Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2011;84(1):49-50

See related article on acute asthma exacerbations.

What is an asthma attack?

An asthma attack, or flare-up, is when your asthma symptoms suddenly get worse.

What are the symptoms?

You may have any of the following:

  • Shortness of breath, trouble breathing, or fast breathing

  • Trouble doing normal activities, such as exercising, playing sports, or doing chores that involve lifting

  • Trouble talking

  • Fingers or lips turning blue or gray

  • A peak flow rate (how fast you can blow air out of your lungs) less than 80 percent of your personal best

  • Tightness in your chest

What causes it?

An asthma attack can be caused by many things, such as viruses; stress; not taking your medicine; or breathing irritants like tobacco smoke, perfumes, animal hair, or dust.

How can I avoid it?

Try to stay away from whatever makes your symptoms worse. You should have regular checkups with your doctor to make sure your asthma is under control. Take your medicines as directed by your doctor and get refills before they run out. You should use a spacer with your inhaler to get the most from your medicine.

Having an asthma action plan can help you notice when your symptoms are getting worse. Your doctor can help you make a plan like this one: Once you know what your personal best peak flow is, you can check it regularly and keep a flow chart to track your asthma.

You should get a flu shot every year to help avoid getting the flu. Your doctor may also tell you to get a pneumonia shot.

What should I do if I think I'm having an asthma attack?

Stay calm and use your inhaler with the spacer. If you can, check your peak flow to see how bad the attack is. If you have a nebulizer, use this instead of an inhaler. If your breathing gets easier after using your medicine, you may still want to call your doctor to discuss follow-up or other treatments. Make sure your family knows what to do if you have an asthma attack.

When should I go to the emergency department?

Call 911 or go to the emergency department if:

  • Your inhaler is not helping

  • Your breathing is getting worse

  • Your peak flow gets worse after a treatment, or is less than 50 percent of your personal best (or less than 70 percent if you have frequent asthma attacks)

  • You feel drowsy

What can I expect at the hospital?

The doctor or nurse will check your oxygen level and give you more oxygen. He or she may check your peak flow and do a blood test. You may have to take other medicines, such as nebulizer treatments or steroids. The medicines may be given through an IV. You also may need to stay overnight in the hospital, depending on how bad your attack was and your response to treatment.

Where can I get more information?

Your doctor

AAFP's Patient Education Resource

Allergy and Asthma Network Mothers of Asthmatics

American Academy of Allergy Asthma and Immunology

Asthma and Allergy Foundation of America

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