Treatment Options For Severe Asthma
Your asthma treatment depends on how severe your symptoms are on a regular basis. If you have severe asthma, its likely that you already take long-term control medications. You may also have a rescue inhaler on hand just in case an asthma attack occurs.
Severe asthma attacks dont respond to regular asthma treatment, so you need emergency medical treatment if your rescue medications arent working. At the emergency room, your medical team may:
- use a test called pulse oximetry to tell how much oxygen is in your blood
- measure your PEF to determine how much and how fast you exhale
- take a nitric oxide measurement to determine bronchial tube inflammation
- measure your forced expiratory volume with a spirometry test
- perform a chest X-ray
Once your doctor confirms that youre having a severe asthma attack, they may administer one or more of the following:
- albuterol, an inhaled aerosol or powder
- ipratropium , a type of inhaled bronchodilator used when rescue inhalers alone are not enough
- oral or intravenous corticosteroids to control inflammation
- practicing breathing techniques
- eating anti-inflammatory foods
First, its important to get lots of rest post-attack. Your body needs to recover from the stress of an asthma attack, and you may also feel emotionally drained. Take time off work if needed and put chores on the back burner while you recover. Ask for help from friends and family for anything that cant wait.
What Other Tools Can I Use For Monitoring Asthma Control
Peak Flow Meter
Sometimes doctors recommend a peak flow meter a handheld device that measures how well air moves out of your lungs. A peak flow meter, when used every day, can spot reduced airflow before you notice the signs and symptoms of an asthma episode.
Peak flow meter readings can help you monitor your asthma control. But they are just one tool. Your peak flow meter reading is not the only indicator of asthma control. Always follow your Asthma Action Plan.
Pulse Oximeter
Doctors use pulse oximeters to measure how much oxygen your blood is carrying. Some people with asthma may experience a drop in their oxygen levels in their blood.
Pulse oximeters you can buy online and use at home are not as accurate as medical grade devices. Monitoring your blood oxygen levels with pulse oximeters is not a recommended part of home management of asthma.
Lung Function Tests
Your allergist or pulmonologist may use different lung function tests to assess your asthma control. Learn more about the tests used to diagnose and monitor asthma.
How Is A Severe Asthma Attack Diagnosed
A healthcare provider will perform a lung function test to determine the severity of your asthma. There are different types of lung function tests using different types of devices to measure your airflow, including:
- Spirometry: During a spirometry test, the patient will breathe into a tube that is attached to a laptop or a machine called a spirometer. As you breathe, the spirometer will measure how much and how fast air goes in and out. You can expect your provider to do this test before and after you take a medication to open up your airways, called a bronchodilator, to see if there is improvement with medication.
- Peak expiratory flow : Peak flow measures the amount of air you can forcefully exhale. This form of measurement is helpful in monitoring severity, but is not used for diagnosing asthma.
- Fractional exhaled nitric oxide :Asthma causes the lungs to become inflamed and produces a substance called nitric oxide. This test measures the amount of nitric oxide to determine how much inflammation is in the lungs.
- Provocation: During a provocation test, a healthcare provider will introduce different allergens to see how your body reacts and how you respond when medication is administered.
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After An Asthma Attack: Changing Your Asthma Management Or Asthma Attack Treatment
After an asthma attack evaluation, your doctor may want to step up treatment, step down treatment, change treatment, or increase your doctor visits, said Bernstein.
Some signs that your treatment plan may need to change include:
- Frequent asthma attacks
- Needing to take more asthma medication than prescribed
- Waking up at night with asthma symptoms
- Daytime activity limited by asthma
- Continued cough, congestion, and mucous production
- Poor peak flow rates
Knowing what to do after an asthma attack is part of learning how to manage your asthma. Each asthma attack is a chance to learn more about your asthma triggers and your asthma medications. Sharing this information with your doctor gives you and your doctor the opportunity to make the right adjustments to your asthma action plan â and that could mean fewer asthma attacks in your future.
Who Can Get Asthma
Anyone can develop asthma at any age. People with allergies or people exposed to tobacco smoke are more likely to develop asthma. This includes secondhand smoke and thirdhand smoke .
Statistics show that people assigned female at birth tend to have asthma more than people assigned male at birth. Asthma affects Black people more frequently than other races.
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What To Do After An Asthma Attack:
One in six people who receive treatment at the hospital needs emergency treatment again within two weeks. Asthma attacks are not normal and you should not tolerate them.
Take the following key steps to prevent you having another attack in the future:
- Book an urgent appointment with your healthcare provider
- Keep taking your asthma medication as prescribed
- Take the rest of the day to recover after the attack
It is important to know that the majority of severe asthma episodes can be avoided by having good asthma control.
Asthma Symptoms In A Severe Allergic Reaction
People having a severe allergic reaction can also have asthma-like symptoms. If the person has an anaphylaxis action plan, follow the instructions.
Always give adrenaline injector first, then asthma reliever if someone with known asthma and allergy to food, insects or medication has sudden breathing difficulty even if there are no skin symptoms. In case of an emergency, call triple zero and ask for an ambulance.
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Why Does My Asthma Act Up At Night
Asthma can get worse at night. If you have symptoms at night, it’s called nighttime asthma. This is often a sign of uncontrolled asthma. It probably has to do with natural body rhythms and changes in your body’s hormones. With the right asthma management and treatment, you should be able to sleep through the night.
How Do I Recognize The Early Signs Of An Asthma Attack
Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These changes start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.
In general, these early asthma attack symptoms are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an asthma attack or prevent one from getting worse.
Early warning signs of an asthma attack may include:
- Frequent cough, especially at night
- Reduced peak flow meter readings
- Losing your breath easily or shortness of breath
- Feeling very tired or weak when exercising
- Wheezing or coughing during or after exercise
- Feeling tired, easily upset, grouchy, or moody
The severity of an asthma attack can escalate rapidly, so it’s important to treat these symptoms immediately once you recognize them.
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When To Go To The Er For Asthma
If you or someone you know are experiencing a severe asthma attack, seek medical attention immediately. Ideally, you should have already talked with your doctor to develop an asthma action plan in the case of an emergency. Otherwise, here are some common signs that indicate you should seek medical help:
- Minimal/no improvement with quick-relief inhaler use
- Abnormal shortness of breath during minimal physical exertion
- Rapid decline in breathing or wheezing
- Blue lips or fingernails
Know The Four Steps Of Asthma First Aid
Its important for everyone in the community to know the four steps of asthma first aid.:
If you are not sure if someone is having an asthma attack, you can still use blue reliever medication because it is unlikely to cause harm.
- the person is not breathing
- their asthma suddenly becomes worse
- the person is having an asthma attack and theres no blue reliever medication available.
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What Is An Asthma Action Plan
Your healthcare provider will work with you to develop an asthma action plan. This plan tells you how and when to use your medicines. It also tells you what to do if your asthma gets worse and when to seek emergency care. Understand the plan and ask your healthcare provider about anything you dont understand.
What Should I Do If I Have A Severe Asthma Attack
A severe asthma attack needs immediate medical care. The first step is your rescue inhaler. A rescue inhaler uses fast-acting medicines to open up your airways. Its different than your normal maintenance inhaler, which you use every day. You should only use the rescue inhaler in an emergency.
If your rescue inhaler doesnt help or you dont have it with you, go to the emergency department if you have:
- Anxiety or panic.
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Spacers And Asthma Medication
For all people with asthma, it is recommended that a spacer device is used when asthma medication is delivered via a puffer . A spacer is a specially designed container that attaches to a puffer and has its own mouthpiece to breathe through.
Using a spacer helps the medication to go where it is supposed to into the small airways in the lungs rather than ending up coating your childs mouth, tongue and throat. It is much more effective than using a puffer on its own. Using a spacer with a puffer can reduce or prevent side effects from inhaled medication.
Babies and young children may need a spacer with a special face mask attached to inhale asthma medicines effectively. These fit tightly around your childs mouth and nose to make sure none of the medicine leaks out. Talk to your pharmacist for advice and to have your technique checked.
Watch this Asthma Australia video which shows you how to use a spacer with a face mask.
What Is Good Asthma Care
Your doctor or nurse will tailor your asthma treatment to your symptoms. Sometimes you may need to be on higher levels of medication than at others.
You should be offered:
- care at your GP surgery provided by doctors and nurses trained in asthma management
- full information about your condition and how to control it
- involvement in making decisions about your treatment
- regular checks to ensure your asthma is under control and your treatment is right for you
- a written personal asthma action plan agreed with your doctor or nurse
It is also important that your GP or pharmacist teaches you how to properly use your inhaler, as this is an important part of good asthma care.
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What Are The Treatments For Asthma
If you have asthma, you will work with your health care provider to create a treatment plan. The plan will include ways to manage your asthma symptoms and prevent asthma attacks. It will include:
- Strategies to avoid triggers. For example, if tobacco smoke is a trigger for you, you should not smoke or allow other people to smoke in your home or car.
- Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to carry with you all the time. It may also include other types of medicines which work quickly to help open your airways.
- Control medicines. You take them every day to help prevent symptoms. They work by reducing airway inflammation and preventing narrowing of the airways.
If you have a severe attack and the short-term relief medicines do not work, you will need emergency care.
Your provider may adjust your treatment until asthma symptoms are controlled.
Sometimes asthma is severe and cannot be controlled with other treatments. If you are an adult with uncontrolled asthma, in some cases your provider might suggest bronchial thermoplasty. This is a procedure that uses heat to shrink the smooth muscle in the lungs. Shrinking the muscle reduces your airway’s ability to tighten and allows you to breathe more easily. The procedure has some risks, so it’s important to discuss them with your provider.
What Is An Asthma Attack
An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways. This tightening is called a bronchospasm. During the asthma attack, the lining of the airways also becomes swollen or inflamed and thicker mucus — more than normal — is produced. All of these factors — bronchospasm, inflammation, and mucus production — cause symptoms of an asthma attack such as trouble breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack can include:
- Severe wheezing when breathing both in and out
- Coughing that won’t stop
- Worsening symptoms despite use of your medications
if you have any of these symptoms.
Some people with asthma may go for extended periods without having an asthma attack or other symptoms, interrupted by periodic worsening of their symptoms due to exposure to asthma triggers such as exercise or exposure to cold air.
Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours after treatment. Severe asthma attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild symptoms of an asthma attack to help you prevent severe episodes and keep asthma under control.
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What To Do If You Are Having An Asthma Attack
If someone is having a mild asthma attack, they may be able to treat it with asthma medication, such as a quick-acting inhaler. Some mild asthma attacks may even resolve on their own.
It is important that people with asthma talk with their healthcare team about an asthma action plan. This is a plan that guides people through how to treat their asthma, depending on the symptoms they are experiencing, and what to do in case of an asthma attack.
A person will need to carry a reliever inhaler with them, which may contain asthma medication to relax the muscles around the airways. These medications include short-acting, rapid onset beta-2 agonist and anticholinergic bronchodilators.
A person can first try dealing with an asthma attack by:
- using quick-relief medications, usually through a blue inhaler, and following their asthma action plan
In the case of a severe asthma attack, it is essential to seek medical help or call 911 immediately. While waiting for help, a person should continue to take their inhaler medication as the manufacturer outlines.
After an asthma attack, regardless of whether medical help was necessary, the following steps are important:
According to the American Lung Association, people will need to see their doctor at least once a year if they have asthma and more frequently if they have symptoms.
A person should contact their doctor straight away if they:
Anyone who experiences any of the following needs emergency medical help:
What Happens If An Asthma Attack Goes Untreated
Without immediate asthma medicine and asthma treatment, your breathing may become more labored, and wheezing may get louder. If you use a peak flow meter during an asthma attack, your reading will probably be less than your personal best.
As your lungs continue to tighten during the asthma attack, you may be unable to use the peak flow meter at all. Gradually, your lungs may tighten so much during the asthma attack that there is not enough air movement to produce wheezing. This is sometimes called the “silent chest,” and it is a dangerous sign. You need to be taken to a hospital immediately with a severe asthma attack. Call 911 for help. Unfortunately, some people interpret the disappearance of wheezing during the asthma attack as a sign of improvement and fail to get prompt emergency care.
If you do not receive adequate treatment for an asthma attack, you may eventually be unable to speak and can develop a bluish coloring around your lips. This color change, known as “cyanosis,” means you have less and less oxygen in your blood. Without immediate aggressive treatment in an emergency room or intensive care unit, you may lose consciousness and eventually die.
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What Causes Asthma Attacks
Having asthma is like having a touchy airway, says Richard Castriotta, MD, director of the Division of Pulmonary and Sleep Medicine at the McGovern Medical School at the University of Texas Health Science Center in Houston and medical director of the Sleep Disorders Center at the Memorial Hermann-Texas Medical Center. This airway i.e., the bronchial tubes that usher air in and out of our lungs overreacts to a large number of irritants that dont bother other people, he explains.
Some doctors also describe an asthma attack as an asthma exacerbation. Thats because the airways may become tightly constricted during an asthma attack. But constriction isnt the only problem these airways also become inflamed and swollen. The exact cause of asthma is not known, but its probably a combination of genetic risk and environmental factors.
Asthma attacks often occur in response to triggers, or elements in your environment that increase the irritation in your airways. Triggers vary from person to person. You may be able to tell immediately if something causes asthma symptoms, or you might need to be tested for allergies to find out whats causing your symptoms.
According to the AAAAI, some of the most common asthma triggers are:
- Nitrogen dioxide from gas heaters and stoves
- Dust mites or cockroaches
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