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What is an asthma attack?

Asthma affects approximately 300 million people worldwide. People who have this condition have inflamed, swollen and sensitive airways that can narrow and become clogged with sticky mucus when exposed to a trigger. This can lead to shortness of breath, tightness in the chest and coughing and wheezing during an asthma attack.

Every ten seconds, someone has a potentially life-threatening asthma attack. The main reason an attack will occur is when asthma isn’t controlled well, so the chances of you having an asthma attack are much lower when you correctly take your asthma treatment.

Medically reviewed by

Daniel Atkinson, GP Clinical Lead

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Medically reviewed by

Dr Daniel Atkinson

GP Clinical Lead

on August 02, 2022.

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What to do in an asthma attack

Knowing the signs of an asthma attack and what to do is important if you or someone you know suffers from asthma. It’s also a really good idea to learn how to treat an asthma attack if you encounter one, as this could save a life. A severe asthma attack that does not get better with conventional asthma treatment could become a life-threatening emergency.

If you are having an asthma attack, you should sit upright and avoid lying down. Concentrate on taking slow and steady breaths and try to remain calm.
Every 30-60 seconds take one puff of your reliever inhaler (this is often blue). Take no more than 10 puffs. If you don’t have your inhaler on you, you are feeling worse after using your inhaler, or you are feeling concerned at any point, then you must call an ambulance.
If the ambulance takes more than 15 minutes to arrive, then you should repeat the above process (taking a puff of your reliever inhaler every 30-60 seconds up to 10 puffs). Don’t be afraid to call the emergency services for help. If you follow the above steps and your symptoms improve, then you don’t need to call the emergency services. However, you should still arrange an urgent appointment with your GP (on the same day if possible).

If someone you know is having an asthma attack, then you should help them follow the above steps.

The above advice is not applicable for those who take SMART or MART treatment. You should speak to an asthma nurse or GP for advice on what to do if you are taking this treatment and have an asthma attack.

How can friends and family help?

Friends and family should know how to help asthma patients in the event of an emergency. Speak to the people you spend time with about your asthma condition so that they are aware of it and can help you if needed.

Writing up your action plan to deal with an asthma attack and sharing it with people close to you will help them know what to do if you have an attack in their presence. Keeping a copy on your phone is also highly recommended.

What causes asthma attacks?

Understanding what triggers your asthma attacks could help you prevent them, however, it’s possible for everyone to have different asthma attack triggers, so it can be difficult to fully understand what causes them.

That being said, one of the main asthma attack causes is poorly managed asthma, so keeping on top of your medication could potentially save your life.

Other common triggers of asthma attacks include infections, allergies, air pollutants, medicines, strong emotions, the weather, exercise, mould or damp air. Taking your asthma medications properly and knowing your triggers will help you to control your symptoms and reduce the risk of an asthma attack in the future.

Signs of an asthma attack

When the symptoms of asthma worsen for a short and intense period, this means you are having an asthma attack. Asthma attacks can come on gradually or suddenly. Therefore, in some cases, especially when the attack is gradual, you’ll have time to ask yourself ‘am I having an asthma attack?’ Knowing how to recognize an asthma attack can help you or someone you know control their symptoms and get through the attack safely.

Common symptoms of an asthma attack include:

wheezing
coughing
a tight chest
being too breathless to talk, eat or sleep
a rapid heart rate
faster breathing
drowsiness
exhaustion
dizziness
confusion

In severe cases, the attack could cause people to have blue fingers or lips and to faint.

If you notice the signs and symptoms of a severe asthma attack and the steps to stop the attack aren’t working, then you should call an ambulance on 999 to get the help you need.

What is a slow onset asthma attack?

Gradual asthma attacks are also known as a slow-onset asthma attack. Most people associate asthma attacks with a quick and sudden occurrence, so being aware of slow-onset attacks is also important.

These gradual attacks are associated with a progressive difficulty to breathe. Fortunately, unlike sudden onset asthma attacks (which can become serious within minutes), people who experience a slow onset attack will have more time to seek help or follow the necessary steps to relieve their symptoms.

What happens in an asthma attack?

In order to understand what happens in an asthma attack, we need to understand a little about the biological makeup of the lungs. The lungs are complex organs that have a specific structure that allows them to work efficiently.
Inside the lungs, the larger airways are lined with cartilage, so they don’t collapse. However, the smaller airways (bronchi and bronchioles) lack this support. Muscular tubes make up the smaller airways and many mucus-secreting cells are located within their lining.
When you have an asthma attack, your airways become inflamed and swollen. This will lead to the muscles around the airways contracting and an increased production of mucus. This will block up the smaller airways that contain the mucus-secreting cells and lack cartilage support. Contractions and mucus secretions will narrow the bronchial (breathing) tubes, which obstruct airflow and make it harder to breathe. Therefore, many people will struggle to catch their breath, experience a tight chest and will wheeze and cough when they are having an asthma attack.

Is there asthma attack treatment?

There is no cure for asthma at present but getting the right asthma medication can help you control your symptoms so you can live normally and have an active lifestyle.

If you have an asthma attack, the initial treatment is found in the form of a reliever inhaler. This contains medicine that can help you to breathe more easily. If your reliever inhaler doesn’t reduce your symptoms during an asthma attack, then you’ll need to go to the hospital.

What asthma attack treatment is given in the hospital?

When you attend A&E, the first thing you will have to do is register. If you are taken in by ambulance, a member of the team will register you. This will include personal details, like your name, address and reasons for your visit to A&E. Some hospitals will have a separate A&E department for children.

Once you are registered, a nurse or doctor will carry out a pre-assessment. The assessment will determine your treatment, which may include a nebuliser or steroids.

A nebuliser allows you to inhale liquid medication in the form of a mist, while steroids help to calm and reduce swelling and inflammation, easing the symptoms of an asthma attack. Steroids are usually given in the form of a liquid or tablets. In urgent cases, they will be administered through a cannula (a small tube in a vein in the back of your hand) or injected into a vein.

For the medical team to get a clear understanding of your symptoms, they may arrange scans or X-rays. The results will allow doctors to rule out or treat infections, blockages, heart failure, pulmonary fibrosis (lung scarring) and tumours. Once you have been discharged from the hospital, you should book an appointment with your GP or an asthma nurse soon after.

How to prevent asthma attacks

If you want to know how to stop an asthma attack, the best thing you can do is prevent it from happening in the first place.
If you notice your asthma symptoms are getting worse, don’t ignore them. This can be the first indication that your asthma is poorly managed.
Check your own inhaler technique regularly. You should also attend a regular asthma review with your doctor or asthma nurse where they check on your technique as well.
If you’re prescribed any other medication for another condition, check that it is suitable for people with asthma.
If possible, try and identify what it is that triggers your asthma symptoms and avoid it as much as you can.
Living a healthy lifestyle by exercising often, eating a healthy diet, not smoking and keeping up with vaccinations (like the flu jab and pneumococcal vaccines) can also reduce the risk of an asthma attack.
Speak to friends and family about your condition so that they can help you pick up on any concerns.
Is your asthma action plan up to date? If you’re unsure, speak to your doctor or asthma nurse.

Manage your asthma on subscription

As we’ve already mentioned, the best way to avoid an asthma attack is to keep your asthma well-managed. If you’re concerned that your asthma might not be as well under control as it could be, talk to a clinician. They can help you select the best treatment for your condition and even switch you to a new inhaler if they think another one might work a little better for you. Find out more about asthma subscription options and our aftercare service.

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When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

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Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.