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Key Information:

Following new national guidance, the emergency steps for an asthma attack are now different depending on what type of inhaler you use.

You must know which plan corresponds to your specific medication (Standard vs. MART).

If you are ever in doubt, or if the patient is unconscious, call 999 immediately.

Signs of an Asthma Attack

An attack can happen gradually or suddenly. Watch for these signs:

  • Symptoms: Coughing, wheezing, breathlessness, or a very tight chest that is not responding to your usual treatment.
  • Severity: Struggling to speak, eat, or sleep due to breathlessness.
  • Speed: Breathing is getting faster, and it feels like you cannot “catch your breath.”

PLAN A: For “Blue Inhaler” Users

Use this plan if you have a separate blue rescue inhaler (eg ventolin or salamol).

  • Sit Up: Sit up straight and try to stay calm.
  • Puff: Take one puff of your blue inhaler every 30 to 60 seconds.
  • Maximum: You can take up to 10 puffs.
  • Emergency: If you do not feel better after 10 puffs, or you feel worse at any time, call 999.
  • The Wait: If the ambulance takes longer than 15 minutes, repeat Step 2 (another 10 puffs).

PLAN B: For “MART” Users

Use this plan if you use a “2-in-1” combination inhaler for both prevention and relief (Maintenance and Reliever Therapy).

  • Sit Up: Sit up straight and try to stay calm.
  • Puff: Take one puff of your combined (MART) inhaler.
  • Wait: Wait one minute.
  • Repeat: If you still feel breathless, take another puff. Repeat this (one puff every minute) up to a maximum of 6 puffs (or as stated in your personal plan).
  • Emergency: If you do not feel better after 6 puffs, or you feel worse at any time, call 999.
  • The Wait: If the ambulance takes longer than 15 minutes, you can repeat the steps.

After an Attack

Even if you feel better after using your inhaler, you must contact the surgery for an urgent follow-up. We need to check your airways and review your treatment to prevent a future, potentially more dangerous attack.

Check Your Plan Now

Look at your personal asthma action plan today. Make sure you know which of the two plans above applies to you.

If you are not sure, please contact us.

Discuss Your Asthma
 

Importance of Technique

Using your inhalers correctly is important. Even the best medicine will not work if it does not get deep into your lungs.

If you are unsure about your technique, click the link below to learn how to use your inhaler properly.

How to use your inhaler


If you would like to discuss your inhalers, please click the link below.

Discuss Your Inhalers
 

Further Information

Asthma Diagnosis: Connecting the Dots

Updating Asthma Care: The “2-in-1” Approach

Asthma Triggers: Managing Your “Sparks”

Winter-Proofing Your Asthma: 3 Steps to Stay Well


For more information about asthma, including symptoms, treatment and living with asthma, please visit the NHS website.

Learn more about asthma

Last reviewed: 06 April 2026
Next review due: 06 April 2029