An asthma attack occurs when the endothelial lining of the bronchial tubes becomes inflamed, leading to narrowing of the airways and restriction of the airflow into and out of the lungs. Some particular factors, known as triggers, are linked to the worsening of asthma symptoms and may increase difficulty breathing.
Signs that indicate poorly controlled asthma, such as wheezing and difficulty breathing, should prompt intervention to improve symptoms and prevent progression to an acute asthma attack. During an attack, it can be very difficult for the individual to breathe and emergency medical help is often required to manage the symptoms.
Triggers for an asthma attack
There are several triggers that are associated with worsening of asthma symptoms and the onset of an asthma attack, including:
- Exposure to allergens (e.g. pollen, dust, animal fur)
- Exposure to irritants (e.g. smoke, chemical fumes)
- Illness (e.g. cold, influenza)
- Strenuous exercise
- Extreme weather conditions
- Crying or laughing
- Significant emotional changes
Symptoms of Worsening Asthma
Often people with asthma go through periods where their symptoms of asthma are more profound than usual, and their breathing may be somewhat inhibited, known as a flare-up. This commonly occurs after exposure to a trigger, such as when an individual has been sick with the flu.
Symptoms of worsening asthma may include:
- Shortness of breath
- Chest tightness or pain
- Coughing or wheezing
The lung function can be measured with respiratory tests such as the peak expiratory flow (PEF) meter that indicates how fast the air can be exhaled from the lungs. Lower results than usual indicate that inflammation and narrowing of the airways have increased, making it more difficult for the air to pass through.
The symptoms of an asthma attack may last for a varied length of time, depending on the cause and level of inflammation in the airways. In some cases, the symptoms may only last for a few minutes and resolve simultaneously but may last for hours or day. The patient should follow their asthma action plan that outlines the steps to be taken to manage a flare up and may require reliever medication to enable normal breathing.
Signs of an Acute Attack
An acute asthma attack occurs when the inflammation in the airways restricts the airways substantially and may be life-threatening in some cases. It is important for all individuals to have an understanding of these danger signs so that bystanders can recognise an asthma attack and seek the appropriate help.
Signs of an asthma attack include:
- Severe breathlessness and/or wheezing
- Inability to form full sentences due to shortness of breath
- Straining of chest muscles to breath
- Hunched posture and difficulty walking
- Confusion and reduced responsiveness
The PEF measurement is likely to be significantly reduced but, in many cases, patients are unable to control their breathing significantly to perform the test.
When someone is having an asthma attack, it is crucial to maintain composure and follow the asthma action plan without causing the patient to become more stressed, which can worsen symptoms.
Short-acting, rapid onset beta2-agonist medications, such as salbutamol, should be administered via inhalation to dilate the bronchi and allow the patient to breathe more easily. Anticholinergic medications can also be used to help relax the muscles in the airways.
If the symptoms do not resolve with the administration of reliever medications, emergency medical aid is likely to be needed. While waiting for emergency help, administration of reliever medication should be continued at regular intervals to help reduce narrowing of the airways.