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Parent’s Guide

Parent’s Guide: Managing an Asthma Attack

⚠️ Important: Use this guide only if a doctor has already diagnosed your child with asthma. If your child has never been diagnosed but is struggling to breathe, seek medical help immediately.

1

Is this an Asthma Attack?

An attack happens when the airways tighten and swell. Look for these signs:

  • Wheezing: A high-pitched whistling or purring sound, usually heard when your child breathes out.
  • Tight Chest: Your child may complain their chest feels heavy or hurts.
  • Coughing: A frequent dry cough.
  • Retractions: The skin pulls in between the ribs or at the neck when breathing.

2

Check the “Zone” (Severity Scale)

If your child is old enough (usually 6+), use their Peak Flow Meter to get a number. If not, rely on what you see and hear.

ZoneSeveritySymptomsPeak Flow Rate (PFR)
GREENMild / Doing WellNo symptoms. Normal talking, playing, and sleeping.80-100% of normal
YELLOWModerate / CautionMild: Cough or wheeze comes and goes.
Getting Worse: Chest feels tight. Breathing is faster. Ribs pull in slightly. Can speak in phrases but maybe not full sentences.		50-80% of normal
REDSEVERE / DangerShort of breath even while sitting still. Can only speak in single words. Struggling to breathe. Ribs pull in hard.Less than 50% of normal
3

🚨 When to Get Help

Call 911 Now

  • Struggling to breathe: They can barely speak or cry.
  • Color Change: Lips or face turn bluish or gray.
  • Consciousness: They pass out, or are drowsy/confused.
  • Anaphylaxis: The wheezing started suddenly after a bee sting, new medication, or eating a food allergen (like peanuts).

Call Doctor Now or Go to ER

  • Red Zone Symptoms: Your child is in the Red Zone (see chart above).
  • Treatment Failed: The wheezing is not gone 20 minutes after using the nebulizer or inhaler.
  • Frequency: You need to give the rescue medicine (Albuterol) more often than every 4 hours.
  • Pain: Severe chest pain.
  • Fever: Temperature is over 104° F (40° C).

Contact in 24hrs

  • Mild wheezing or coughing has lasted more than 3 days.
  • Asthma is interfering with school or sleep.
  • You have used the rescue inhaler more than once a day (outside of exercise).
4

Immediate Home Care (The Action Plan)

If your child is in the Yellow Zone or having mild symptoms, start treatment immediately. The sooner you treat it, the faster it stops.

Step 1: Give Quick-Relief Medicine (Rescue Meds)

  • Medicine: Usually Albuterol (or what your doctor prescribed).
  • Method: Give 2 puffs via Inhaler with a Spacer, or one treatment via nebulizer.
  • Frequency: Repeat every 4 hours if symptoms persist.
  • Important: If the inhaler hasn’t been used in 7 days, spray it into the air twice to “prime” it first.

Step 2: Continue Controller Medicine

  • If your child takes a daily preventative steroid, do not stop giving it. Continue it alongside the rescue medicine

Step 3: Hydration & Environment

  • Fluids: Give lots of clear fluids. Being hydrated helps thin the mucous in the lungs, making it easier to cough up.
  • Humidifier: If the air is dry, use a humidifier to soothe the cough.
  • Remove Triggers: If there is smoke, dust, or animal dander nearby, move the child to a clean air environment immediately. shower them off if pollen is the trigger.

5

How to Use the Devices Correctly

Technique matters! Poor technique means the medicine hits the tongue instead of the lungs.

Using an Inhaler WITH a Spacer (Best Method)

Always use a spacer if you have one. It delivers double the medicine to the lungs compared to an inhaler alone.

  1. Shake the inhaler well and attach it to the spacer.
  2. Have the child breathe out completely (empty the lungs).
  3. Seal lips around the spacer mouthpiece.
  4. Press the inhaler once to release a puff into the spacer.
  5. Have the child breathe in slowly and deeply.
  6. Hold breath for 10 seconds.
  7. Wait 1 minute before the second puff.

Using a Home Nebulizer

  1. Connect the tubing to the compressor.
  2. Add the premixed medicine vial to the cup.
  3. Turn it on to create a mist.
  4. Older Child: Seal lips around the mouthpiece. Breathe slow and deep.
  5. Younger Child: Use a facemask that covers the nose and mouth snugly.
  6. Continue until the liquid is gone (usually 10 minutes).

⚠️ A Note on Vaping

If you have a teen with asthma, you must discuss vaping. Vaping can cause permanent, severe lung damage and is dangerous for asthmatics. Homemade or street-purchased vaping solutions are the most dangerous.

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.