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Asthma Attack

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Dec.15.2020
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 Asthma Attack

Asthma Attack

Asthma attack, also called acute bronchospasm, is the sudden narrowing and tightening of the air passages, which limits the amount of oxygen that can get into the lungs. The narrowing is caused by inflammation and tightening of the muscles in the air tubes (bronchi) in the lungs.

Too much mucus is also produced, which narrows the airways more. This can cause trouble breathing, loud breathing (wheezing), and coughing. The goal of treatment is to open the airways in the lungs and reduce inflammation.

What are the causes?

Possible causes or triggers of this condition include:
  • Animal dander, dust mites, or cockroaches.
  • Mold, pollen from trees or grass, or cold air.
  • Air pollutants such as dust, household cleaners, aerosol sprays, strong chemicals, strong odors, and smoke of any kind.
  • Stress or strong emotions such as crying or laughing hard.
  • Exercise or activity that requires a lot of energy.
  • Substances in foods and drinks, such as dried fruits and wine, called sulfites.
  • Certain medicines or medical conditions such as:
    • Aspirin or beta-blockers.
    • Infections or inflammatory conditions, such as a flu (influenza), a cold, pneumonia, or inflammation of the nasal membranes (rhinitis).
    • Gastroesophageal reflux disease (GERD). GERD is a condition in which stomach acid backs up into your esophagus and spills into your trachea (windpipe), which can irritate your airways.

What are the signs or symptoms?

Symptoms of this condition include:
  • Wheezing. This may sound like whistling while breathing. This may only happen at night.
  • Excessive coughing. This may only happen at night.
  • Chest tightness or pain.
  • Shortness of breath.
  • Feeling like you cannot get enough air no matter how hard you breathe (air hunger).

How is this diagnosed?

This condition may be diagnosed based on:
  • Your medical history.
  • Your symptoms.
  • A physical exam.
  • Tests to check for other causes of your symptoms or other conditions that may have triggered your asthma attack. These tests may include:
    • A chest X-ray.
    • Blood tests.
    • Tests to assess lung function, such as breathing into a device that measures how much air you can inhale and exhale (spirometry).

How is this treated?

Treatment for this condition depends on the severity and cause of your asthma attack.
  • For mild attacks, you may receive medicines through a hand-held inhaler (metered dose inhaler, or MDI) or through a device that turns liquid medicine into a mist (nebulizer). These medicines include:
    • Quick relief or rescue medicines that quickly relax the airways and lungs.
    • Long-acting medicines that are used daily to prevent (control) your asthma symptoms.
  • For moderate or severe attacks, you may be treated with steroid medicines by mouth or through an IV injection at the hospital.
  • For severe attacks, you may need oxygen therapy or a breathing machine (ventilator).
  • If your asthma attack was caused by an infection from bacteria, you will be given antibiotic medicines.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
    • Keep your medicines up-to-date.
    • Make sure you have all of your medicines available at all times.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
  • Tell your doctor if you may be pregnant to make sure your asthma medicine is safe to use during pregnancy.

Avoiding triggers

  • Keep track of things that trigger your asthma attacks. Avoid exposure to these triggers.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
  • When there is a lot of pollen, air pollution, or humidity, keep windows closed and use an air conditioner or go to places with air conditioning.

Asthma action plan

  • Work with your health care provider to make a written plan for managing and treating your asthma attacks (asthma action plan). This plan should include:
    • A list of your asthma triggers and how to avoid them.
    • A list of symptoms that you may have during an asthma attack.
    • Information about which medicine to take, when to take the medicine and how much of the medicine to take.
    • Information to help you understand your peak flow measurements.
    • Daily actions that you can take to control your asthma symptoms.
    • Contact information for your health care providers.
  • If you have an asthma attack, act quickly. Follow the emergency steps on your written asthma action plan. This may prevent you from needing to go to the hospital.

General instructions

  • Avoid excessive exercise or activity until your asthma attack goes away. Ask your health care provider what activities are safe for you and when you can return to your normal activities.
  • Stay up to date on all your vaccines, such as flu and pneumonia vaccines.
  • Drink enough fluid to keep your urine pale yellow. Staying hydrated helps keep mucus in your lungs thin so it can be coughed up easily.
  • Do not use alcohol until you have recovered.
  • Keep all follow-up visits as told by your health care provider. This is important. Asthma requires careful medical care.

Contact a health care provider if:

  • You have followed your action plan for 1 hour and your peak flow reading is still at 50–79%. This is in the yellow zone, which means "caution."
  • You need to use your quick reliever medicine more frequently than normal.
  • Your medicines are causing side effects, such as rash, itching, swelling, or trouble breathing.
  • Your symptoms do not improve after 48 hours.
  • You cough up mucus that is thicker than usual.
  • You have a fever.

Get help right away if:

  • Your peak flow reading is less than 50% of your personal best. This is in the red zone, which means "danger."
  • You have trouble breathing.
  • You develop chest pain or discomfort.
  • Your medicines no longer seem to be helping.
  • You are coughing up bloody mucus.
  • You have a fever and your symptoms suddenly get worse.
  • You have trouble swallowing.
  • You feel very tired, and breathing becomes tiring.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Asthma attacks are caused by narrowing or tightness in air passages, which causes shortness of breath, coughing, and loud breathing (wheezing).
  • Many things can trigger an asthma attack, such as allergens, weather changes, exercise, strong odors, and smoke of any kind.
  • If you have an asthma attack, act quickly. Follow the emergency steps on your written asthma action plan.
  • Get help right away if you have severe trouble breathing, chest pain, or fever, or if your home medicines are no longer helping with your symptoms.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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