During an asthma attack, your airways swell, become inflamed, and produce extra mucus. As the muscles around your airways contract, your bronchial tubes narrow. You may cough or wheeze and find it hard to breathe.

Asthma attacks can be minor or severe. Most improve with use of your rescue inhaler. Those that don’t can become life-threatening and should be treated as an emergency.

The best way to stop an asthma attack is to recognize the symptoms and treat it as soon as possible.

Asthma attack signs and symptoms vary from person to person. It’s important to speak with your doctor about the symptoms that are specific to you. Your doctor can also help you create an action plan. This explains what to do if your asthma worsens.

You may notice mild symptoms before an asthma attack. These include:

  • feeling tired
  • tiring easily, especially with exertion
  • signs of allergies or a cold, such as a runny nose, tickle in your throat, or nasal congestion

Common asthma attack symptoms include:

  • shortness of breath
  • chest tightening
  • coughing or wheezing
  • difficulty talking

A minor asthma attack can quickly become severe if not treated promptly. The following signs and symptoms indicate your asthma attack is worsening:

  • bluish lips
  • silent chest, which means the attack is so severe that you don’t have enough airflow to wheeze
  • low blood pressure
  • slow heart rate
  • confusion

A severe asthma attack can be life-threatening and requires emergency medical treatment.

An asthma attack can be triggered by a number of things, from allergies to illnesses. Triggers can vary from person to person.

Common triggers include:

Sometimes it can be hard to tell if you’re having an asthma attack. Knowing the signs and symptoms and tracking them can help.

Asthma action plan

People with asthma should have an asthma action plan, which you develop with your doctor. It can help you identify an asthma attack and what to do based on your symptoms.

An asthma action plan includes:

  • the type of medication you take
  • how much medication to take based on your symptoms
  • information to help you identify worsening symptoms
  • what to do in case of a severe asthma attack

Asthma action plans can help you, your family, friends, and colleagues know what to do in case you have an attack. There are forms available for children and adults that can be given to an employer or a child’s school in the event of an emergency.

Samples of electronic and printable action plans are available online through the Centers for Disease Control and Prevention and the Asthma and Allergy Foundation of America.

Peak flow meter

A peak flow meter is a portable, handheld device that’s used to measure how well you’re able to push air out of your lungs. It can be used to manage your asthma and help your doctor determine if your treatment is working.

To get your peak expiratory flow (PEF) reading, blow hard into the device’s mouthpiece. The device measures the force of air.

Your normal PEF is based on your age, height, sex, and race. Your doctor will tell you what’s normal for you. Ideally, your PEF reading should fall between 100 and 80 percent of your normal PEF.

You may notice reduced PEF readings before and during an asthma attack. For example, a PEF reading between 50 and 80 percent indicates that you’re having an asthma attack. A reading below 50 percent is considered a severe asthma attack that requires emergency medical treatment.

Peak flow meters aren’t recommended for every person with asthma. They’re most helpful for people with moderate to severe asthma who are on a long-term asthma control medication. Speak to your doctor about whether a peak flow meter is right for you.

If your rescue inhaler doesn’t help

Seek immediate medical treatment if your fast-acting inhaler doesn’t provide relief for at least four hours or fails to improve your symptoms.

Follow the directions outlined in your asthma action plan at the first sign of an asthma attack.

Treatment can vary, but it generally includes taking two to six puffs of a rescue inhaler to expand your airways.

A nebulizer may be used in small children or others who have trouble using an inhaler. A nebulizer is a device that turns liquid asthma medication, or the medication in your inhaler, into a mist. This mist is then inhaled deep into the lungs.

If your symptoms don’t improve within 20 minutes, repeat the treatment.

If your doctor has prescribed long-term asthma control medication, use it as directed in order to prevent a future asthma attack. Avoiding known triggers is also an important part of prevention.

Go to the nearest emergency room if you experience any of the following:

  • trouble speaking
  • severe wheezing or shortness of breath
  • no relief from your rescue inhaler
  • a low PEF reading

In the emergency room, you’ll be given medications to control your asthma. These include:

  • short-acting beta agonists through an inhaler or nebulizer
  • oral or IV corticosteroids to reduce lung inflammation
  • a bronchodilator
  • intubation and mechanical ventilation to pump oxygen into your lungs

The duration of an asthma attack can vary. Recovery time depends on what triggered the attack and how long your airways have been inflamed. Minor attacks may last just a few minutes. Severe attacks can last hours or days. Prompt treatment with a rescue inhaler can help you recover faster.

If you’re using your rescue inhaler frequently, speak to your doctor about changing your long-term asthma control medications.

Asthma attacks can be upsetting and interrupt your life. Work with your doctor to develop a treatment plan that works for you. Be sure to mention any changes in the frequency or severity of your symptoms.

Knowing and avoiding your triggers and taking your medication as directed can help you manage your condition and prevent future asthma attacks.