b'ChapterHow to ManageConscious Patient Reassure the patient and assist them to sit comfortably upright leaning forward with elbows extended, resting on a soft support like a pillow. This helps expand the rib spaces. Remove any tight or restrictive clothing. Do not leave the patient alone.Assist the patient to administer their prescribed reliever medication, in accordance to theirasthma plan. Borrow a puffer inhaler if necessary.If asthma plan is not known or available, shake the reliever puffer (inhaler) and give 4 separatepuffs (one at a time) preferably through a spacer device*. After each puff, the patient inhales 4 slow deep breaths. The patient does not need to take their mouth away as the mouthpiece contains a one-way valve. Wait 4 minutes and closely assess the patients condition. In most cases, the patient will improve quickly after medication. f there is little or no relief, repeat the 4 puffs x 4 breaths x 4 minutes process.I* If a spacer device is unavailable, use a blue reliever puffer (inhaler) on its own.If Oxygen is available, it should be administered at a flow rate of at least 8 litres per minute via a face mask, by a first aider trained in its use.If there is still little or no improvement or you are unsure CALL AMBULANCE 000 - keep repeating 4 puffs x 4 breaths x 4 minutes until Ambulance arrives.What if it is the first attack of asthma and what if asthma has never been diagnosed before? f a patient is in respiratory distress and you suspect it may be asthma, Iinitiate the 4 puffs x 4 breaths x 4 minutes process and call an Ambulance 000. Keep repeating the 4 puffs x 4 breaths x 4 minutes process until Ambulance arrives.No harm is likely to result from giving a reliever medication to a patient who does not have asthma. Reliever medications are safe. An overdose cannot be given by following instructions outlined. It is important to note that some minor side effects may be experienced such as muscle tremors (shakiness) and a fast beating heart.What if you suspect someone is having an asthma attack and you have no reliever medication available?Rest and reassure the patient.Encourage controlled breathing.Loosen restrictive clothing.If there is no improvement, call Ambulance 000.178 Medical Emergencies'