Asthma and sudden breathing difficulty

Sudden breathing difficulty presenting in a pharmacy may be due to asthma, anaphylaxis, infection, panic, choking, or another serious cause. If someone is severely breathless, cannot finish sentences, looks exhausted, or becomes blue, grey, or confused, call 999 immediately.

Recognising a serious asthma attack

• obvious breathlessness or audible wheeze
• tight chest and persistent coughing
• unable to speak in full sentences
• increasing distress, exhaustion, or noticeably reduced air movement
• blue or grey colour change, pallor, or collapse

Immediate first response

• Help the person sit upright: do not lay them flat.
• Help them use their own reliever inhaler: use a spacer if available and local guidance permits.
• Call 999 if severe, worsening, or not improving: do not wait for exhaustion.
• If trained and equipment is available: give oxygen according to local protocol.
• If unsure: treat as a serious breathing emergency and escalate promptly.

Some pharmacies, for example those providing vaccinations or commissioned clinical services, may have local arrangements to supply salbutamol and a spacer. Other pharmacies may assist only with the person's own inhaler while awaiting ambulance arrival. Staff should know their local arrangements in advance.

A practical note on panic and hyperventilation