Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency help if the child:
Does not resume normal breathing promptly
Remains unresponsive or is difficult to awaken
Has ongoing or prolonged stiffening or jerking
Develops persistent breathing difficulty or an abnormal color after the spell
Is seriously injured during the event
Collapses during exercise
Has signs of a severe allergic reaction, choking, poisoning, or another medical emergency
If the child is not breathing normally and is unresponsive, call emergency services and begin age-appropriate cardiopulmonary resuscitation if trained.
Emergency dispatchers can provide instructions.
And for anyone, someone who:
is struggling to breathe, gasping, choking, or cannot get words out
has lips or skin that look pale, blue, grey or blotchy
Other emergency signs, for anyone
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek prompt medical advice if spells begin before 6 months of age, first appear after early childhood, occur without crying, pain, or fright, happen during sleep or exercise, or involve a slow or incomplete recovery.
And for anyone, someone who:
is getting rapidly more short of breath, or has gained several pounds in a few days with swelling
3
Does any of this apply?
Book an appointment
Arrange routine follow-up if this is the child’s first suspected breath-holding spell, the episodes are becoming more frequent, or caregivers are unsure whether the pattern is typical.
Follow-up is also appropriate if the child has a limited diet, looks unusually pale, has low energy, or has previously had anemia or low iron.
And for anyone, someone who:
is more tired or breathless than usual doing things they used to manage
The article also says
Keep a brief record of the trigger, color change, duration, movements, and recovery.
If it can be done without delaying care or compromising safety, a video may help the clinician understand what happened.
Every sign above is quoted from the sofidex article on Breath-holding spell. If you are not sure, err upward — it is always reasonable to be checked.