Treatment for an acute asthma exacerbation

At home, treatment should follow the person's written asthma action plan. In a clinic or emergency setting, care is adjusted to breathing effort, oxygen level, ability to speak, airflow measurements when feasible and response to initial medicine.

A rapid-acting inhaled bronchodilator relaxes tightened airway muscle. A spacer can help inhaled medicine reach the lungs, while a nebuliser may be selected when repeated or assisted delivery is appropriate. These delivery methods do not replace assessment of severity.

Clinicians may add anti-inflammatory corticosteroid treatment when a significant flare is present. Supplemental oxygen is used when oxygen levels are low. Antibiotics do not treat airway tightening and are reserved for situations where the assessment supports a bacterial infection.

Take only the rescue medicine, dose and timing specified in your action plan or by the treating clinician. Sit upright, use the prescribed spacer correctly and note whether speaking, chest tightness and breathing effort improve. Bring all inhalers and the action plan when attending urgent care.

Once the immediate flare settles, complete any prescribed short course exactly as directed and continue controller medicine unless told otherwise. A review should check inhaler technique, adherence, trigger exposure and whether the daily regimen offers adequate protection. Rinsing the mouth after an inhaled corticosteroid can reduce local irritation.

Call emergency services when the person is struggling to speak, becoming drowsy or confused, turning blue or grey around the lips, collapsing, or showing severe chest and neck effort with each breath. Do the same if rescue treatment has little effect or deterioration continues.

Urgent reassessment is also needed when relief fades much sooner than expected or breathlessness returns after discharge. Do not drive yourself if breathing is severely impaired; continue action-plan rescue treatment while someone contacts emergency help.

Ask what improvement to expect from each medicine, which side effects need attention, and when to return for review. Confirm the exact action-plan threshold for rescue doses and emergency care, and request hands-on correction of your inhaler and spacer technique.