Table of ContentsView AllTable of ContentsSymptomsWhat to Do Without InhalerWhat to Do With InhalerWhen Symptoms StopWhen to Go to the ERNext in Asthma GuideManaging Asthma Flare-Ups
Table of ContentsView All
View All
Table of Contents
Symptoms
What to Do Without Inhaler
What to Do With Inhaler
When Symptoms Stop
When to Go to the ER
Next in Asthma Guide
Asthmaattacks can cause distress, especially if you don’t feel prepared or confident to handle one. An asthma attack can cause the airway tubes in your lungs (bronchi) to tighten up, causing symptoms like coughing,wheezing, a tight feeling in the chest, and difficulty breathing.
This article discusses how you know you are having an asthma attack. You’ll learn what you should do if you have or don’t have your rescue inhaler, the type used to treat an immediate asthma attack. You’ll also learn how long to expect the attack to last and when to call a healthcare provider or seek emergency treatment.
Javier Zayas Photography / Getty Images
Asthma Attack Symptoms: How to Tell in the Moment
Sometimes your asthma symptoms will start after exposure to something you knowtriggersyour asthma, like exercise, cold air, a viral infection, chemicals, smoke, perfume, pet dander, dust, or pollen.However, sometimes, the trigger isn’t apparent.
If you’ve had asthma for a while, you probably know what an asthma attack feels like. It might start with coughing, and then you might begin to wheeze, making a whistling sound when you breathe. Your chest may feel tight, like something is pressing on it.
You can have a hard time getting your breath. Some people describe it as feeling like the air is getting sucked out of them or trying to get all their air through a straw. Difficulty getting air in could cause you to feel light-headed.Many people have mild symptoms that are bothersome but treatable.
Asthma Action PlanEveryone with asthma should have an asthma action treatment plan they’ve worked out with a healthcare provider. This might includeyour regular daily medications (oral or inhaled), a short-acting “rescue inhaler” to use during an attack, and additional therapies if you still have symptoms afterward.
Asthma Action Plan
Everyone with asthma should have an asthma action treatment plan they’ve worked out with a healthcare provider. This might includeyour regular daily medications (oral or inhaled), a short-acting “rescue inhaler” to use during an attack, and additional therapies if you still have symptoms afterward.
Severe Attack Symptoms
Severe attacksare more serious. In a more severe attack, you may have such difficulty breathing that it becomes challenging to complete a sentence. People with more severe attacks may also have symptoms such as:
If this happens, seek immediate medical attention.
Quiet Asthma AttackSometimes a person with a severe asthma attack might not move enough air through the lungs to cough or wheeze. Aquiet attackcan be serious and potentially life-threatening.
Quiet Asthma Attack
Sometimes a person with a severe asthma attack might not move enough air through the lungs to cough or wheeze. Aquiet attackcan be serious and potentially life-threatening.
Asthma Attack Without Inhaler: What to Do
Ideally, you’ll always have a rescue inhaler around to use if an asthma attack happens. However, even if you don’t have an inhaler, you can take steps like the following to help resolve the attack:
It may help to drink abeverage with caffeine, like tea or coffee. Caffeine is closely related to a compound sometimes used to treat asthma (theophylline).
Asthma Attack With Inhaler: What to Do
If you have an asthma attack and your rescue inhaler is available, use it immediately. The medication you inhale opens up the bronchi in your lungs, allowing you to breathe more easily. Unlike other medicines you might take for asthma, you should only use the rescue inhaler if you have an attack.
Ideally, you’ll already have read the instructions that came with your inhaler or talked with a healthcare professional about administering it.
The specifics of giving yourself the inhaler may vary based on the type of medication and the healthcare provider’s instructions. It’s best to use an inhaler attached to a spacer, a space connecting the inhaler medication and the mouthpiece.This helps you breathe the medicine more effectively.
However, as a general rule, you should do the following:
The medical professional who prescribed the inhaler for you should have given you instructions about how frequently you can use the inhaler. For some medications, you can repeat this process immediately, starting with shaking. For others, like albuterol, you should wait one minute before repeating the sprays.
Rinse your mouth with water after using your inhaler, and spit it out afterward to reduce potentialmedication side effects.
The approach of removing triggers, staying calm, breathing slowly, and sitting upright also applies to people who have a rescue inhaler available.
Other Rescue Therapies
Not everyone uses an inhaler for their rescue asthma treatment. Another option is anebulizer, which turns the liquid medicine into a mist you can inhale through a face mask.
After your initial rescue treatment, follow your healthcare provider’s instructions about follow-up with additional treatment. For example, if your symptoms are still significant after an hour, they might have prescribed you to use a different type of rescue inhaler, a rescue nebulizer treatment, or an oral steroid.
4:4:4 RuleYou can use the 4:4:4 rule to remember how to handle an asthma attack. After sitting upright, take four separate puffs on their inhaler. If you haven’t improved after four minutes, take another four puffs.If there is still no improvement, get emergency help. Keep delivering four puffs every four minutes, up to the limit your specific medication allows.
4:4:4 Rule
You can use the 4:4:4 rule to remember how to handle an asthma attack. After sitting upright, take four separate puffs on their inhaler. If you haven’t improved after four minutes, take another four puffs.If there is still no improvement, get emergency help. Keep delivering four puffs every four minutes, up to the limit your specific medication allows.
When Do Asthma Attack Symptoms Stop?
When an asthma attack stopscan varybased on the length and severity of airway inflammation. After a mild episode, symptoms might go away within minutes, sometimes spontaneously. Other times they resolve within a few minutes after using a quick-acting inhaler. However, you might feel the lingering effects of more severe attacks for hours or even days.
If Symptoms Don’t StopIf symptoms aren’t starting to improve after 20 minutes of using a rescue inhaler, seek emergency medical care. If you have moderate symptoms that still haven’t gone away after 24 hours, call a healthcare provider.
If Symptoms Don’t Stop
If symptoms aren’t starting to improve after 20 minutes of using a rescue inhaler, seek emergency medical care. If you have moderate symptoms that still haven’t gone away after 24 hours, call a healthcare provider.
Asthma Attack Not Ending: When to Get Emergency Care
Some people need to get emergency care for an asthma attack. It’s imperative if the person has previously experienced apotentially fatal asthma attackknown as status asthmaticus.
Always seek assistance if you have any doubts, but the following situations might increase the need for emergency care:
If you or someone you care for is showing any life-threatening signs that don’t quickly resolve, get emergency care immediately—don’t wait for a healthcare provider to call you back. Emergency symptoms include fingernails or lips turning blue or gray, severe difficulty breathing, confusion, or decreased consciousness.
At the emergency room, they can use treatments given through a nebulizer or intravenous (IV) line in your vein. They could also provide oxygen or breathing support through a ventilator if needed.
Summary
The shortness of breath, chest pain, cough, and wheezing from an asthma attack can be scary to experience or watch. However, knowing how to handle a potential attack can make you feel more confident and in control.
Asthma attack symptoms sometimes resolve quickly, but other times they may take longer. Some people even need emergency treatment. Don’t hesitate to get help for potentially life-threatening symptoms like severe difficulty breathing or blue or gray skin.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling C, Buhl R, et al.Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.NPJ Prim Care Respir Med. 2023 Feb 8;33(1):7. doi:10.1038/s41533-023-00330-1American College of Emergency Physicians.Asthma.National Institutes of Health. National Heart, Lung, and Blood Institute.Asthma attack.Centers for Disease Control and Prevention.Asthma action plan.Guo H, Zhao Q, Li SY, Xu X, Xu N, Lv C, Shen ZS, Li JG.Successful treatment of fatal asthma combined with a silent chest: A case report.J Int Med Res. 2020 May;48(5):300060520925683. doi:10.1177/0300060520925683American College of Allergy, Asthma & Immunology.Asthma attack.Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonça KM.Breathing exercises for adults with asthma.Cochrane Database Syst Rev. 2020 Mar 25;3(3):CD001277. doi:10.1002/14651858.CD001277.pub4Welsh EJ, Bara A, Barley E, Cates CJ.Caffeine for asthma.Cochrane Database Syst Rev. 2010 Jan 20;2010(1):CD001112. doi:10.1002/14651858.CD001112.pub2Sockrider M, George, M.Treating asthma symptoms with quick relief bronchodilators: Prescription or over-the-counter inhalers.American Thoracic Society.Food and Drug Administration.PROAIR HFA (albuterol sulfate).National Institutes of Health. Medline plus.How to use an inhaler—no spacer.New South Wales Government.4 steps of asthma first aid.Al-Shamrani A, Al-Harbi AS, Bagais K, Alenazi A, Alqwaiee M.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019 Jun;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling C, Buhl R, et al.Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.NPJ Prim Care Respir Med. 2023 Feb 8;33(1):7. doi:10.1038/s41533-023-00330-1American College of Emergency Physicians.Asthma.National Institutes of Health. National Heart, Lung, and Blood Institute.Asthma attack.Centers for Disease Control and Prevention.Asthma action plan.Guo H, Zhao Q, Li SY, Xu X, Xu N, Lv C, Shen ZS, Li JG.Successful treatment of fatal asthma combined with a silent chest: A case report.J Int Med Res. 2020 May;48(5):300060520925683. doi:10.1177/0300060520925683American College of Allergy, Asthma & Immunology.Asthma attack.Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonça KM.Breathing exercises for adults with asthma.Cochrane Database Syst Rev. 2020 Mar 25;3(3):CD001277. doi:10.1002/14651858.CD001277.pub4Welsh EJ, Bara A, Barley E, Cates CJ.Caffeine for asthma.Cochrane Database Syst Rev. 2010 Jan 20;2010(1):CD001112. doi:10.1002/14651858.CD001112.pub2Sockrider M, George, M.Treating asthma symptoms with quick relief bronchodilators: Prescription or over-the-counter inhalers.American Thoracic Society.Food and Drug Administration.PROAIR HFA (albuterol sulfate).National Institutes of Health. Medline plus.How to use an inhaler—no spacer.New South Wales Government.4 steps of asthma first aid.Al-Shamrani A, Al-Harbi AS, Bagais K, Alenazi A, Alqwaiee M.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019 Jun;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling C, Buhl R, et al.Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.NPJ Prim Care Respir Med. 2023 Feb 8;33(1):7. doi:10.1038/s41533-023-00330-1American College of Emergency Physicians.Asthma.National Institutes of Health. National Heart, Lung, and Blood Institute.Asthma attack.Centers for Disease Control and Prevention.Asthma action plan.Guo H, Zhao Q, Li SY, Xu X, Xu N, Lv C, Shen ZS, Li JG.Successful treatment of fatal asthma combined with a silent chest: A case report.J Int Med Res. 2020 May;48(5):300060520925683. doi:10.1177/0300060520925683American College of Allergy, Asthma & Immunology.Asthma attack.Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonça KM.Breathing exercises for adults with asthma.Cochrane Database Syst Rev. 2020 Mar 25;3(3):CD001277. doi:10.1002/14651858.CD001277.pub4Welsh EJ, Bara A, Barley E, Cates CJ.Caffeine for asthma.Cochrane Database Syst Rev. 2010 Jan 20;2010(1):CD001112. doi:10.1002/14651858.CD001112.pub2Sockrider M, George, M.Treating asthma symptoms with quick relief bronchodilators: Prescription or over-the-counter inhalers.American Thoracic Society.Food and Drug Administration.PROAIR HFA (albuterol sulfate).National Institutes of Health. Medline plus.How to use an inhaler—no spacer.New South Wales Government.4 steps of asthma first aid.Al-Shamrani A, Al-Harbi AS, Bagais K, Alenazi A, Alqwaiee M.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019 Jun;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling C, Buhl R, et al.Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.NPJ Prim Care Respir Med. 2023 Feb 8;33(1):7. doi:10.1038/s41533-023-00330-1
American College of Emergency Physicians.Asthma.
National Institutes of Health. National Heart, Lung, and Blood Institute.Asthma attack.
Centers for Disease Control and Prevention.Asthma action plan.
Guo H, Zhao Q, Li SY, Xu X, Xu N, Lv C, Shen ZS, Li JG.Successful treatment of fatal asthma combined with a silent chest: A case report.J Int Med Res. 2020 May;48(5):300060520925683. doi:10.1177/0300060520925683
American College of Allergy, Asthma & Immunology.Asthma attack.
Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonça KM.Breathing exercises for adults with asthma.Cochrane Database Syst Rev. 2020 Mar 25;3(3):CD001277. doi:10.1002/14651858.CD001277.pub4
Welsh EJ, Bara A, Barley E, Cates CJ.Caffeine for asthma.Cochrane Database Syst Rev. 2010 Jan 20;2010(1):CD001112. doi:10.1002/14651858.CD001112.pub2
Sockrider M, George, M.Treating asthma symptoms with quick relief bronchodilators: Prescription or over-the-counter inhalers.American Thoracic Society.
Food and Drug Administration.PROAIR HFA (albuterol sulfate).
National Institutes of Health. Medline plus.How to use an inhaler—no spacer.
New South Wales Government.4 steps of asthma first aid.
Al-Shamrani A, Al-Harbi AS, Bagais K, Alenazi A, Alqwaiee M.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019 Jun;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
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