During an asthma attack, what is the first recommended intervention?

• A. Calm and reassure patient
• B. Administer salbutamol inhaler
• C. Give oxygen
• D. Call 999 if not improving

Answer: (B)

Relieving airway obstruction quickly is the priority in an acute asthma attack. A fast-acting inhaled bronchodilator, such as salbutamol, directly reverses bronchoconstriction by relaxing the smooth muscle around the airways, which opens up the airways within minutes. Using an inhaler with a spacer helps deliver the dose effectively to the lungs, making it the most efficient first intervention to improve breathing, reduce wheeze, and lessen the work of breathing.

Calming and reassuring the patient is helpful for comfort, but it doesn’t address the underlying bronchospasm. Oxygen is important if there are signs of hypoxaemia, but bronchodilation should come first to restore airflow. If the symptoms don’t improve after using the inhaled salbutamol, escalate care and seek emergency help.