Treatment for an acute asthma flare

Use your prescribed reliever exactly as your written asthma action plan directs and sit upright. If breathing is severely difficult, symptoms worsen quickly, or the reliever is not helping as expected, call emergency services without delay.

During a flare, muscles around the breathing tubes tighten while the lining becomes inflamed and may produce extra mucus. This reduces airflow and can cause wheezing, cough, chest tightness and shortness of breath. Symptoms can follow a respiratory infection, smoke, dust, allergens, exercise, weather changes or missed controller medicine, although a trigger is not always obvious.

A clinician assesses how hard you are working to breathe, your ability to speak, oxygen level and response to reliever treatment. Peak-flow measurement may help when you can perform it reliably, but it should not delay emergency care.

A fast-acting inhaled bronchodilator is commonly given through an inhaler with a spacer or through a nebuliser when clinically appropriate. Medical teams may add oxygen and a short course of corticosteroid for a more significant attack. The exact medicines and doses must follow your personal plan or the treating clinician's instructions.

After symptoms settle, arrange follow-up to review inhaler technique, controller treatment, likely triggers and the written action plan. Continue prescribed controller medicine; feeling better after reliever treatment does not resolve the underlying tendency toward airway inflammation. Keep the reliever accessible and check that the device is usable before it is urgently needed.

Call emergency services if you are gasping, cannot finish a sentence, become exhausted or confused, develop blue or grey lips, or have marked pulling-in of the skin around the ribs or neck. A very quiet chest despite severe breathlessness is also dangerous because too little air may be moving to create a wheeze.

Do not drive yourself during a severe attack. Keep using emergency medicine according to your action plan while help is on the way, and do not lie flat if sitting upright makes breathing easier.

Request a written plan that explains your everyday medicines, how to recognise deterioration, what reliever instructions apply to you and when to seek emergency help. Ask the clinician to watch your inhaler and spacer technique, discuss whether allergy symptoms are affecting control, and explain when follow-up is needed after this episode.