What to do if you have an asthma attack

GB-37403 DOP 04-2023

What is an asthma attack?

An asthma attack is generally brought on by asthma triggers. It is the sudden worsening of asthma symptoms in which the muscles around your airwaves tighten. This tightening is called a bronchospasm.

What happens during an asthma attack?

An asthma attack can be a very frightening thing to experience, and it can cause people to panic. During an attack, you'll find people struggle to breathe and may have shortness of breath, as well as chest tightness, wheezing and coughing (it's important to note that not everyone gets all these symptoms). This is down to the muscles that line the small airways contracting, reducing the size of the airways, and the lining of the airways becoming swollen or inflamed.

The early warning signs of an asthma attack

Spotting the signs and symptoms of an asthma attack and attending to them immediately is key to saving lives.

The symptoms of an asthma attack include:

• Rapid breathing and feeling you can't get the air into your lungs properly.

• Wheezing or coughing a lot.

• Severe or worsening chest tightness.

• Difficulty talking or walking.

• Becoming pale.

• Sweating.

• Feeling anxious.

• Blue lips or fingernails.

However, not everyone will have all of these symptoms. For example, not everyone will have blue lips or start wheezing.

Asthma UK further explains the signs of an asthma attack, adding that you are having an asthma attack if your reliever inhaler isn't helping, or you need to use it more than every four hours.

"An asthma attack happens when your symptoms get much worse. This can happen quite suddenly or can build up gradually over a few days. You can stop an asthma attack before it happens or make it less serious, so you don't end up in hospital, by recognising when your symptoms are getting worse," they say.

What causes an asthma attack?

Everyone will have triggers that their asthma is more sensitive to than those experienced by others, but some of the common triggers include:

• Exposure to an allergen (such as tree, grass or weed pollen).

• Air irritants (such as smoke, chemical fumes and strong odours such as perfume).

• Dust mites.

• Mould.

• Disinfectants.

• Pests (cockroaches, mice).

• Animal dander (material shed from animals with fur, hair, or feathers).

• Bad weather (thunderstorms, high levels of humidity, or dry air).

• Strong emotions that involve heavy breathing.

Some asthma attacks are linked to influenza (flu), colds, and respiratory infections. People can also experience a flare-up with sinus infections or acid reflux, but this is less common.

It has also been known for physical exercise, as well as some medicines, to trigger an asthma attack.

According to theAsthma and Allergy Foundation, some of the medications that can trigger asthma attacks include:

• Aspirin.

• Beta-blockers (these slow down the heart and are often prescribed for people with heart problems).

• Non-steroidal anti-inflammatory drugs (such as ibuprofen).

Additionally, Asthma UK stresses that recreational drugs can lead to serious problems with your asthma, plus your wider physical and mental health.

Recreational drugs that can have negative effects on asthma include:

• Cannabis.

• Cocaine.

• Heroin.

• Poppers.

Can you die from an asthma attack?

Since asthma attacks have the potential to be life-threatening, knowing what to do in that situation can save lives.

According to the National Review of Asthma Deaths, produced by the Royal College of Physicians, asthma deaths in the UK are among the highest in Europe.

After investigating 195 UK asthma deaths that occurred during one year, they found that 2 out of 3 of the deaths could have been prevented. When reviewing the reasons for the asthma attack deaths, 65% of cases were influenced by patient factors that could have been avoided. These include continuing to smoke despite an asthma diagnosis, not following advice from doctors about managing asthma, and not attending asthma review appointments.

The report also showed that 45% of deaths occurred before the people sought medical assistance or before emergency medical care could be given.

How long does an asthma attack last?

The length of an asthma attack tends to vary. How long an asthma attack lasts depends on what triggered it in the first place. While mild attacks can last just a few minutes, more severe asthma attacks can last for hours, or even days.

As for how they are resolved, mild asthma attacks tend to settle spontaneously or with a quick-acting inhaler. However, more severe episodes can be shortened with appropriate asthma treatment and quick thinking in contacting a medical professional.

What to do if you have an asthma attack

Keeping the knowledge of what to do during an asthma attack at the forefront of your mind could save your own - or someone else's - life.

However, they stress that this advice does not apply if you use a Maintenance and Reliever Therapy (MART) inhaler. To understand the regime for an attack if you are following a MART treatment plan, ask your GP or asthma nurse to write down step-by-step instructions for how to use your specific inhaler when it is needed.

They should tell you:

• How many puffs to take and at what intervals.

• When to call 999 if the attack does not settle.

• How many puffs to take while waiting for an ambulance.

• Whether you should switch to a blue reliever inhaler.

What to do if someone else has an asthma attack

If a friend, relative, or even a stranger, starts to have an asthma attack, it is vital you know how to respond - your actions could save their life.

It is understandable that you might panic, especially if you do not have asthma yourself or have never witnessed an attack. However, panicking and becoming flustered could make their flare-up worse. Therefore, you should try to remain as calm as possible while reassuring them that they are going to be OK.

You should also:

• Tell them to sit upright.

• Loosen any tight or restrictive clothing they are wearing.

• Encourage them to take slow, steady breaths and breathe with them to demonstrate.

• Understand the instructions with regard to using their inhaler and calling for an ambulance if their condition worsens.

Do not leave someone unattended while they are experiencing an asthma attack, and ensure they are fully recovered and their breathing is back to normal before they return to any previous activities.