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Categories > Breathing Disorders > Asthma

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Handling an asthma attack

» Heeding early warning signs

» Recognizing a severe attack

If you have asthma, you know how frightening it can be to suffer an acute attack. Watching a loved one, especially a child, struggle to breathe during a flare-up can be just as traumatic. Recognizing early symptoms of an attack and taking prompt action before they get worse is key to avoiding a health emergency.

Ideally, every person with asthma has developed an action plan with his or her doctor. An action plan outlines step-by-step treatment instructions and emergency protocol. It should list all medications, including quick-relief and long-term control medicines, their doses and when to take them. Such a plan can help you and those around you know what to do in case of an attack.

Heeding early warning signs

Not all attacks come on suddenly. At first, you may simply be breathing faster than usual. Wheezing, coughing or chest tightness may feel only mildly uncomfortable. Don’t ignore these symptoms. By taking your appropriate medicine now, you may avoid a more severe episode.

If you have difficulty breathing, use a peak flow meter—a small handheld device that measures your airflow—to help you determine a flare-up’s severity and your treatment response. Sometimes, you may feel your breathing is fine, but using a flow meter can indicate decreased lung function before symptoms worsen. Peak flow below 20 percent of your best airflow signals a flare-up. At the first sign of an attack, even a mild one, take your medicine as directed by your doctor. You should know how quickly your medicine is expected to work. If airflow and symptoms don’t improve, call your doctor.

Recognizing a severe attack

Asthma symptoms can progress to an urgent situation quickly. Warning signs include:

  • coughing that won’t stop
  • very rapid breathing or difficulty breathing; the abdomen “sucks in” and nostrils widen when trying to inhale
  • severe wheezing
  • chest pain or pressure
  • difficulty talking
  • feelings of anxiety or panic
  • poor or pale skin color
  • tightened neck and chest muscles
  • decreased awareness or, in a child, drowsiness
  • blue lips or fingernails
  • a peak airflow of less than 50 percent

If you have an attack, do your best to stay calm. Check your action plan, use your rescue inhaler and take other acute action medications as directed. Be sure to grab the correct inhaler and use your quick-relief medicine instead of your long-term control one. Measure your lung function to see how your medicine is working. If symptoms don’t improve, if they worsen or if peak airflow remains less than 50 percent, seek emergency medical help.


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