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Asthma Guide
Asthma Attack
Written by WebMD Editorial Contributors
How Do I Recognize the Early Signs of an Asthma Attack? What Do I Do If I Have An Asthma Attack?
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Some people with asthma may go for extended periods without having an asthma attack
or other symptoms, interrupted by periodic worsening of their symptoms due to
exposure to asthma triggers such as exercise or exposure to cold air.
Mild asthma attacks are generally more common. Usually, the airways open up within a
few minutes to a few hours after treatment. Severe asthma attacks are less common but
last longer and require immediate medical help. It is important to recognize and treat
even mild symptoms of an asthma attack to help you prevent severe episodes and keep
asthma under control.
Without immediate asthma medicine and asthma treatment, your breathing may
become more labored, and wheezing may get louder. If you use a peak flow meter during
an asthma attack, your reading will probably be less than your personal best.
As your lungs continue to tighten during the asthma attack, you may be unable to use
the peak flow meter at all. Gradually, your lungs may tighten so much during the asthma
attack that there is not enough air movement to produce wheezing. This is sometimes
called the "silent chest," and it is a dangerous sign. You need to be taken to a hospital
immediately with a severe asthma attack. Call 911 for help. Unfortunately, some people
interpret the disappearance of wheezing during the asthma attack as a sign of
improvement and fail to get prompt emergency care.
If you do not receive adequate treatment for an asthma attack, you may eventually be
unable to speak and can develop a bluish coloring around your lips. This color change,
known as "cyanosis," means you have less and less oxygen in your blood. Without
immediate aggressive treatment in an emergency room or intensive care unit, you may
lose consciousness and eventually die.
Early warning signs are changes that happen just before or at the very beginning of an
asthma attack. These changes start before the well-known symptoms of asthma and are
the earliest signs that your asthma is worsening.
In general, these early asthma attack symptoms are not severe enough to stop you from
going about your daily activities. But by recognizing these signs, you can stop an asthma
attack or prevent one from getting worse.
Signs of a cold or allergies (sneezing, runny nose, cough, nasal congestion, sore
throat, and headache)
The severity of an asthma attack can escalate rapidly, so it's important to treat these
symptoms immediately once you recognize them.
If you or a loved one is having an asthma attack and the symptoms don’t get better
quickly after following the asthma action plan, follow the "red zone" or emergency
instructions and contact your doctor or call 911 right away. You need urgent medical
attention.
If the person has asthma medication, such as an inhaler, help them take it.
If the person doesn’t have an inhaler, use one from a first aid kit. Do not borrow
someone else’s. The medicine in it may be different than the needed rescue
medicine. Also, using someone else's inhaler has a slight risk of passing on an
infection.
Have the person breathe out completely and put their mouth tightly around the
spacer mouthpiece.
Have the person breathe in slowly through their mouth and hold their breath for 10
seconds.
Give a total of four puffs, waiting about a minute between each puff.
Have the person breathe out all the way and seal their lips tightly around the inhaler
mouthpiece.
As the person starts to breathe in slowly, press down on the inhaler one time.
The person should keep breathing in as slowly and deeply as possible (about 5 to 7
seconds) and then hold their breath for 10 seconds.
Give a total of four puffs, waiting about 1 minute between each puff.
After four puffs, wait 4 minutes. If the person still has trouble breathing, give another
set of four puffs.
If there’s still little or no improvement, give four to eight puffs every 20 minutes until
the ambulance arrives, for up to 4 hours. If you are still waiting for help after 4 hours,
the recommended dose is four to eight puffs as needed every 1 to 4 hours.
Do not assume that the person’s asthma is improving if you no longer hear
wheezing.
6. Follow up.
An emergency room doctor will check the severity of the attack and give treatment,
including medications.
The person may be sent home or stay in the hospital for further care, depending on
their response to treatment.
Show Sources
SOURCES:
National Heart, Lung, and Blood Institute: "What are the Signs and Symptoms of Asthma?" “How Is Asthma Treated and
Controlled?”
Handal, K. The American Red Cross First Aid and Safety Handbook, Little, Brown and Company, 1992.
Institute for Clinical Systems Improvement: “Emergency and Inpatient Management of Asthma Emergency Room Management.”
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