4x4x4 Rule

What’s the 4x4x4 rule?

  • This is the first aid protocol for asthma where you give 4 puffs of a rescue inhaler every 4 minutes
  • Using a spacer
  • Each puff needs 4 breaths (in & out).
  • This can be given every 4 minutes if there is no improvement, until help arrives
  1. 1 puff then 4 breaths
  2. 1 puff then 4 breaths
  3. 1 puff then 4 breaths
  4. 1 puff then 4 breaths
  5. Repeat in 4 minutes