Recognising and responding to an asthma flare-up

Asthma often presents with more cough, wheeze, chest tightness, or breathlessness during a flare. Waking at night, struggling with usual activity, or needing the reliever more often can be early signs that control is deteriorating.

A viral illness, tobacco smoke, dust, pollen, animal allergens, strong fumes, weather changes, exercise, or missed controller doses may provoke worsening. Sometimes several factors overlap, and a clear trigger is not always found.

The severity can change over hours. A quiet chest in someone working hard to breathe is not reassuring because very little air may be moving. Response to the prescribed reliever and the person's ability to speak and move are more useful warning clues.

Stop strenuous activity, sit upright, leave an obvious smoky or dusty area, and take the prescribed reliever according to your written plan. Use the correct inhaler technique and a spacer if one forms part of the prescription.

Monitor whether breathing, speaking, and movement become easier. If improvement is incomplete or short-lived, seek urgent assessment rather than repeatedly improvising extra doses. Continue controller treatment unless the plan or a clinician gives different instructions.

Call emergency services if breathlessness is severe, talking becomes difficult, lips or face turn blue or grey, confusion or drowsiness develops, the person collapses, or the reliever has little effect. Someone with severe symptoms should not be left alone or drive.

Contact a clinician promptly when symptoms keep returning, disturb sleep, restrict everyday tasks, or require reliever treatment more often than the action plan allows. Early review can prevent further deterioration.

Discuss the likely trigger, inhaler technique, controller adherence, and whether the written plan needs updating. Ask how to recognise your earliest warning sign and exactly when to move from home treatment to urgent assessment.