Asthma Attacks

Symptoms

• Shortness of breath: A feeling of not getting enough air, often worse at night, early morning, or with activity.
• Wheezing: A high-pitched whistling sound, usually most noticeable when breathing out.
• Chest tightness: A squeezing or heavy sensation that makes each breath feel like work.
• Persistent cough: A nagging cough, often at night or early morning, that may or may not bring up mucus.
• Difficulty speaking: Needing to pause for breath partway through a sentence.
• Rapid breathing: A fast breathing rate as the body tries to take in more oxygen.
• Retractions: Skin pulling in between the ribs or at the base of the neck with each breath, a sign of respiratory distress.
• Bluish lips or fingernails: A serious sign of low oxygen that needs emergency care now.

When It's an Emergency

A severe asthma attack is a medical emergency. Call 911 or get to an ER right away if your lips or fingernails look blue or gray, you cannot speak more than a few words without gasping, you are breathing very fast, or you feel drowsy or confused. These are signs of dangerously low oxygen.

Watch closely when your rescue inhaler is not enough. Quick-relief inhalers such as albuterol should ease symptoms within minutes. If your inhaler does not help, its effect wears off within an hour or two, or you find yourself needing it again and again, your airways are not responding and you need emergency evaluation — come straight to Bellaire ER, where oxygen and breathing treatments start immediately, 24/7.

Other red flags include skin pulling in between the ribs or at the neck (retractions), a peak flow reading well below your personal best, or a chest that suddenly goes quiet because too little air is moving. Any of these, or symptoms that keep worsening despite your usual medicines, means it is time for the ER.

If you are severely short of breath, do not drive yourself. Call 911 so treatment can begin on the way.

When It's Not an Emergency

Many mild asthma flare-ups can be managed at home if your rescue inhaler works quickly and your symptoms fully settle. If you can speak in full sentences, your breathing returns to normal after treatment, and your peak flow stays near your personal best, you are usually safe to continue your asthma action plan and follow up with your regular doctor.

For mild or lingering symptoms, a refill question, or help adjusting a controller medication, telemedicine or your primary care physician is a reasonable choice. Bellaire ER also offers telemedicine for these lower-acuity concerns. When symptoms are severe or you are unsure, choose the ER.

What Happens at Bellaire ER

When you arrive at Bellaire ER with an asthma attack, a board-certified emergency physician sees you quickly and checks your oxygen level. Treatment often starts right away with oxygen and nebulizer or inhaler breathing treatments to open your airways, and may include steroids to reduce airway inflammation.

We have on-site X-ray, CT, ultrasound, and a full lab to rule out other causes of shortness of breath, such as pneumonia or a lung problem, and to confirm you are responding to treatment. We diagnose and treat in a single visit, and most patients do not need a hospital transfer.

Before you leave, your physician explains your results, adjusts your medications if needed, and gives you a clear follow-up and asthma action plan.

Prevention

You can lower the chance of an asthma attack by identifying and avoiding your triggers, such as smoke, dust, pet dander, pollen, cold air, and respiratory infections. Taking a daily controller (preventer) inhaler exactly as prescribed keeps airway inflammation down between flare-ups.

Keep a written asthma action plan, carry your rescue inhaler, and check your peak flow if your doctor recommends it. Staying up to date on flu and pneumonia vaccines helps prevent infections that commonly set off attacks.