So the sorts of things that we get with an asthmatic are:

Typical Asthma Puffer or Ventolin Inhaler

Typical Asthma Puffer

  • They all have a shortness of breath.
  • They may have an audible wheeze.
  • They can be gasping for air
  • They may mumble sentences
  • Their skin can become quite pale
  • They get blue around the lips
  • And a tightness in the chest

The thing with all these signs is you may actually miss what’s going on with them.  But the main ones are they will have shortness of breath and tightness in the chest.

Using An Asthma Puffer

So what we do is use a device called a Ventolin Inhaler or Asthma Puffer.  They are generally a grey or blue colour.  But there are a lot of inhalers out there.  There are red ones, brown ones, green ones, purple ones or orange ones and more.  They all have different purposes and requirements. Some of those are preventers. They are steroid based inhalers that they’d take in the morning or the afternoon.  They would settle all the inflammation down.  And some are a mixture of relieving medication and a preventative.  But the lead medication comes in a grey or blue asthma inhaler.

Now what happens with some asthmatics is “in the moment” or because they panic they may not use the asthma puffer properly.  As a first aider you can actually assist them with their medication.  Give the inhaler a shake.  Sit the casualty up or stand them up or if they are having a severe asthma attack have them lean against a hard surface. They should arch their back or drop their chest to try and make that chest volume a little bit larger.

The open end goes into their mouth.  Tell them to breathe out. Breathe in.  Then get them to hold their breath for 4 seconds.  1, 2, 3, 4 and then breathe out

Go again, breathe in, 1, 2, 3, 4. Then breathe out.

Again.  And then a fourth time.

Use the asthma puffer for four inhalations holding their breath for 4 seconds each time.  After that wait for 4 minutes.  If there is no improvement you do it again. Do another cycle of 4 breaths and holding it for 4 seconds.

You can overdose on Ventolin. What it does is make their pulse rate race and they can feel a little bit anxious. So it’s very important, this person will be distressed. They can’t breathe.

Talk to them – everything’s going to be fine, help is on the way, those sorts of things. It’s very important to keep the situation under control.

Using A Ventolin Spacer

Ventolin Spacer that connects to asthma puffer

Spacer Connected To Asthma Puffer

Another device that’s commonly used is called a Spacer. It’s a more efficient way of delivering Ventolin. The problem is Spacers are quite bulky. They don’t sort of fit into your back pocket. You’ll generally find that Asthmatics won’t carry one with them.

They are brilliant, especially for children because Spacers are so easy to use. Again, the thing you need to remember about this protocol is just “Fours”.

One end goes into the mouth of the casualty and the asthma puffer just plugs into the other end. It has a little one-way plug valve so that they can breathe in and out through it.

Like before, get them to relax. Press and it sprays the Ventolin into their mouth. They breathe through this, four deep breaths in and out through the tube.

Go again, in and out four times through the tube. A third time and then a fourth time. The vapour stays in the column more efficiently and they get a lot more Ventolin into their lungs.

Just like before, wait 4 minutes. If there is no improvement do the whole procedure again.

So that’s the practice for using Asthma Puffers. Are there any questions?

Questions About Asthma Puffers In General

What’s the maximum number of puffs you can give a person?

According to the Australian Resuscitation Council Guidelines you just continue giving them the puffs. There are other organisations out there such as National Asthma Council that have their own protocols.

What are the legal ramifications of having an Asthma Puffer in a first aid kit?

There are side effects. They will have a racing heart and those sorts of things. If someone is an Asthmatic they should really be carrying their own with them. In an emergency I guess you can use it. This is a pharmacy prescribed medication so you can’t get it over the counter. There really are not too many downsides of using this. But when you are giving it you need to make sure you are giving it appropriately for that condition.