Asthma, anaphylaxis and severe breathing problems

Severe breathing problems can worsen quickly in children's homes. A young person may have an escalating asthma attack, react to a food allergen, or become breathless after a sting, medicine or unknown trigger. Staff should note how hard the person is working to breathe, whether they can speak, any change in colour and whether the condition is deteriorating despite help.

What can make asthma or breathing difficulty look serious

• Struggling to speak in full sentences.
• Obvious wheeze, chest tightness or repeated cough.
• Increasing distress, exhaustion or poor air movement.
• Blue, grey or very pale colour change.
• Little or no improvement after reliever treatment.

Immediate first response to severe breathing problems

• Help the person sit upright in the position that eases breathing.
• Help them use their own reliever inhaler and spacer if they have one and can use it.
• Call 999 early for severe, worsening or non-improving breathing difficulty.
• Keep talking calmly and keep watching breathing and response.
• Move to the CPR response if they become unresponsive and stop breathing normally.

When to suspect anaphylaxis

Suspected anaphylaxis is one or more airway, breathing or circulation symptoms after likely allergen exposure, with or without rash or gut symptoms. Look for throat tightness, swelling, hoarse voice, wheeze, collapse, clammy skin, severe abdominal pain or a sudden sense that something is seriously wrong.

• Call 999 and say "suspected anaphylaxis".
• Help with the person's adrenaline auto-injector if they have one and you are trained to assist.
• Do not make them stand or walk.
• Keep watching breathing, colour and responsiveness closely.
• A second auto-injector may be needed after 5 minutes if symptoms persist and one is available.

Manager focus: individual emergency plans and medicines

With severe breathing problems, getting help early is safer than waiting to see whether panic, asthma or allergy will settle on its own.