Asthma attack causes: triggers and warning signs

Triggers differ between people and may include viral respiratory infections, smoke, dust mites, pollen, pets, strong fumes, cold air, exercise or emotional stress. Sometimes no single trigger is obvious.

Muscles around the breathing tubes tighten while the lining swells and produces mucus. Less air can move through, causing wheeze, cough, chest tightness or shortness of breath. Asthma commonly presents with these symptoms, but their intensity and combination can change from one episode to another.

An attack may follow several exposures rather than one event. For example, a respiratory infection can make the airways more sensitive, then smoke or exertion can worsen the narrowing.

Stop the activity, move away from smoke, fumes or another identifiable trigger, and sit upright. Follow your written asthma action plan and use your prescribed reliever exactly as directed. Stay with a child or anyone who is frightened or struggling to breathe.

Once breathing has settled, record where the episode occurred, recent illness, exposures and how the reliever worked. Repeated symptoms, night waking or increasing reliever use merit a clinical review of inhaler technique, treatment and trigger control.

Call local emergency services now if the person is gasping, cannot speak comfortably, has blue or grey lips, becomes confused or drowsy, collapses, or is rapidly worsening. Urgent help is also needed when the prescribed reliever is unavailable, does not provide the expected relief, or symptoms return quickly after use.

Do not drive yourself during severe breathing difficulty. Continue the emergency steps in the person’s action plan while help is coming, and do not lie them flat.

Ask which triggers fit your symptom pattern, whether your preventer needs adjustment, and how to recognise that an episode is becoming dangerous. Request a demonstration of inhaler and spacer technique and a written plan explaining daily treatment, worsening symptoms and emergency action.