Treatment for an Asthma Flare-Up

During a flare-up, the airways narrow and become inflamed, making it harder to move air. Cough, wheezing, chest tightness and shortness of breath may increase, sometimes after a viral infection, allergen, smoke, exercise or cold air. A person can have a serious flare-up without dramatic wheezing, so the ability to speak, walk and carry out the action plan matters. Asthma symptoms that repeatedly wake you or limit activity suggest that regular treatment needs review.

Stop the activity, sit upright and stay calm. Use the reliever inhaler exactly as your written asthma action plan says, with a spacer if prescribed. If the medicine is not helping, symptoms are worsening, or you have no inhaler, call emergency services. Do not drive yourself when breathing is severely difficult. A nebuliser may be used by healthcare professionals for selected severe attacks, but it is not a reason to delay emergency care. Once recovered, arrange a review to check inhaler technique, triggers, preventer use and the written plan.

Call emergency services immediately if the person is struggling to breathe, cannot speak in full sentences, becomes drowsy or confused, has blue or grey lips, collapses, or gets little relief from the reliever. Seek urgent assessment for rapidly worsening symptoms, chest pain, or a flare-up after a severe allergic reaction. Keep taking prescribed preventer treatment unless a clinician gives different instructions; do not borrow another person’s inhaler.

Ask the clinician to demonstrate inhaler and spacer technique, explain exactly when to repeat reliever doses, and provide a written action plan. Discuss preventer adherence, allergy or smoke triggers, vaccinations, exercise, and when lung-function review is needed.