First Aid for an Asthma Attack and Croup: How to Use a Nebulizer

An asthma attack or false croup usually occurs suddenly and can quickly lead to severe breathing difficulties. In such a situation, it is important not to panic, but to follow a plan agreed with a doctor in advance. Properly administered first aid helps stabilize the condition until medical professionals arrive.

In this article, we will discuss how to recognize an asthma attack and false croup, when it is appropriate to use a nebulizer, why only medications prescribed by a doctor are used for nebulization, and when it is necessary to seek emergency medical assistance immediately.

Asthma Attack and False Croup: How to Recognize the Danger?

An asthma attack and false croup may both be accompanied by difficulty breathing; however, they are different conditions that arise for different reasons and require different approaches to treatment.

During an asthma attack, bronchospasm occurs: the smooth muscles of the bronchi contract, the airway lumen narrows, and the mucous membrane swells. As a result, it becomes more difficult for air to pass through the bronchi, making it hard for the person to exhale fully. This condition is called bronchial obstruction.

The main symptoms of an asthma attack are:

• wheezing, especially during exhalation;
• shortness of breath;
• a feeling of tightness or heaviness in the chest;
• a cough that may worsen at night or in the early morning;
• rapid breathing.

False croup (acute stenosing laryngitis) most often occurs in young children against the background of a viral infection. The mucous membrane of the larynx swells, causing the upper airways to narrow (stenosis).

False croup is characterized by:

• a sudden barking cough;
• noisy, difficult inhalation (stridor);
• hoarseness;
• difficulty breathing that may rapidly worsen;
• anxiety or crying, which often intensifies the symptoms.

Important. If shortness of breath rapidly worsens, the person has difficulty speaking or breathing, the lips or face become bluish, or consciousness is impaired, emergency medical services must be called immediately.

More up-to-date information can be found in the guide “Global Strategy for Asthma Management and Prevention,” developed by GINA (Global Initiative for Asthma), at this link.

First Aid for an Asthma Attack: Nebulizer Use Algorithm

During an asthma attack, the main objective is to relieve bronchospasm as quickly as possible and restore normal airflow through the bronchi. If a doctor has prescribed inhalation therapy via a nebulizer in advance and explained what to do during an attack, it is important to follow these recommendations precisely.

Step-by-Step Algorithm

1. Remain calm. Panic can intensify the feeling of air hunger and make breathing more difficult.
2. Help the person assume a comfortable position. If this makes breathing easier, they may lean slightly forward and rest their hands on their knees or another support.
3. Provide access to fresh air. Loosen tight clothing and open a window.
4. Administer an inhalation using the medication prescribed by the doctor for emergency relief. Do not change the dosage yourself or use medications that are not included in the individual treatment plan.
5. Monitor the person’s condition. If breathing becomes easier, continue following the doctor’s recommendations.
6. Call emergency medical services immediately if the condition does not improve after first aid, shortness of breath worsens, or the person has difficulty speaking or maintaining their usual breathing pattern.

Bronchodilators: How They Help During an Attack

During an asthma attack, a doctor may prescribe bronchodilators for emergency therapy – medications that relax the smooth muscles of the bronchi and help relieve bronchospasm more quickly. Berodual is one such medication. It is used only as prescribed by a doctor and according to an individually selected treatment regimen.

Important. According to current international recommendations for the treatment of bronchial asthma, every patient should have an individual action plan for exacerbations agreed with their doctor. This plan determines which medications to use and when emergency medical assistance must be sought immediately.

Detailed recommendations on what to do during an exacerbation of bronchial asthma and on the importance of an individual treatment plan can be found in the CDC recommendations.

False Croup in Children: What to Do Before the Doctor Arrives?

False croup (acute stenosing laryngitis) most often develops in children approximately 6 months to 5 years of age. Swelling of the laryngeal mucosa makes it more difficult for the child to inhale, causing a barking cough, hoarseness, and noisy inhalation (stridor). This condition may worsen rapidly, so it is important to assess its severity promptly and call emergency medical services when necessary.

First Aid for Croup

1. Remain calm and soothe the child. Crying and severe anxiety can worsen breathing difficulties.
2. Place the child in a comfortable seated position. Do not force the child to lie down if breathing is easier while sitting.
3. Provide access to fresh air. If possible, ventilate the room or take the child outside into fresh air.
4. Administer an inhalation using a nebulizer only with a medication that was previously prescribed by a doctor. Do not use any medications without medical advice.
5. Continuously monitor the child’s breathing until the doctor arrives or the condition improves.

Why Is a Nebulizer Used for False Croup?

A compressor nebulizer converts a medication solution into a fine aerosol that the child inhales during treatment. In other words, an inhaler for false croup is used only as a means of delivering medication into the airways. Using a nebulizer without the prescribed medication does not replace treatment and does not eliminate the cause of breathing difficulties.

Berodual for Inhalation: Instructions for Use and Safety Precautions

Berodual belongs to the group of bronchodilators – medications that help relieve bronchospasm and facilitate airflow through the bronchi. It may be prescribed for bronchial asthma and certain other conditions accompanied by bronchial obstruction.

Berodual for inhalation is administered only via a nebulizer (both Ulaizer compressor nebulizer models – Air+ and Home – are suitable) and exclusively according to the regimen determined by a doctor. The dosage depends on the patient’s age, the severity of the attack, and other individual characteristics, so there is no universal dose. If the treatment regimen requires the medication to be diluted, only sterile isotonic sodium chloride solution (0.9%) should be used. Distilled or boiled water must not be used for dilution.

After the inhalation is completed, all nebulizer components that came into contact with the medication solution or the respiratory tract must be cleaned according to the manufacturer’s instructions. Regular cleaning and disinfection of the components help reduce the risk of microbial contamination of the equipment. Principles for the care of medical devices are also provided in the CDC recommendations on cleaning and disinfecting medical equipment.

Pulmicort for Croup and Asthma: When Hormonal Therapy Is Used

Pulmicort (active ingredient: budesonide) belongs to the group of inhaled glucocorticosteroids. The medication may be used in bronchial asthma to control airway inflammation and in false croup to reduce laryngeal swelling.

During an acute asthma attack or croup, Pulmicort is used only when included in a treatment regimen prescribed by a doctor in advance. Only Pulmicort suspension intended for administration via a compressor nebulizer is used for nebulization. After inhalation, it is recommended to rinse the mouth with clean water and, if an inhalation mask was used, to wash the face. This helps reduce the risk of local adverse reactions.

Why Should Steam Inhalers Not Be Used in Acute Conditions?

Steam inhalers are not recommended during an asthma attack or false croup. They produce hot steam, which is not intended to deliver medications into the airways and does not replace nebulizer therapy.

In false croup, hot steam may increase the risk of burns, while in asthma it does not relieve bronchospasm. Therefore, in both cases, only medications prescribed by a doctor should be administered via a compressor nebulizer.

Ulaizer Air+: Why This Model Is Useful in Emergency Situations

During an acute attack of bronchial asthma or false croup, it is important to begin nebulization as quickly as possible if it is included in the individual treatment plan. Therefore, compact nebulizer models that are convenient to use not only at home are worth considering.

Ulaizer Air+ is compact and operates from a 12 V / 1 A direct-current power source. If necessary, it can be connected to a power bank or charging station using a compatible converter cable, which is especially relevant during power outages or while traveling.

The model provides a nebulization rate of at least 0.20 mL/min, and the median aerosol particle size (MMAD) is approximately 3 μm, which corresponds to the characteristics of a compressor nebulizer for delivering medications to the lower respiratory tract.

Table: How to Distinguish an Asthma Attack from False Croup

Checklist: What Must Never Be Done During an Attack of Shortness of Breath

• Do not panic or leave the person alone.
• Do not force the person to lie down if breathing is easier while sitting.
• Do not use medications that were not prescribed by a doctor.
• Do not change medication dosages yourself.
• Do not perform steam inhalations or use hot steam.
• Do not put essential oils, herbal decoctions, or other solutions not intended for nebulization into the nebulizer.
• Do not delay calling emergency medical services if the person’s condition worsens or does not improve after first aid.

When Should an Ambulance Be Called Immediately?

During an attack of bronchial asthma or false croup, it is important to monitor the person’s condition carefully. If breathing does not become easier after first aid or the symptoms worsen rapidly, emergency medical services must be called immediately.

Danger signs include:

• severe shortness of breath at rest;
• inability to speak in full sentences because of shortness of breath;
• bluish discoloration of the lips, tongue, or skin around the mouth;
• noisy breathing that becomes louder or, conversely, suddenly becomes much weaker;
• retraction of the intercostal spaces or the suprasternal notch during inhalation;
• drowsiness, confusion, or lethargy;
• oxygen saturation below 92%, if it can be measured with a pulse oximeter.

In children with false croup, noisy inhalation at rest that does not decrease after first aid is particularly dangerous, as are any signs of increasing respiratory failure.

A nebulizer can be an important first-aid device during an attack of bronchial asthma or false croup when used as prescribed by a doctor. It delivers medication directly into the airways but does not replace a medical examination and further treatment.

If the symptoms do not decrease after inhalation or the person’s condition worsens, emergency medical services must be called immediately.

Important! This article is for informational purposes only and does not replace a consultation with a doctor. An attack of bronchial asthma and false croup (stenosing laryngitis) can be life-threatening and may require emergency medical assistance.

During an acute condition, a nebulizer is used only as a first-aid device according to a treatment regimen prescribed by a doctor in advance. If the person’s condition does not improve or worsens, emergency medical services must be called immediately!