Asthma is a chronic lung condition that inflames and narrows the airways. An asthma attack can feel like a sudden battle raging inside your chest. Your lungs become constricted and inflamed, making every breath a struggle. 

Taking action during an asthma attack is crucial because if left untreated, a lack of oxygen reaches your bloodstream. This oxygen deprivation can have serious consequences.

The primary purpose of this guide is to arm you with tips and techniques to manage an asthma attack either as the primary victim or as a bystander.

We’ll also cover the telltale signs of an asthma attack, from the initial discomfort to the more alarming symptoms.  

What Happens To Your Airways During An Asthma Attack

To effectively manage an asthma attack, it’s important that you first understand what’s happening within your lungs. 

Your lungs are shaped like a branching network of airways, similar to an upside-down tree. These airways, called bronchi and bronchioles, lead to tiny air sacs called alveoli. 

The alveoli are where the magic happens – oxygen from the air you breathe enters your bloodstream, while carbon dioxide, a waste product, is released.

In someone with asthma, these airways are hypersensitive. When triggered by allergens, irritants, or even exercise, the airways become inflamed and narrowed. This narrowing, caused by muscle tightening and mucus production, restricts one’s airflow, which further leads to the hallmark symptoms of an asthma attack.

In severe cases, the airways can become completely blocked, leading to respiratory failure, a life-threatening condition where your body can’t get enough oxygen.

Telltale Signs of an Asthma Attack

An asthma attack doesn’t always hit like a bolt of lightning. Often, there are subtle signs that your airways are starting to narrow, giving you a window of opportunity to intervene before the attack intensifies. Here are some early warning signs to watch out for:

Wheezing

This high-pitched whistling sound is a tell-tale sign that your airways are narrowed. You might hear it when you breathe in or out, or both. It’s caused by the turbulent airflow through the constricted airways.

Fatigue and Weakness

Due to the strain on your body and the lack of oxygen, you might experience fatigue and weakness during an asthma attack.

Coughing

A dry, hacking cough is a frequent companion to an asthma attack. This cough can worsen at night or early morning, disrupting your sleep and making it difficult to rest. Sometimes, the cough might produce mucus, but not always.

Chest Tightness

This feels like a pressure or squeezing sensation in your chest, making it difficult to breathe comfortably. It can be a constant feeling or come in waves, intensifying the struggle to breathe.

Shortness of Breath (Dyspnea)

This is the most common and distressing symptom. You might feel a tightness in your chest that makes it difficult to take a full breath. 

This shortness of breath can lead to rapid, shallow breathing as you try to compensate for the limited airflow.

Rapid Breathing (Tachypnea)

As your body tries to compensate for the lack of oxygen, you might breathe much faster than usual, taking short, shallow breaths. This rapid breathing can be exhausting and further worsen your anxiety.

Blue Lips or Fingernails

This is a serious symptom indicating a lack of oxygen in your bloodstream. It requires immediate medical attention.

Inability to Speak or Complete Sentences

Due to severe shortness of breath, you might not be able to form complete sentences or speak clearly. This can be a sign that the attack is worsening and requires immediate medical attention.

Steps to Take During an Asthma Attack

 Here’s a step-by-step guide to help you regain control of your breathing:

Step One: Stay Calm

Panicking can worsen your symptoms. Find a comfortable position, preferably sitting upright and leaning slightly forward. 

This helps open your airways and makes breathing easier. Focus on taking slow, controlled breaths through your nose and out through your pursed lips.

Step 2: Use Your Reliever Inhaler 

This is your blue inhaler, often referred to as a quick-relief inhaler. It contains medicine that relaxes the muscles around your airways, making them open wider and easing your breathing. If you use a spacer device with your inhaler, now is the time to use it. 

An Asthma Spacer is a plastic chamber that attaches to your inhaler. It helps deliver the medication more effectively to your lungs, especially during an attack when coordinating breathing with inhaler use can be difficult. 

Here’s how you can use your inhaler with a spacer:

• Shake the inhaler well for at least 5 seconds. 
• Attach the inhaler to the mouthpiece end of the spacer. 
• Place the mouthpiece of the spacer between your lips and form a tight seal.
• Breathe out slowly and completely. 
• Press the inhaler canister down once while you begin to inhale slowly and deeply through your mouth. 
• Hold your breath for 10 seconds, or as long as you comfortably can. 
• Breathe out slowly through your mouth or nose.
• Repeat steps 3-6 as many times as your doctor has prescribed. The usual dosage for most reliever inhalers in Australia is 2 puffs every 4 hours. However, following your doctor’s specific instructions for your situation is crucial.

Step 3: Wait and Monitor

After using your reliever inhaler, wait for a few minutes to see if your breathing improves. Most bronchodilators start working within minutes, but it can take up to 20 minutes for the full effect. 

If you’re using a spacer, this waiting period is even more crucial as the medication needs time to settle within the spacer chamber. While you wait, continue to take slow, controlled breaths.

Step 4: Repeat If Necessary 

If your breathing doesn’t improve after the first dose, or if it starts to worsen again, use your reliever inhaler again, following the same steps as before. 

The maximum recommended dosage for most reliever inhalers, but if your breathing doesn’t improve after the maximum dosage as prescribed by your doctor, then you have to seek medical attention immediately.

Step 5: Try Practicing Breathing Techniques

Techniques like pursed-lip breathing and diaphragmatic breathing can help slow your breathing rate and manage mild asthma symptoms. However, they should not be a substitute for using your reliever inhaler during an attack.

Steps Bystanders Can Take to Help the Situation

An asthma attack can be a stressful experience for both the victims and the bystander. However, by staying calm and taking the following steps, you can offer valuable support and potentially help them manage the attack effectively.

Assess the Situation

First, try to determine the severity of the attack. Here are some things to look for:

• Is the person struggling to speak or breathe in complete sentences?
• Are their lips or fingernails turning blue?
• Is their breathing very rapid and shallow?
• Are they using their inhaler, and does it seem to be helping?

Stay Calm and Reassure the Person

An asthma attack can be frightening, so remaining calm and reassuring is crucial. Speak to the person in a gentle and supportive way. Let them know you’re there to help and that they should focus on their breathing.

Help Them Get into a Comfortable Position

If possible, assist them in sitting upright and leaning slightly forward. This position helps open their airways and makes breathing easier. Avoid laying them flat on their back, as this can worsen their breathing.

Help Them Use Their Reliever Inhaler

If the person has a reliever inhaler (usually blue) but struggles to use it, offer to help. If they use a disposable asthma spacer, help them attach it to the inhaler.

Know When to Call for Emergency Help

Even with your assistance, there are situations where immediate medical attention is critical. Call 000 if the person experiences any core asthma symptoms. 

Clear the Area of Triggers

If possible, try to identify and remove any potential triggers that might be worsening the attack. This could include dust, smoke, pet dander, or strong smells.

Stay with Them Until Help Arrives

If you’ve called for emergency services, stay with the person and continue to monitor their breathing until help arrives. Reassure them and help them stay calm.

After the Attack

Once the attack subsides, encourage the person to seek medical attention from their doctor as soon as possible. 

Their doctor can assess the severity of the attack, ensure their inhaler technique is correct, and discuss any potential adjustments to their asthma management plan.

Also Read: Why is Asthma Spacer an Indispensable Tool for Asthma Management