Types of asthma attacks

During a flare-up, muscles around the airways tighten, the lining swells and mucus can increase. You may notice wheezing, cough, chest tightness or shortness of breath. Some attacks build gradually after a trigger such as an infection, exercise, smoke, cold air or an allergen; others become difficult quickly.

A mild episode may settle with the reliever plan provided for you. A worsening episode may show through repeated symptoms, reduced ability to speak or do usual activities, or relief that does not last. Severity is judged by symptoms and response, not by a label alone.

Stop the activity, sit upright and follow your personal asthma action plan, including the reliever dose it specifies. Move away from a known trigger if possible. Keep track of how symptoms respond and ask someone to stay with you if breathing is becoming harder.

If your plan says to use a spacer, use it as instructed. A nebuliser may be used by healthcare professionals when inhaled treatment needs to be delivered during an acute episode; it is not a substitute for emergency assessment.

Call emergency services if you are struggling to breathe, cannot speak in full sentences, become drowsy or confused, develop blue or grey lips, or your reliever is not helping as your plan predicts. Do not drive yourself during severe breathing difficulty. Urgent review is also needed after a serious attack or repeated night symptoms.

Ask how to recognise your early warning signs, when to repeat reliever treatment, when to call emergency services, and whether your preventer needs adjustment. Practise inhaler and spacer technique during a review.