Medically Reviewed by Nayana Ambardekar, MD on May 08, 2021 You may go for weeks or months without having a flare. But suddenly, your chest feels tight. You're coughing and wheezing a bit. During an asthma attack, the muscles in your airway tighten. The lining gets swollen and makes more and thicker mucus. All of this makes it hard to breathe. Just before or at the very start of an attack, you may notice changes that can tip you off. They include: Follow the steps in your asthma action plan. You may be able to stop the episode or keep it from getting bad. When symptoms flare, it might be hard for you to do normal, everyday things. You may have: Use your rescue inhaler. Try to stay calm. Signs of worsening asthma include:
Follow the "Red Zone" or emergency instructions in your asthma action plan. Call 911 or get to the hospital. You need medical attention right away. Some warning signs of asthma are more serious. They include:
If you have any of these asthma symptoms, call 911. Some people's asthma is triggered by allergies. For example, hay fever is a risk factor for developing asthma. It is important to manage your asthmas because some triggers can make it worse, and in some cases a serious type of allergic reaction called anaphylaxis can occur. Anaphylaxis can be caused by food allergies, latex allergies, medication allergies, or allergies to insect stings. Most allergic reactions are localized to one area of your body. An allergic reaction in your skin leads to hives. An allergic reaction in your nose leads to congestion. But in anaphylaxis, many organs of your body are affected at once. The results are rapid and life-threatening. Some of the symptoms of a severe asthma attack or a severe allergic reaction may seem similar. Signs of anaphylaxis are: Anaphylaxis is a medical emergency. Keep in mind that anaphylaxis often develops quickly after exposure to the allergen -- possibly within minutes. If you know you’re at risk for anaphylaxis, your doctor should have prescribed an epinephrine injection kit for emergencies (usually two pens). Always carry it with you and do not hesitate to use it to inject yourself, even if you are unsure that your symptoms are allergy related. You'll probably feel tired and worn out. For the next few days, you're more likely to have another flare too. Pay attention to warning signs. Take care of yourself. An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways. This tightening is called a bronchospasm. During the asthma attack, the lining of the airways also becomes swollen or inflamed and thicker mucus -- more than normal -- is produced. All of these factors -- bronchospasm, inflammation, and mucus production -- cause symptoms of an asthma attack such as trouble breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack can include:
Call 911 if you have any of these symptoms. 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. Early warning signs of an asthma attack may include: 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. 1. Give asthma first aid. If the person doesn't have an asthma plan:
2. Use an inhaler with a spacer, if possible.
3. Use an inhaler without a spacer, if necessary.
4. Continue using the inhaler if breathing is still a problem.
5. Monitor the person until help arrives.
6. Follow up.
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