Asthma exacerbation explained

It may develop quickly or build over time. Cough, wheezing, chest tightness, breathlessness, night waking and reduced ability to carry out normal activities can signal deterioration. The episode can become dangerous when breathing effort rises or prescribed reliever medicine provides inadequate relief.

Airway muscles tighten while the airway lining swells and may produce more mucus, leaving less space for air to move. Respiratory infections, smoke, dust, allergens, cold air, exercise or missed controller treatment may contribute. Sometimes no single trigger is clear, so the change from your usual symptom pattern matters.

Use your written asthma action plan as soon as symptoms worsen. Sit upright, stay away from an obvious trigger, and take prescribed reliever treatment according to the plan. Do not lie flat or wait for severe symptoms before acting. If the plan includes monitoring, record symptoms and readings without delaying care.

After an exacerbation, arrange follow-up to discuss the likely trigger, inhaler technique, controller use and whether the action plan needs updating. Do not make ongoing medicine changes without clinical guidance.

Seek emergency medical help for severe or rapidly worsening breathlessness, inability to speak in full sentences, blue or grey lips, confusion, exhaustion, marked drowsiness, or reliever medicine that is not working as your plan describes. Continue the emergency actions in your plan while help is on the way, and do not drive yourself if breathing is severely impaired.

Ask what may have triggered the episode, whether your daily control is adequate, and how to recognise early deterioration next time. Have the clinician observe your inhaler technique and clarify each action-plan instruction, including when to repeat reliever treatment and when to call emergency services.