Learn how to recognize when you need to step up treatment.
During an asthma attack, also called an asthma exacerbation, the airways become swollen and inflamed. The muscles around the airways contract and the airways produce extra mucus, causing the breathing (bronchial) tubes to narrow.
During an attack, you may cough, wheeze and have trouble breathing. Symptoms of a minor asthma attack get better with prompt home treatment. 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. Your treatment plan should include what to do when your asthma starts getting worse, and how to deal with an asthma attack in progress.
Asthma attack signs and 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 don't improve or get worse after you take medication as your doctor directed, you may need emergency treatment. Your doctor can help you learn to recognize an asthma emergency so that you'll know when to get help.
If your asthma flares up, immediately follow the treatment steps you and your doctor worked out 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. PEF readings ranging from 51% to 79% of your personal best are a sign you need to use the quick-acting (rescue) medications prescribed by 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, you're more likely to have an asthma attack. 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, or if you have low peak flow readings or other signs your asthma isn't well controlled, make an appointment to see your doctor.
Seek medical attention right away if you have signs or symptoms 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 respiratory infections, such as those caused by the common cold. Some people have asthma flare-ups caused by something in their work environment. Sometimes, there isn't an apparent cause for an asthma attack.
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. They can:
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-acting inhaler.
See your doctor if you're following your asthma action plan but still have frequent or bothersome symptoms or low peak flow readings. These are signs 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 allergy triggers, and wear a face mask when exercising in cold weather.
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 also used in asthma emergencies to help your doctor understand the severity of an asthma attack or how well treatment is working.
Lung function tests include:
Peak flow. Your doctor may take a peak flow reading when you come in for a scheduled visit or for emergency treatment during an asthma attack. This test measures how quickly you can breathe out. You may also use a peak flow meter at home to monitor your lung function.
The results of this test are known as peak expiratory flow (PEF). A peak flow test is done by blowing into a mouthpiece as hard and as fast as you can with a single breath (expiration).
Spirometry. During spirometry, you take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. A common spirometry measurement is forced expiratory volume, which measures how much air you can breathe out in one second.
The results of this test are known as forced expiratory volume (FEV). Spirometry can also measure how much air your lungs can hold and the rate at which you can inhale and exhale.
If you and your doctor have worked out an asthma plan, follow its directions at the first sign of an asthma attack.
This generally means taking two to six puffs of a quick-acting (rescue) inhaler to get airway-expanding medication, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others) and levalbuterol (Xopenex), deep into your lungs. Small children and those who have trouble with inhalers can use a nebulizer. After 20 minutes, you can repeat the treatment one time if necessary. If you continue to wheeze or feel breathless after treatment, visit your doctor or urgent care that day.
If you're having symptoms of a severe asthma attack, such as difficulty speaking because you're so short of breath, use your quick-acting (rescue) medication and get to a doctor's office or urgent care immediately.
Your doctor may recommend that you continue to use quick-acting medication every three to four hours for a day or two after the attack. You might also need to take oral corticosteroid medication for a short time.
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 improve, your doctor may want you to stay in the emergency room 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 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.
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 during your appointment.
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: