Extreme wheezing

Wheezing is a musical or whistling sound caused by narrowed airways. It can accompany asthma, COPD, acute bronchitis or a viral illness; allergic rhinitis may aggravate airway symptoms. Bronchiolitis is a consideration in young children. Sudden wheeze after food, medicine or an insect sting can be part of anaphylaxis. Note whether the sound is on breathing in or out, whether it started abruptly, and whether you can speak in full sentences.

Sit upright, loosen tight clothing and move away from smoke, dust or a known trigger. Use your prescribed reliever inhaler exactly as your action plan says; do not borrow someone else’s medicine. Keep a child calm and avoid forcing food or drink when breathing is hard. If symptoms do not settle quickly, arrange urgent medical assessment. A clinician may use inhaled treatment, oxygen or a nebuliser depending on the cause and examination.

Call emergency services for blue or grey lips, severe breathlessness, exhaustion, confusion, fainting, chest pain, inability to speak normally, or rapidly worsening wheeze. Swelling of the lips, tongue or throat, widespread hives, or wheeze after an exposure may indicate anaphylaxis and needs immediate action. Do not drive yourself if you are struggling to breathe.

Ask what triggered the episode, whether asthma or another airway condition should be checked, and how to use your inhaler or written action plan. Share your usual breathing symptoms, previous attacks, medicines, allergies, smoking or vaping exposure, and any fever or cough.