Asthma Attacks: What to Do
When most people hear the words “asthma attack,” they immediately picture a person struggling to breathe, and an extremely scary situation. In reality, the terms “asthma attack” or “asthma flare-up” mean any sudden worsening of asthma symptoms.
During an attack, the muscles in the airways tighten, narrow, and become inflamed. This is called a bronchospasm. An attack is characterized by three components: the bronchospasm, inflammation of the airways, and increased, thicker mucus production.
Many different things can bring on an attack, but the most common causes are allergens, changes in weather, viral infections, strenuous activity, and even stress!
There are also many different symptoms that stem from an attack. A person may have one or more of the following, depending on the severity of the flare-up:
- Wheezing and cough
- Pale, sweaty face
- Blue lips and/or nails
- Chest pain or pressure
- Differences in talking
- Rapid or difficult breathing
- Higher pulse
- Anxiety or panic
- Tightened neck and chest muscles (known as retractions)
- Itchy chin before shortness of breath
- Nocturnal coughing
- Problems feeding, poor sucking, or grunting during feeding (infants)
“Before an asthma attack, patients’ eyes may start looking differently, their coughing may increase or wake them up at night, and some may even start sleepwalking,” explained Dr. Robert Strunk, professor of pediatrics at the Washington University School of Medicine.
The most effective way to treat an asthma attack is to follow the instructions in the “asthma action plan.” Asthma action plans are developed between parents and healthcare providers, and give detailed instructions on what to do when asthma symptoms increase.
The plan is divided into three color-coded zones, much like a traffic light, and is meant to be used to control asthma symptoms. The plan includes treatment goals, medications, dosage instructions, and in some instances, an asthma diary section and directions for a peak flow meter, which measures how well a person’s asthma is controlled.
Asthma symptoms are well-controlled, and patient is feeling well and acting normally. Lung function is good, and peak flow meter readings are at or above 80 percent of personal best readings. Suggestions are to avoid asthma triggers and continue medication regimen. This is a preventative zone.
Asthma symptoms are present and the airways are somewhat narrowed. Patients may need to change or increase their medications during this time. Peak flow meter readings are between 50 and 79 percent of personal best readings. It is recommended to use quick-acting or “rescue” medications at this time.
Asthma symptoms are unbearable. Airways are extremely narrowed and breathing is so hard it interferes with walking, talking, eating, etc. Yellow zone medications have already been administered and have had no effect. Peak flow meter readings are less than 50 percent of personal best readings. It is imperative to seek medical help as soon as one is in this zone.
“Definitely follow the action plan if your child is having an attack,” said Strunk. “The green is when the child is well; yellow is when symptoms like the eyes and sleepwalking start and medications are increased; and red is time to call your doctor or go to the ER.”
Remember: Immediately call 911 if the skin around the neck or ribs is sucked in and/or lips and fingernails are gray or blue.