Difficulty breathing

1. 1

   Sit upright and lean slightly forward

   This position opens the airways more than lying down. Hands on knees, leaning forward slightly — this is the natural position that experienced asthmatics know instinctively.

   Important: Call 911 immediately if: lips or fingertips are turning blue, breathing is getting faster not slower, they can't complete a full sentence, or there is no inhaler available.
2. 2

   Use rescue inhaler if asthma

   Shake the inhaler. Have the person exhale fully. Seal lips around mouthpiece. Press down while inhaling slowly and deeply. Hold breath for 10 seconds. Wait 1 minute and repeat once.

   Tip: A homemade spacer — plastic bottle with a hole in the bottom for the inhaler — significantly improves medication delivery, especially for children.
3. 3

   Slow controlled breathing

   Coach them through it: breathe in slowly through the nose for 4 counts, hold for 2, breathe out through pursed lips for 6 counts. This reduces hyperventilation and slows the panic response.

4. 4

   Loosen tight clothing

   Loosen collars, belts, and anything restricting chest expansion.

5. 5

   Call 911 if no improvement in 10 minutes

   If two doses of rescue inhaler haven't improved breathing or there's no inhaler, call 911 immediately.

   Important: Never leave a person having breathing difficulty alone. Respiratory distress can escalate rapidly, especially in children and elderly people.

Guidance only — in any emergency, call 911.