What should you know about prolonged expiratory phase and wheezing?

Wheezing is a musical or whistling sound made when air moves through narrowed airways. Asthma, acute bronchitis, COPD, bronchiolitis and allergic rhinitis can all be associated with wheezing. A sudden episode after eating, taking a medicine or an insect sting may indicate anaphylaxis and is an emergency. The direction is from an airway problem to wheezing: wheezing alone does not establish which condition is present.

Sit upright and avoid smoke, strong fragrances and known triggers. If you have a prescribed reliever inhaler or written action plan, follow it exactly. Note when the sound began, whether it occurs at rest or with activity, and whether cough, fever, rash or chest tightness accompanies it. Arrange an assessment for new, persistent or recurrent wheezing. A clinician may consider inhaler technique, breathing tests or a nebuliser treatment depending on the findings.

Seek emergency help for sudden wheezing with facial or throat swelling, widespread hives, faintness, severe breathlessness, blue or grey lips, confusion, or difficulty speaking. Urgent assessment is also needed if breathing is worsening or prescribed reliever treatment is not helping. Children with noisy breathing, poor feeding or unusual sleepiness need prompt medical attention.

Ask what may be narrowing the airways, whether you need breathing tests, how to use prescribed treatment, and which warning signs should trigger emergency help. Tell the clinician about smoking or vaping, allergies, infections, workplace exposures and previous episodes.