What should you know about severe asthma attack symptoms?

A severe asthma attack can cause breathlessness at rest, rapid breathing, chest tightness, persistent cough, and wheezing. Speaking may become difficult because each breath is being used to move air. The person may pull in muscles around the ribs or neck, sit forward to breathe, or become exhausted.

Some severe attacks produce very little wheeze because airflow is so restricted. A quiet chest in someone who is struggling is therefore not reassuring. Symptoms of asthma can overlap with other emergencies, so do not try to diagnose the cause at home when breathing is seriously impaired.

Use the person’s prescribed reliever and written action plan, keep them upright, and remove obvious irritants such as smoke. Watch their ability to speak, alertness, colour, and breathing effort while arranging help. Do not give someone else’s inhaler or delay emergency care while trying home remedies. Note the time symptoms worsened and which medicines were taken for the clinicians.

Call emergency services when breathing is severe, speech is limited to words, the person is confused or drowsy, lips appear blue or grey, or rescue medicine is not bringing clear improvement. An emergency team can provide oxygen and fast-acting inhaled treatment, sometimes through a nebuliser, and assess whether hospital monitoring is needed.

Ask how your early symptoms differ from severe symptoms, what your action plan says at each stage, how to check inhaler technique, and whether allergies, infection, or another condition may be aggravating your asthma.