What should you know about severe asthma exacerbation?

An exacerbation, also called a flare, occurs when asthma symptoms become more intense than usual. Inflamed, tightened airways can lead to breathlessness, wheezing, cough, and chest tightness. The change may follow a cold, allergen exposure, air pollution, smoke, exertion, or missed regular treatment, although the cause is not always obvious.

Severity is judged by breathing effort, ability to speak and function, alertness, and response to the person’s reliever plan. A flare can worsen quickly, so waiting for symptoms to disappear without following the plan can be unsafe.

Stop exertion, sit upright, and follow the written asthma action plan. Take prescribed reliever medicine exactly as instructed and arrange urgent clinical advice if improvement is incomplete or short-lived. Avoid smoke and other known triggers. Keep a record of the trigger you suspect, symptom changes, and medicines taken; this helps the clinician adjust prevention after the episode.

Call emergency services for severe or rapidly worsening breathlessness, inability to speak normally, blue or grey lips, confusion, marked drowsiness, or little response to rescue treatment. Urgent clinicians may use oxygen, inhaled medicines, steroids, and observation. Arrange follow-up after any severe exacerbation, even if breathing feels better, so the action plan and long-term treatment can be reviewed.

Ask what may have triggered the flare, whether your preventer dose and inhaler technique are suitable, how to recognise your personal warning signs, and when to seek same-day or emergency care next time.