Treating an Asthma Attack

Identifying an asthma attack

The first step to treating an asthma attack is identifying the nature of the attack: most episodes are mild and can be dealt with through quick relief medication. However, some individuals may experience a severe attack that requires emergency treatment.

Here are the symptoms of a normal, mild asthma episode:

  • Breathlessness
  • Coughing
  • Wheezing
  • Constricted chest

Symptoms of a severe attack that merits urgent medical attention from an expert are described below:

  • Shortness of breath, even when you’re sitting.
  • Difficulty in talking, walking or performing other routine activities.
  • Ineffectiveness of your rescue inhaler in alleviating the symptoms.
  • Anxiety and confusion.
  • Blue hue of fingernails and lips.
  • ‘Sucked in’ skin around the ribs (particularly in child patients).
  • Passing out.
  • Peak flow readings that are less than half of your record best.

If your episode has been brought on by an allergy you may experience a very hazardous form of allergic response known as anaphylactic shock: your entire body will have reacted to the offending allergen, causing your airways to completely swell and shut off, so you will not able to breathe at all. If left untreated this situation can be fatal. Symptoms include:

  • Swelling and closing off of the throat and other parts of the respiratory system.
  • Losing consciousness.
  • Difficulty in swallowing.
  • Labored breath, constricted chest and wheezing.
  • Reddened or pale face.
  • Vomiting, cramping and diarrhoea.
  • Hoarse voice.

It is recommended that care givers of an asthma patient be aware of these symptoms and what they signify, so they can get adequate medical assistance to the patient when required.

Treating a mild asthma attack

Depending on your condition, your doctor will have worked out a plan that you must follow in the event of an asthma attack.

Normally, such a plan involves the inhalation of 2-6 doses from a fast response inhaler containing albuterol (e.g. Evohaler, Accuhaler). This will get your constricted airways to loosen up and relieve your breathing. Small children may require the application of a nebulizer, since inhalers aren’t always easy to manage. If you do not experience relief, you may repeat the exercise one more time.

If your symptoms still persist you can call an emergency helpline to have an ambulance pick you up, or if the condition is manageable get a same day appointment with your doctor. Even if you experience mild discomfort after the initial attack has subsided, it is vital that you do not neglect it in the hope that it goes away on its own. It could be indicative of a more serious issue that can only be diagnosed after an examination by your doctor.

Treating a severe asthma attack

If you determine that you’re experiencing a severe asthma attack (or your symptoms are not relieved after the initial medical treatment) you must get to a hospital as quickly as possible. You’ll be administered a number of drugs, possibly in an ER. These may include:

  • Short-acting beta2agonists, such as Ventolin:

This is the same medication as the one present in your rescue inhaler. However, it will be given to you via a nebulizer device that makes it easier to inhale a stronger dosage straight into your lungs.

  • Ipratropium (Atrovent):

This medication is used as a bronchodilator in some cases, to alleviate a severe asthma attack when albuterol (Ventolin) fails to make an impact.

  • Oral corticosteroids:

This medicine is taken in the form of a pill and helps bring down inflammation of the lungs so the attack can be subsided. In the event of an especially severe attack, it may be administered via a vein.

  • Breathing tubes, oxygen and mechanical ventilation:

If the asthma episode attains a life-threatening quality, the doctor may choose to insert a breathing tube into your upper airway by way of your throat. An oxygen-pumping device will assist in restoring your breathing while the doctor provides you with asthma controlling medication.

In some cases, the patient’s condition may not improve, even after they’ve been in emergency treatment. In these situations the patient has to stay admitted in hospital for as long as it’s necessary. The doctor will give them medication and monitor their condition every hour or so to check for improvement.

Even after you asthma has improved the doctor may keep you in the emergency room for a few more hours to ensure that there isn’t a repeat attack. Once the doctor deems it safe, you’ll be discharged with instructions on how to handle another attack if it happens.

In rare cases where there is a severe and persistent asthma episode the patient may be admitted to the ICU (intensive care unit).

Detecting an asthma attack before it happens:

The best way to prevent a severe asthma attack is to anticipate it well before it happens. Early warning signs include:

  • Coughing frequently, particularly during the night.
  • Lowered peak flow meter values.
  • Running out of breath with minimal work.
  • Feel lethargic while exercising.
  • Coughing or wheezing through your exercise session or after it.
  • Feeling on edge or getting upset easily.
  • Symptoms of cold or allergy e.g. runny or congested nose, cough, sneezing, headache or sore throat.
  • Difficulty sleeping.
  • Ineffectiveness of your prescribed dosage of Ventolin.

If you experience any of the symptoms mentioned above, schedule an appointment with your doctor at the earliest convenience to ward off a potentially life threatening attack.

Let your friends and family know

Your friends and family must know what to do if they are with you while you’re having an asthma attack. You should make copies of the asthma action plan that your doctor has devised for you and share it with anyone you feel should be made aware of it.

You can find a blank copy of the personal action plan on the Asthma UK website.