Asthma Attack – Diagnosis and Treatment
Diagnosis
When asthma is suspected, doctors look at both symptoms and test results to make a diagnosis. Common signs that point to asthma include shortness of breath, wheezing, coughing that often gets worse at night, and a feeling of tightness in the chest.
These symptoms can change in how often and how strongly they happen. The doctor will also ask about any triggers, such as dust, pollen, exercise, or other irritants that make symptoms worse.
Key Symptoms of Asthma:
- Wheezing (a whistling sound when breathing)
- Repeated cough
- Chest tightness or discomfort
- Shortness of breath
- Coughing that worsens at night or with activity
Doctors may do several tests in the clinic or hospital to check the lungs and assess the severity of the condition. These tests show how well the lungs work and how much air a person can move in and out.
| Test Name | What It Measures | Why It Matters |
|---|---|---|
| Peak flow meter | Speed of air forced out of lungs | Detects narrowing of airways (bronchoconstriction) |
| Spirometry | Amount and speed of air breathed out | Shows lung function and degree of obstruction |
| Pulse oximeter | Percent of oxygen in blood | Checks how well oxygen is reaching the body |
| Nitric oxide test | Nitric oxide in exhaled breath | Indicates swelling and inflammation in lungs |
Doctors may also consider blood tests and check the heart rate to see if low oxygen is making the heart work harder. Allergy tests can help identify allergic asthma.
Based on symptoms and test results, doctors classify asthma as mild, moderate, or severe. Pulmonary function tests help track asthma in adults or children and guide treatment choices.
Treatment
Moderate Warning Signs
When asthma symptoms become moderate—such as increased coughing, wheezing, chest tightness, or a peak flow reading between 50% and 79% of a person’s best score—this indicates that action is needed.
At this stage, people often use short-acting beta-agonists (SABAs) delivered through an inhaler or a nebulizer as quick-relief medication. A spacer device may help deliver the medication more effectively if someone has difficulty using an inhaler.
A typical approach in this situation includes:
- Taking the recommended number of puffs of the quick-relief inhaler.
- Waiting for a set period, then repeating if needed.
- Using a nebulizer for young children or those unable to use an inhaler.
- Starting oral corticosteroids (a type of steroid pill) if directed by a healthcare professional.
- Monitoring symptoms closely to see if there is any improvement.
People should track how they feel and check peak flow readings regularly. If recommended by a doctor, they may change doses or add extra medicines. If symptoms persist or worsen, they should visit a clinic for further treatment.
Example Table: Key Medications for Moderate Symptoms
| Medication | How Given | Purpose |
|---|---|---|
| Short-acting beta-agonist (SABA) | Inhaler/Nebulizer | Opens airways quickly |
| Corticosteroids | Pill | Reduces inflammation |
Sometimes, health care providers prescribe daily control medicines such as inhaled steroids to improve overall asthma control and prevent future attacks.
Serious Warning Signs
If breathing becomes much harder, symptoms get worse, or peak flow drops below 50% of the person’s best, urgent action is needed. Signs for concern include extreme shortness of breath, difficulty talking, and being unable to do ordinary activities.
Immediate steps include:
- Using fast-acting bronchodilators right away.
- Taking extra doses as advised by a doctor.
- Following instructions to take oral steroids if prescribed.
- Preparing to seek urgent medical care, such as calling a healthcare professional or going to the emergency department.
Medical staff at the emergency department may use bronchial thermoplasty or other advanced treatment options for long-term asthma control in some cases.
Warning Signs Table
| Symptom | Action Needed |
|---|---|
| Severe shortness of breath | Seek emergency care immediately. |
| Peak flow <50% | Use emergency medication, go to the hospital. |
| Unable to do daily tasks | Get medical help right away. |
Care for Extreme Breathing Problems
If a person goes to the emergency department for a severe asthma flare-up, the medical team takes several steps to stabilize breathing. Treatments may include:
- Giving oxygen through a mask or nose tube if blood oxygen is low.
- Providing fast-acting inhalers or nebulizers with bronchodilators.
- Using oral or injected corticosteroids to quickly reduce airway swelling.
- Administering mechanical ventilation, which could be a mask or a breathing tube placed in the windpipe, if breathing stops or the attack is very severe.
Nurses and doctors closely watch the person while treatments take effect. The patient may stay at the hospital until their breathing returns to normal for a period of time.
Checklist: Discharge and Follow-Up Care
- Instructions on using long-term and emergency medicines at home.
- Plan for when to use quick-relief inhalers.
- Steps for monitoring symptoms and peak flow readings.
- Guidance on when to return for follow-up with a regular healthcare provider.
- Information about when to seek urgent help for future asthma attacks.
Support from a healthcare professional helps manage asthma over time and lowers the risk of future severe attacks.
Getting Ready for Your Visit
Questions Your Doctor May Ask
Before a visit about asthma management, prepare to discuss your condition. The healthcare provider will focus on how well you control your asthma and whether you need any changes.
Expect to answer questions about your recent symptoms and any challenges you have using your inhaler or peak flow meter.
Common topics discussed:
- Triggers: Doctors often ask if symptoms get worse around tobacco smoke, pollen, dust mites, animal fur, mold, or air pollution. Note if exercise or respiratory infections bring on attacks.
- Medicine Use: List all current asthma medicines, how often you need quick-relief inhalers, and any problems with the medicine.
- Asthma Action Plan: Doctors may ask you to explain how you use your asthma action plan, when you follow its steps, and if you have any confusion.
- Symptoms: The doctor might ask how often asthma causes issues, any new or worsening symptoms, and if anything keeps you from everyday activities.
Sample Table of Common Questions
| Topic | Possible Questions |
|---|---|
| Triggers | Do you notice issues with tobacco smoke, pollen, or dust? |
| Medicine | Are you taking all prescribed asthma medicines? |
| Action Plan | Can you explain how your asthma plan helps you? |
| Emergency Steps | Do you know when to seek urgent care? |
Practical tips to help the visit:
- Bring an updated list of all medicines and the asthma action plan.
- Carry any peak flow meter results and prepare to show how to use both the inhaler and meter.
- Consider questions or problems with management, such as handling triggers like pet dander or air pollution.
