Asthma emergency first aid

Asthma Emergency First Aid in Grand Rapids, MI

Asthma emergencies can happen quickly, especially with West Michigan’s changing weather, cold winters, and spring/fall allergy seasons. Knowing asthma first aid can save a life in Grand Rapids homes, schools, workplaces, and sports fields.

If someone in Grand Rapids is having trouble breathing and you suspect an asthma attack, follow these steps immediately.

Stay Calm and Stay With the Person

Be calm and reassuring

Speak slowly and clearly.
Help them sit comfortably and focus on breathing.
Panic and stress can make asthma symptoms worse.

Do not leave them alone

Stay with the person until their breathing improves or emergency help arrives.
If you are in a public place in Grand Rapids (school, church, sports facility, workplace), ask others to help:
- One person to call 911
- One person to locate the person’s inhaler and spacer
- One person to meet the ambulance (if possible)

Asthma First Aid Steps (Using a Blue/Grey Reliever Inhaler)

In the United States, one of the most common reliever medications is salbutamol (albuterol), often called the “blue puffer” or “rescue inhaler.” Brand names include Ventolin, ProAir, and others.

Step 1: Sit the Person Upright

Sit them upright in a comfortable position.
Do not let them lie down.
Loosen tight clothing around the neck and chest (scarves, jackets, ties), which can be common in cold Grand Rapids winters.

Step 2: Shake the Inhaler and Use a Spacer if Available

If you have a spacer:

Shake the inhaler well.
Insert the inhaler into the spacer.
Put the spacer mouthpiece in the person’s mouth, ensuring a good seal.
Press 1 puff into the spacer.
Have the person take 4 slow, normal breaths in and out through the spacer.
Repeat: Shake, 1 puff, 4 breaths
Continue until 4 separate puffs have been taken (each puff followed by 4 breaths).

If you do NOT have a spacer:

Shake the inhaler well.
Place the mouthpiece in the person’s mouth, forming a tight seal with their lips.
As they start to breathe in slowly and deeply, press 1 puff.
Ask them to hold their breath for as long as is comfortable (about 5–10 seconds), then breathe out gently.
Wait about 30 seconds, then repeat until 4 separate puffs have been given.

Step 3: Wait 4 Minutes

Wait 4 minutes after the 4 puffs.
Watch their breathing carefully.
If they are not improving, move to the next step.

Step 4: If No Improvement, Call 911 and Continue First Aid

If breathing does not return to normal or is still difficult after 4 minutes:
- Call 911 immediately and say:
  “We have a person having an asthma emergency in Grand Rapids, Michigan.”
While waiting for the ambulance:
- Give 4 more separate puffs of the blue/grey reliever inhaler, using the same method as above (with or without spacer).
- Continue to give 4 puffs every 4 minutes until:
  - The ambulance arrives, or
  - The person’s breathing improves and they feel better.

What Is an Asthma Flare-Up or Asthma Attack?

An asthma flare-up is a worsening of asthma symptoms and lung function compared to your usual day-to-day breathing. It can:

Develop slowly over hours, days, or weeks
Happen suddenly within minutes (often called an asthma attack)

An asthma attack can quickly become an emergency, especially during:

Cold, dry Grand Rapids winter air
High pollen seasons (spring and early summer)
Sudden weather changes and thunderstorms in West Michigan
Viral infections and flu season

Quick action and correct use of your asthma action plan can reduce the risk of a life-threatening emergency.

Follow Your Asthma Action Plan

If you live in Grand Rapids and have asthma:

Your primary care doctor, pulmonologist, or allergist (for example, at Spectrum Health, Trinity Health Grand Rapids, Metro Health, Mercy Health, or Helen DeVos Children’s Hospital) should provide a written asthma action plan.
This plan explains:
- Your daily medications
- What to do when symptoms get worse
- When to start asthma first aid
- When to call 911 or go to the emergency department

If Symptoms of an Asthma Attack Appear

If you notice any of the following signs:

Increasing shortness of breath
Chest tightness
Wheezing
Worsening cough, especially at night or early morning
Needing your rescue inhaler more often

Follow your asthma action plan right away.
If you do not have an action plan, or you are helping someone who does not have one, start asthma first aid immediately as described above.

Do Not Wait Until Asthma Is Severe

In Grand Rapids, people often delay treatment, especially in winter when coughing and breathing issues may be blamed on “just a cold.” Do not wait until symptoms are severe.

Use your reliever (rescue) inhaler as directed in your action plan.
If you are unsure whether someone is having an asthma attack, you can still safely give a blue reliever inhaler (albuterol/salbutamol) – it is unlikely to cause harm.

Call 911 immediately if:

Symptoms are severe (see below), or
The person is not improving with reliever medication, or
You are unsure what to do.

Different Types of Reliever Medications

Not everyone in Grand Rapids uses the same asthma reliever. Common options include:

Blue relievers (short-acting bronchodilators)
- Salbutamol/albuterol inhalers (Ventolin, ProAir, etc.)
- Bricanyl (terbutaline) – often used in a Turbuhaler device
Dual-purpose relievers (anti-inflammatory relievers)
- Contain budesonide and formoterol (e.g., Symbicort, DuoResp Spiromax, BiResp Spiromax, Fostair)
- Used “as-needed” for both:
  - Quick symptom relief
  - Reducing the risk of serious asthma flare-ups by:
    - Relaxing tight airway muscles
    - Treating airway inflammation

Important: These medicines may also be prescribed as daily “preventers.”
Always follow your doctor’s instructions and your asthma action plan about what to use during a flare-up or asthma attack.

Some people may use the same inhaler as both their preventer and reliever. Always:

Check the label on the inhaler
Follow the written asthma action plan from your Grand Rapids healthcare provider

Asthma and Anaphylaxis (Severe Allergic Reaction)

People with both asthma and serious allergies (to foods, insect stings, or medications) are at higher risk of life-threatening reactions.

If a person with known asthma and a known allergy suddenly has:

Difficulty breathing
Wheezing
Persistent cough
Hoarse voice

—even without skin symptoms (like hives or swelling):

ALWAYS GIVE ADRENALINE (EPINEPHRINE) AUTOINJECTOR FIRST
- Use EpiPen or other prescribed autoinjector immediately.
Then give the asthma reliever inhaler (blue puffer or dual-purpose reliever) as per asthma first aid steps.
Call 911 right away and say the person may be having anaphylaxis and an asthma emergency.

If the person has an anaphylaxis action plan, follow it carefully.

Thunderstorm Asthma in West Michigan

Thunderstorm asthma occurs when:

High grass pollen levels in the air
Combine with a certain type of thunderstorm
Trigger sudden, severe breathing problems in people with asthma or hay fever

While thunderstorm asthma is more widely reported in some regions, people in Grand Rapids can still be affected during:

High pollen days in late spring and early summer
Stormy weather fronts moving across Lake Michigan

If you have asthma or seasonal allergies in Grand Rapids:

Monitor pollen counts and air quality reports.
Keep your rescue inhaler with you, especially on stormy, high-pollen days.
Follow your asthma action plan and seek urgent care if symptoms escalate quickly.

Signs You Need to Use Asthma First Aid

Mild to Moderate Asthma Signs

(Start asthma first aid and follow your action plan)

Minor difficulty breathing
Able to talk in full sentences
Able to walk or move around
May have a mild wheeze or cough

Severe Asthma Signs

(Call 911 for an ambulance and start asthma first aid)

Obvious difficulty breathing
Cannot speak a full sentence in one breath
Tugging of the skin between the ribs or at the base of the neck
May have a loud wheeze, persistent cough, or chest tightness

Life-Threatening Asthma Signs

(Call 911 immediately and start asthma first aid)

Extreme difficulty breathing (gasping for air)
Can only say 1–2 words per breath or cannot speak at all
Confused, agitated, or exhausted
Lips or face turning blue or gray
Symptoms getting worse very quickly
Collapsing or losing consciousness
Getting little or no relief from the reliever inhaler

When to Call 911 in Grand Rapids

Call 911 and ask for an ambulance if:

The person is not breathing or breathing is very weak
Their asthma suddenly becomes worse or is not improving with reliever medicine
The person is having an asthma attack and there is no reliever medication available
You are unsure if it is asthma, but the person has serious breathing difficulty
The person has asthma and possible anaphylaxis (severe allergic reaction)

While waiting for the ambulance:

Continue asthma first aid (4 puffs every 4 minutes).
Stay with the person, keep them upright, and keep them warm (important during cold Grand Rapids winters).

It’s important for everyone in the community to know asthma first aid, especially:

Parents and caregivers
Teachers and school staff
Coaches and sports trainers
Childcare workers
Employers and supervisors

Make sure you and your family members with asthma:

Have an updated asthma action plan from your doctor
Know how to use inhalers, spacers, and any dual-purpose relievers
Keep reliever medication with you, especially during:
- Winter and flu season
- High pollen seasons
- Outdoor activities around Grand Rapids and West Michigan

Local Asthma Help and Resources in Grand Rapids, MI

In an emergency, always call 911.

You can also use these local and national resources:

Emergency Departments (24/7)
- Spectrum Health Butterworth Hospital – Grand Rapids
- Trinity Health Grand Rapids
- Metro Health – University of Michigan Health
- Mercy Health facilities in the Grand Rapids area
- Helen DeVos Children’s Hospital – pediatric asthma emergencies and care
Your Primary Care Provider or Asthma Specialist
- Family medicine, internal medicine, pediatrics, or pulmonology clinics throughout Grand Rapids
Kent County Health Department
- Information on air quality, respiratory health, and local health programs
Grand Rapids Public Health and Community Clinics
- Education on asthma management and access to care for uninsured or underinsured residents
Nurse Advice Lines
- Many local health systems (Spectrum Health, Trinity Health, Metro Health, Mercy Health) offer 24/7 nurse lines. Check your insurance card or health system website.
National Resources
- Asthma and Allergy Foundation of America (AAFA)
- National Asthma Education and Prevention Program (NAEPP)
- Allergy and Asthma organizations for education and support

Key Points for Asthma Emergencies in Grand Rapids

Follow your asthma action plan as soon as symptoms of an asthma attack appear.
The most common reliever in the U.S. is salbutamol/albuterol, often called your “blue puffer” or rescue inhaler.
If a person has asthma and a known serious allergy and suddenly has breathing difficulty:
- ALWAYS GIVE ADRENALINE AUTOINJECTOR FIRST, then the asthma reliever, even if there are no skin symptoms.
Some inhalers (budesonide/formoterol and similar) may be prescribed as both preventer and reliever—always follow your doctor’s instructions.
Do not wait for symptoms to become severe. Start asthma first aid early and call 911 if there is any doubt about safety.

By knowing asthma emergency first aid and using local Grand Rapids healthcare resources, you can help protect yourself, your family, and your community from life-threatening asthma attacks.