Hang in there: dealing with asthma attacks

The severity of an asthma attack (exacerbation) will determine the course of treatment. Mild or moderate asthma attacks are generally treatable outside the hospital setting while severe attacks are usually treated in a hospital, where closer monitoring is possible.

Mild or moderate asthma attacks have the following features:

  • peak expiratory flow rate of > 50% predicted or personal best
  • elevated heart rate (between 100 to 120 beats per minute)
  • ability to speak in phrases while sitting up, without agitation

On the other hand, those with severe asthma attacks may experience:

  • peak expiratory flow rate to 50% or less of predicted or personal best
  • elevated heart rate (above 120 beats per minute)
  • only able to speak in words while hunched forward and agitated

The goals of managing asthma attacks are to:

  • relieve any obstructions in airflow, as measured by a return to 60-80% (or higher) of predicted or personal best peak expiratory flow rate
  • restore blood oxygen levels to normal
  • prevent future attacks

The usual treatment for mild asthma attacks is repeated doses of a fast-acting bronchodilator, also called "reliever" medication. Ask your doctor how many puffs you should take, how often, and for how long. For example, a person might be instructed to take 2 to 4 puffs every 20 minutes for the first hour of a mild asthma attack, followed by 2 to 4 puffs every 3 to 4 hours. Make sure that you write your doctor's instructions down on your action plan, so that you know what to do in case of a mild asthma attack.

If a person’s peak expiratory flow rates falls under 60% of their personal best or does not improve after 48 hours after following their asthma action plan, they should speak to their doctor. In addition, people who have had a mild asthma attack should clarify with their health educator, doctor, nurse, or pharmacist that they are using their asthma medications (both controller and reliever) properly. Note that some people have their reliever and their controller medication together in a single inhaler. If this is the case for you, make sure you know how to use the inhaler correctly.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Dealing-with-Worsening-Asthma