What is an asthma attack?

Asthma is a chronic (long-term) inflammatory lung condition that can cause chest tightness and wheezing. An asthma attack, also known as a flare-up, is when your asthma symptoms become worse than normal.

An asthma attack can be caused by a variety of triggers, including cigarette smoke and some respiratory viruses.

Common symptoms of an asthma attack include:

• shortness of breath
• a persistent cough
• chest tightness

What are the symptoms of an asthma attack?

The symptoms of an asthma attack depend on how severe it is.

Mild

The symptoms of a mild asthma episode include:

• a cough
• mild wheezing
• some difficulty breathing

Moderate

The symptoms of a moderate asthma attack include:

• a persistent cough (a cough that won't go away)
• having a lot of difficulty breathing
• only being able to speak a few words at a time
• a loud wheeze

Severe asthma attack

The symptoms of a severe asthma attack include:

• gasping for breath or using a lot of energy to breathe
• not being able to breathe
• only being able to speak one word at a time
• pale or blue-coloured lips

What causes an asthma attack?

Different triggers can cause an asthma attack, including:

• respiratory viruses such as rhinovirus (a virus that causes the common cold)
• air pollution
• environmental allergens (things in the air that cause allergies) such as pollen
• cigarette smoke

Some people have a lot of asthma triggers and other people only have a few. You may have a different response to certain triggers than someone else with asthma.

You can read more about asthma in:

• children under 6
• children 6 to 11
• adolescents and adults
• pregnancy
• thunderstorms

When should I see my doctor?

If you have asthma, it's important to see your doctor every 6 to 12 months to review your asthma medicines and your asthma action plan.

You should also see your doctor as soon as possible after you have an asthma attack. Your doctor may recommend changes to your asthma action plan to lower your chance of having another asthma attack in the future.

See your doctor if you are not sure what to do during an asthma attack.

When to seek urgent care

You should get urgent care if you have any symptoms of a severe asthma attack.

You should also seek urgent care if:

• your asthma symptoms get worse quickly
• you get little or no relief from your inhaler during an asthma attack

Continue to do asthma first aid while you wait for help.

How is an asthma attack treated?

Treatment for an asthma attack will depend on how severe it is.

Medicines for an asthma attack

An asthma attack is usually treated with a bronchodilator, also known as an asthma reliever. Bronchodilators help open your airways, which makes breathing easier. A well-known bronchodilator is salbutamol (also called Ventolin).

Some combination anti-inflammatory inhalers can also be used as a reliever. They contain both a quick-acting reliever called formoterol and a low dose of corticosteroid.

If you are having an asthma attack you should take your reliever medicine as instructed by your asthma first aid plan or your doctor. This will help:

• improve your symptoms quickly
• prevent the asthma attack getting worse
• reduce the chance of damage to your airways

If you have an asthma attack but have not been diagnosed with asthma, your doctor may recommend that you start using asthma prevention medicine.

Asthma prevention medicines contain small amounts of corticosteroids, which reduce the inflammation in your airways. Taking asthma prevention medicine can lower your chance of having an asthma attack in the future.

Self-care at home

Often you can manage a mild or moderate asthma attack at home by following your asthma action plan or doing asthma first aid:

1. Sit upright and remain calm.
2. Take 4 puffs of your blue/grey puffer.
3. Wait 4 minutes.
4. If your symptoms are not improving, call triple zero (000) and ask for an ambulance. Keep repeating steps 1 to 3 while you wait for help.
5. If you start to improve and can breathe normally again, see your doctor for a checkup as soon as possible.

Other treatment options

If your asthma attack is severe, you will need to go to hospital.

In hospital you may be given supplementary (extra) oxygen to help bring your oxygen levels back up to normal. This is usually given by using a face mask or a nasal cannula (small prongs in your nose).

You may also be given fast-acting bronchodilators in hospital. These are like asthma relievers but are designed to work quickly in situations such as a severe asthma attack.

What are the complications of an asthma attack?

Some complications of an asthma attack include:

• Airway damage — if it's not treated quickly, an asthma attack can cause damage to the tissue in your airway. This damage can make it harder for you to respond to asthma medicines in the future.
• Respiratory infection — the medicines used to treat an asthma attack can make you more likely to get respiratory infections such as pneumonia. If you have recently had an asthma attack your doctor may recommend that you take antibiotics to help prevent a respiratory infection.
• Respiratory failure (breathing failure) — an asthma attack can cause respiratory failure; however, this is rare. You are more likely to have respiratory failure due to an asthma attack if you have previously been intubated (had a tube placed in your airway to help you breathe).

Severe asthma attacks can be life-threatening.

How can an asthma attack be prevented?

Asthma attacks can't always be prevented, but there are ways to lower your risk of having an asthma attack.

Asthma medicines

You can help reduce your risk of having an asthma attack by using the right asthma medicines:

• Asthma relievers — these help to open your airways to relieve your symptoms during an asthma attack. If you have asthma, you should have your asthma reliever with you at all times.
• Asthma preventers — these help to keep your asthma under control. Preventer medicines usually contain low doses of corticosteroids that reduce inflammation in your airways.

It's important to learn to use these devices properly. Watch the National Asthma Council's how-to videos on how to use your inhaler.

Learn more about the types of medicines for asthma.

Asthma action plan

See your doctor for an asthma action plan. Your asthma action plan should include:

• the medicines you can take to manage your condition
• what you should do if you have an asthma attack

You should review your treatment plan regularly with your doctor.

Other prevention strategies

You can also help lower your risk of having an asthma attack by:

• avoiding cigarette smoke
• avoiding your asthma triggers, such as pollen
• having a healthy bodyweight
• staying up to date with your vaccinations

Resources and support

Find out more about the latest update to the Australian Asthma Handbook and what it means to people living with asthma.

The National Asthma Council Australia has more information on the signs of an asthma attack and asthma first aid.

The Asthma Australia page offers:

• information about how to recognise and treat an asthma attack
• asthma information and videos in languages other than English

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.