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Asthma

Warning Signs Of An Asthma Attack

Friday, March 16, 2012 - 17:08

Contributing Author: Guy Slowik FRCS

Asthma is an unwelcome intruder in a person's life. It is a chronic lung disease and it can't be cured. But there are several unique features of the disease that are not found with most other respiratory diseases.

  • Asthma is reversible. With good treatment, the damage to the lung can be reversed or minimized.
  • It can be controlled by avoiding asthma triggers and taking the right medicines.
  • Asthma attacks usually can be predicted. Asthma episodes normally do not occur suddenly, without warning (although it may seem that way at times). They develop over a period of time, providing a chance to start countermeasures to ward off an attack.

What Conditions May Bring On An Asthma Attack?

Changes in the external environment may signal an increase in the irritating effect of certain triggers for some people with asthma:

  • Decrease in the environmental air quality (increasing pollution index)
  • Increase in the pollen count
  • Windy, dusty conditions
  • High humidity and high temperature
  • Low humidity and low temperature

The best course of action on such days is to avoid them if at all possible by staying indoors where the environment can be better controlled.

Need To Know:

Predicting An Attack

Any number of triggers can irritate the linings of the airways in sensitive lungs. As the airways overreact, changes occur that signal a worsening of asthma control. Prediction of an asthma attack is based on recognizing changes that occur in:

  • The number of times you need to use reliever medication
  • The effectiveness of asthma medicines
  • Your sleep pattern
  • Physical activity
  • Breathing pattern
  • Peak flow meter readings

Q. Are there any early warning signs of an asthma attack that are reliable? Usually by the time I notice wheezing and coughing I'm already in bad shape.

A. Unfortunately, some "early warning signs" are not all that early for some people. Learning to recognize a cough when you don't have a cold or something caught in your throat might help. The best thing you can do is use a peak flow meter regularly and record the readings. Changes in peak flow values are usually reliable and they may occur hours or days before you notice symptoms. However, always make note of your symptoms. Peak flow measurements on their own are not enough to predict asthma attacks in every case.

If Symptoms Get Worse

Early warning signs of an asthma episode may include symptoms such as:

  • Runny, stuffy nose
  • Sneezing
  • Chin or throat itchiness
  • Headache
  • Feeling or looking tired
  • Reliever drug being used more often than usual
  • Difficulty sleeping because of symptoms such as coughing
  • Physical activity brings shortness of breath

What to do: Follow your action plan and take your medications as per the plan.

Signs that your asthma is becoming severe:

  • Awakening at night, unable to sleep
  • Reliever drug is bringing little relief
  • Breathlessness is getting worse

What to do: Contact your doctor immediately.

Signs that you asthma has become dangerous:

  • Reliever drug brings no relief
  • Peak flow stays in the red zone after using rescue medication
  • Difficulty speaking
  • Walking is difficult
  • Feeling of fright
  • Faint-headed

What to do: Go to the closest hospital emergency department immediately.

How-To Information

If your symptoms do not improve even after you have followed your action plan, you should go to the emergency department.

What To Expect At The Emergency Department

  • Fast-acting beta2-bronchodilators that open the airways will probably first be given to you with a small-volume nebulizer. Nebulizers produce a fine mist of medication that can be inhaled through a facemask or mouthpiece and require no "coordination" between breathing in and the delivery of drug to the lungs.
  • You will also probably receive additional asthma medications, possibly through an intravenous (IV) line that delivers drug directly to the bloodstream.
  • Steroid medication may be necessary to quickly reduce the inflammation in the air passages.
  • Oxygen will probably be delivered through a facemask or through small tubes that fit under your nose.
  • In more serious cases of asthma, intubation may be required. In this procedure a breathing tube is placed into the throat so that oxygen can be delivered directly to the lungs.

Asthma