What is an asthma attack?

Asthma attacks (asthma exacerbation) are when your asthma symptoms become worse, either suddenly or over a few hours or days. 

While asthma attacks are often shown on TV as something quick and easy to fix, this isn’t always the case. It’s important to make sure that you’ve got the right treatment plan in place to prevent and help if you have an attack. 

What are the symptoms of an asthma attack?

The most common signs of an asthma attack are:

• your regular asthma symptoms (coughing, breathlessness, wheezing, or tightening in your chest) getting worse
• your reliever inhaler doesn’t help
• feeling panicky or anxious
• sweating more
• breathing faster or struggling to catch your breath
• scoring lower on a peak flow test
• struggling to eat and sleep because you’re feeling so breathless

Asthmatic children sometimes complain of tummy or chest pain too. 

Asthma attacks don’t always come on quickly, so you may experience some of these symptoms over a longer period like a few hours or days.

What happens during an asthma attack?

During an asthma attack, your airways become inflamed and swollen, and the muscles around your airways get tighter. This produces extra mucus causing your breathing tubes to get narrower too. Because of this, you may have trouble breathing, cough more, and wheeze. 

What does an asthma attack look like?

Asthma attacks usually look like someone getting their normal asthma symptoms, but worse. They may be coughing, wheezing, or becoming too breathless to eat or sleep. Their face may start to sweat and they may look pale.

Not everyone experiences asthma attacks in the same way though, so not all asthma attacks will look the same.

What does an asthma attack feel like?

Asthma attacks can feel like your chest is tightening, it’s getting harder to breathe, or you’re finding it harder to catch your breath. They can also make you feel anxious or panicked.

How long do asthma attacks last?

Mild asthma attacks can last for only a few minutes, whereas severe asthma attacks can last for hours or even days. How long an asthma attack lasts depends on its severity, what’s triggered it, and how long your airways have been inflamed.

How severe is an asthma attack?

Not all asthma attacks are classed as severe. Some can be mild.

Mild asthma attacks can go away on their own or be resolved by taking medication, like using your  reliever inhaler and following the steps on your asthma action plan to increase your preventative treatment until your symptoms have improved. 

Severe asthma attacks that don’t improve with treatment at home can turn into life-threatening emergencies. While severe asthma attacks are rarer, some things can make you more likely to have them. If you’ve had them before or are exposed to things that trigger them, you may be more at risk.

How do I know if I’m having an asthma attack?

The sooner you can work out if you’re having an asthma attack, the faster you can make sure you’re getting appropriate treatment. 

Top 5 early signs of an asthma attack

• Breathing rapidly
• Coughing, and it won’t stop
• Wheezing severely
• Struggling to catch your breath
• Getting tightness in your chest

If you have been diagnosed with asthma, you will be taught the signs and symptoms of an asthma attack by your doctor so you can be prepared if you have one. If you’ve had an asthma attack in the past, you will be familiar with the signs to look out for in yourself too.. You can also check your asthma action plan which you and your doctor or nurse will create together at your yearly asthma review. 

It’s also important to remember that other conditions may have similar symptoms to asthma, so you need to make sure you’re having an asthma attack and not experiencing something else that might require medical attention. If you are unsure if your symptoms are due to your asthma contact a doctor who will be able to ask more questions and examine you to help find the correct treatment. 

What causes an asthma attack?

People with asthma often have common triggers that can cause an asthma attack. It is important to try to avoid these triggers if you have asthma, although sometimes this can be difficult. 

Common triggers include: 

• infections, such as colds or flus, which can affect your breathing tubes
• allergies, particularly to pollen, dust mites, animal fur and feathers, which can irritate your breathing tubes
• smoke, fumes, and pollution, which can make it more difficult to breathe.
• medicines, particularly anti inflammatory painkillers such as ibuprofen and aspirin which can narrow your airways (bronchospasm)
• weather conditions, such as cold air, wind, thunderstorms, heat, and humidity, some of which can make common allergies worse
• mould and damp, which can cause an allergic reaction and lead to an attack if you have allergic asthma
• strenuous exercise, which can narrow your airways

Work related asthma triggers

Asthma can be linked with substances you may be exposed to at work. This is called ‘work related asthma’ or “occupational asthma”.

The most common causes include:

• chemicals usually found in spray paint (isocyanates)
• flour and grain dust
• animals
• colophony
• latex
• wood dust

This usually affects bakers, pastry makers, nurses, chemical workers, animal handlers, and food processing workers who are typically exposed to these substances. However, any kind of job that puts you in contact with chemicals could cause your asthma. If you develop asthma symptoms on starting a new job or your symptoms get better when you are away from work contact your GP. They will speak to you about  specialist referral to help diagnose and manage your symptoms.

How to treat an asthma attack?

How to treat an asthma attack will depend on what triggered your asthma and the severity of the attack. Not everyone experiences asthma in the same way, so how one person treats an asthma attack may be different to how another person does. 

The most common way to treat a mild asthma attack is with a reliever inhaler at home. 

Severe asthma attacks may require an urgent doctor appointment or emergency medical assistance.

What to do if you’re having an asthma attack

If you think you’re having an asthma attack:

• Sit upright, and try to remain calm
• Take a single puff of your reliever inhaler every 30 to 60 seconds, but don’t take more than 10 puffs
• If your asthma is still getting worse or you don’t feel better after 10 puffs, call 999 for an ambulance
• Wait 10 minutes, and repeat the second step if the ambulance has not arrived.
• Wait another 10 minutes, then call 999 again if the ambulance has still not arrived

Bring your medication or asthma action plan to the hospital if you can, but don’t waste time looking for it. 

If you find your symptoms improve by following the instructions on your asthma action plan and you do not need an ambulance, book an urgent appointment immediately to see an asthma nurse or GP.

If you think you are having an asthma attack and you do not have your reliever inhaler, follow these steps.

• Sit up straight and try to remain calm
• Steady your breathing and try to take slow deep breaths as much as possible.
• Call 999 for an ambulance
• If you can identify what’s triggering your asthma attack, move away from it, if possible

What to do if someone else is having an asthma attack

If someone else is having an asthma attack, try to help them by making sure they can follow their asthma action plan.

• Remain calm, and try to help them follow their asthma action plan
• Help them use their reliever inhaler, if they need assistance
• Help them sit and remain upright, if they are unable to do so on their own
• Call 999 and tell them you need an ambulance for someone having a severe asthma attack
• Do not leave them unattended while waiting for an ambulance
• Continue to call 999 for support every 10 minutes until the ambulance arrives

If the person you are helping passes out from an asthma attack, lay them down safely. If they stop breathing, start CPR if you feel able to do so.

Your friends and family should be made aware of how to help you if you have an asthma attack. We recommend making copies of your asthma action plan and sharing this with those close to you or those who are around you regularly such as family, friends, partners, housemates, and work colleagues.. The more advice and support you can give them to help them understand your condition and how to help you, the better prepared they’ll be in an emergency.

How to prevent asthma attacks

The best ways to lower your risk of having an asthma attack are to:

• identify what triggers your asthma where possible, and do your best to avoid these
• attend regular asthma reviews with your asthma nurse or doctor (at least once a year)
• double check with your nurse, GP or pharmacist that you’re using your inhaler correctly
• always follow your asthma action plan and make sure you’re taking all of your asthma medication as prescribed.
• never ignore your symptoms, especially if they’re getting worse or you start using your reliever inhaler more regularly than normal
• get your flu jab and stay away from people when they have colds or flu to prevent yourself from catching these where possible
• use a home peak flow metre to check how well air is moving through your lungs so you can quickly know if you’re having an asthma attack
• stop smoking and avoid smoke in general, such as smoke from fireworks, candles, fire, and incense

sources

Asthma NICE [accessed 1st August 2022]

Asthma NHS [accessed 1st August 2022]

Asthma Attack American College of Allergy, Asthma, and Immunology [accessed 1st August 2022]

Asthma attacks NHS [accessed 1st August 2022]