Acute Asthma Attacks

Asthma can be a dangerous condition. It’s important to prevent regular asthma attacks and have a reliever inhaler at hand at all times

Last reviewed: 27 Apr 2019

Man in shirt holding chest feels an asthma attack coming on

Key takeaways

  • Look out for the signs of an oncoming asthma attack and always keep your reliever inhaler with you

  • Watch out for triggers of your asthma. They may include pollen, smoke, pollution, cold air etc.

  • You can try to prevent attacks by desensitising yourself to some triggers, or by getting treatment for your asthma.

  • Treatments for asthma may include 2 types of inhalers for regular use (usually containing steroids) and for when you're having asthma symptoms, and steroid tablets if necessary

Contents of this article

Reliever inhalers provide fast relief from acute symptoms. However, if you have to use your inhaler often, you may need to also use preventative inhalers to avoid dangerous attacks in the future. Without the correct treatment, your asthma symptoms are likely to get worse.

You can order your repeat prescription for the blue inhaler online via our convenient online assessment. This service is for asthma patients who have been diagnosed with asthma and whose symptoms are under control.

Early symptoms of asthma

If you suffer from chronic asthma, you should always make sure that you are carrying a reliever asthma inhaler in case you suffer an asthma attack. If you experience symptoms on a regular basis you need to speak to your doctor who will devise a preventative treatment plan.

Early symptoms of asthma include a feeling of tightness or narrowing in the chest as well as dry cough. You will feel like you can’t get enough air and your breathing may cause a rattling noise.

A severe or acute asthma attack will cause the same symptoms but they will be more intense: from severe shortness of breath, or heavy and noisy breathing, to blue lips and nails. In some cases, especially when you don’t have a reliever inhaler to hand, patients may also lose consciousness.

What causes asthma attacks – looking out for asthma triggers

Asthma is the result of an inflammation of the bronchial tubes (airways in the lungs) that causes airways to swell and narrow.

Asthma triggers are rather diverse and include allergens (if you suffer from allergic asthma) such as pollen and dust, but also other irritating substances. This is why asthma can also be triggered by cigarette smoke and pollution.

Prevention and chronic asthma therapy

You shouldn’t be lured into thinking that just because you haven’t had an attack in weeks or months it might not happen again. In some cases, asthma is triggered when a combination of factors occur at the same time, for example being ill during a pollution peak or exercising in a dusty environment. This is why it’s important to have your reliever inhaler with you at all times.

If you need to use your reliever inhaler every week, your doctor will usually recommend that you use a daily preventer inhaler as well. These inhalers contain a steroid, which helps to reduce the irritation and the sensitivity of the airways. This means that you’re much less likely to have symptoms from asthma, and to have an asthma attack.

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Asthma attack treatment

The first line of treatment when an asthma attack happens is to use your reliever inhaler (usually salbutamol). This will help to open the airways and make it easier for you to breathe. Your GP or asthma nurse should go through this in your asthma plan.

If you find that your inhaler isn’t working, or you need to use it again very soon after, this can be a sign of a more severe asthma attack. At this point you should phone 999 or go to A and E as soon as possible.

If you find that the inhaler works, you should contact your GP for an urgent appointment that day, so that they can see if you need any other treatment.

Once you’re at A and E or with your GP, they’ll assess your breathing. They might start a nebuliser, which is a machine with a mask that helps to get oxygen and medication to your lungs more easily. They will usually also prescribe a steroid treatment – either as tablets, a liquid, or an injection if needed. If an infection has triggered the attack, you might be given antibiotics too.

If you’re seen by a doctor in A and E after having an attack, it’s important that you make an appointment to see your GP or asthma nurse within a couple of weeks of being at the hospital. This is important to review your regular asthma treatment and to see if you need to be using different inhalers to control your symptoms and prevent you from having more attacks in the future.


Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with Zava. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.

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Last reviewed: 27 Apr 2019

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