During an asthma attack, also called an asthma exacerbation, your airways become swollen and inflamed. The muscles around the airways contract, causing your breathing (bronchial) tubes to narrow. During an asthma attack, you may cough, wheeze and have trouble breathing. An asthma attack may be minor, with symptoms that get better with prompt home treatment, or it may be more serious. A severe asthma attack that doesn’t improve with home treatment can become a life-threatening emergency.
The key to stopping an asthma attack is recognizing and treating an asthma flare-up early. Follow the treatment plan you worked out with your doctor ahead of time. This plan should include what to do when your asthma starts getting worse, and how to deal with an asthma attack in progress.
Asthma attack symptoms include:
Signs and symptoms of an asthma attack vary from person to person. Work with your doctor to identify your particular signs and symptoms of worsening asthma — and what to do when they occur. If your asthma symptoms keep getting worse even after you take medication as your doctor directed, you may need a trip to the emergency room. Your doctor can help you learn to recognize an asthma emergency so that you’ll know when to get help.
When to see the doctor
If your asthma flares up, immediately follow the treatment steps you and your doctor worked out ahead of time in your written asthma plan. If your symptoms and peak expiratory flow (PEF) readings improve, home treatment may be all that’s needed. If your symptoms don’t improve with home treatment, you may need to seek emergency care.
When your asthma symptoms flare up, follow your written asthma plan’s instructions for using your quick-acting (rescue) inhaler. If you use a peak flow meter to monitor your asthma, PEF readings ranging from 50 to 79 percent of your personal best are a sign you need to use quick-acting (rescue) medications prescribed by your doctor.
Check asthma control steps with your doctor
Asthma can change over time, so you’ll need periodic adjustments to your treatment plan to keep daily symptoms under control. If your asthma isn’t well controlled, it increases your risk of future asthma attacks. Lingering lung inflammation means your asthma could flare up at any time.
Go to all scheduled doctor’s appointments. If you have regular asthma flare-ups, low peak flow readings or other signs your asthma isn’t well controlled, make an appointment to see your doctor.
When to seek emergency medical treatment
Seek medical attention right away if you have signs of a serious asthma attack, which include:
An overly sensitive immune system makes your airways (bronchial tubes) become inflamed and swollen when you’re exposed to certain triggers. Asthma triggers vary from person to person. Common asthma attack triggers include:
For many people, asthma symptoms get worse with a respiratory infection such as a cold. Some people have asthma flare-ups caused by something in their work environment. Sometimes, asthma attacks occur with no apparent cause.
Anyone who has asthma is at risk of an asthma attack. You may be at increased risk of a serious asthma attack if:
Asthma attacks can be serious.
Be prepared for your visit to your doctor so that you can get the most out of your appointment. At each visit:
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. Some good questions to ask your doctor include:
In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask questions if you don’t understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
For adults, and children over 5 years old, lung (pulmonary) function tests are used to check how well the lungs are working. Poor lung function is a sign that your asthma isn’t well controlled. In some cases, lung function tests are used in asthma emergencies to help check the severity of an asthma attack or how well treatment is working.
Lung function tests include:
If you’re having an asthma attack, follow the steps in the asthma plan you worked out with your doctor. If your symptoms don’t improve, seek immediate medical care. Home treatment steps to stop an asthma attack generally include taking two to six puffs of albuterol (ProAir HFA, Ventolin HFA, others) or using other quick-acting medication over several minutes (don’t take more than one puff at a time). Generally, less medication is needed for children and in adults with less severe symptoms.
If you use a peak flow meter to monitor your asthma, peak expiratory flow readings ranging from 50 to 79 percent of your personal best are a sign you need to use albuterol or other quick-acting (rescue) inhaler medication. Routinely checking your peak flow readings is important because your lung function may decrease before you notice any other signs or symptoms of worsening asthma.
If you go to the emergency room for an asthma attack in progress, you’ll need medications to get your asthma under immediate control. These can include:
After your asthma symptoms get better, your doctor may want you to stay in the emergency department for a few hours or longer to make sure you don’t have another asthma attack. When your doctor feels your asthma is sufficiently under control, you’ll be able to go home. Your doctor will give you instructions on what to do if you have another asthma attack.
If your asthma symptoms don’t improve after emergency treatment, your doctor may admit you to the hospital and give you medications every hour or every few hours. If you’re having severe asthma symptoms, you may need to breathe oxygen through a mask. In some cases, a severe, persistent asthma attack requires a stay in the intensive care unit (ICU).
All asthma attacks require treatment with a quick-acting (rescue) inhaler such as albuterol. One of the key steps in preventing an asthma attack is to avoid your triggers.
The best way to avoid an asthma attack is to make sure your asthma is well controlled in the first place. This means following a written asthma plan to track symptoms and adjust your medication.
While you may not be able to eliminate your risk of an asthma attack, you’re less likely to have one if your current treatment keeps your asthma under control. Take your inhaled medications as prescribed in your written asthma plan. These preventive medications treat the airway inflammation that causes asthma signs and symptoms. Taken on a daily basis, these medications can reduce or eliminate asthma flare-ups — and your need to use a quick-relief inhaler.
See your doctor if you’re following your asthma action plan but you still have frequent or bothersome symptoms or low peak flow readings. This is a sign that your asthma isn’t well controlled, and you need to work with your doctor to change your treatment.
If your asthma symptoms flare up when you have a cold or the flu, take steps to avoid an asthma attack by watching your lung function and symptoms and adjusting your treatment as needed. Be sure to reduce exposure to your allergic triggers.
When exercising in cold weather, wear a face mask.