Understanding What an Asthma Attack Is
You may have asthma, but have you had an asthma attack?
Hopefully not, but for many people with asthma, asthma attacks are a normal part of life with asthma. An inevitable part of their disease state.
Regardless of whether this is “your normal," you should know a bit more about asthma attacks so that you can detect one if it is occurring – and treat it quickly with or without an inhaler. You should also know the triggers – because maybe, just maybe, it doesn’t have to be “your normal."
What Is an Asthma Attack?
If you are reading this, you may know what it feels like to have asthma.
That feeling of chest tightness and the wheezing.
When you have an asthma attack, your asthma symptoms are worsening – and it is happening rapidly. Those tell-tale symptoms worsen because the muscles surrounding the airways are tightening due to bronchospasm.
In addition, inflammation of the airways occurs. This inflammation causes excess mucus to become produced.
Bronchospasm and inflammation with excess mucus are the “perfect storm" for symptoms to rapidly worsen – causing an asthma attack.
What Does an Asthma Attack Feel Like?
On a personal level, I have approximately one asthma attack each winter, when the cold exacerbates my symptoms. The best way that I can describe my attack? It is like I am breathing through a straw, sucking for air, while a large animal is sitting on my chest – and it is frightening.
On Quora, where users can ask questions of other users, one user posted the question “What does it feel like, when one is experiencing an asthma attack?" Here are snippets of a few of the responses, that I believe, describe what it's like to have an asthma attack:
- "It's bizarre. You can't get enough air into your lungs. You try to breathe deeply, but it's not really helping. It's almost like you're slowly suffocating like your lungs just can't keep up with the oxygen demands of your body. You might start to get light headed. Your heart might be beating fast. You're often wheezing too, struggling to move air past all the inflammation and mucus that's blocking it." – Christine Ricks
- "You feel suffocated... you can't breathe normally... you feel like someone is sitting on your chest or being pushed into the water." – Pruthvi Sathish.
- "For a non-asthmatic person, it would be like breathing in-out directly through [a] chimney." – Lavya Gavshinde.
- "With asthma, it feels awful. The first half of my lungs I can get air in, and it feels like breathing normal, no problem, but then the second half is the most painful, miserable, scariest stuff you will ever experience. I have to grab on something like my upper thighs to help push my torso up because for some reason I feel like that would help me breathe." – Zoe Freddy.
Asthma Attack Triggers: What Can Trigger an Asthma Attack?
Anything can trigger asthma. Yes, you read that right. Anything can trigger an asthma attack.
What an asthma trigger is for one person may not be an asthma trigger for another. And one person may have a “strange" trigger that exacerbates their asthma symptoms, something that is not a “usual" asthma trigger, but still manages to set their immune system into “fire" mode.
That being said, there are several things that are most common in triggering asthma symptoms. When the respiratory system is exposed to these triggers, it is more likely to elicit an immune response because the immune system is sensitive; this causes inflammation and production of mucus, as we’ve previously discussed.
Common asthma triggers may include:
- Pollens
- Pet exposures
- Mold
- Dust mites
- Upper respiratory infection
- Tobacco smoke exposure
- Inhalation of cold, dry air
- Stress
- Having a condition called gastroesophageal reflux disease (GERD)
Asthma Attack Symptoms
An asthma attack is all the usual symptoms of asthma but intensified. Asthma attack symptoms may include:
- Difficulty breathing, often rapidly
- Severe wheezing when breathing in and out
- Coughing that won’t stop
- Difficulty performing daily activities
- Chest tightness
- Tight chest muscles – this is called chest retractions
- Difficulty speaking
- Anxiety
- Cyanosis
- Symptoms that worsen, despite the use of rescue medications
Asthma Attack Treatment: What to Do During an Asthma Attack
The best way to treat an asthma attack is by acting quickly.
If you have asthma, you should have an asthma action plan in place. An asthma action plan is created with the help of your physician, and it guides you with the proper steps to take an emergency.
In an ideal situation, you’d have a quick-acting inhaler at your disposal. This type of inhaler is also called a rescue inhaler. An example of this type of inhaler is albuterol (ProAir HFA, Proventil HFA, Ventolin HFA). At the onset of an asthma attack, you’d likely be asked by your physician to take anywhere from two to six puffs of this inhaler. Generally, this dosage can be repeated in 20 minutes.
For severe symptoms – such as your shortness of breath is extreme, or you are unable to speak – the step above should be taken, but you must consider the fact that you may need to see your physician, go to an urgent care clinic, or even go to the emergency department, depending on the severity of your symptoms.
Once you begin to feel better, your physician may ask you to continue using the rescue inhaler every four hours for several days. This inhaler may reduce inflammation that is continuing in the lungs due to the exacerbation. Your physician may even prescribe an oral medication called a corticosteroid.
For asthma that progresses, as we previously discussed, an emergency can occur. If you must seek emergency treatment, here are some things that may occur:
- You may be given a short-acting inhaler. This could be in the same form as the inhaler that you use at home. However, you may also receive through a nebulizer, which helps the medication get deep into the lungs.
- An oral medication may be prescribed. This would likely be a corticosteroid such as prednisone, which helps to reduce inflammation. In the emergency setting, corticosteroids can also be given intravenously. If symptoms are very acute, an intravenous dose may be administered.
- A medication called ipratropium (Atrovent) may be prescribed. Atrovent is a bronchodilator that is used in severe cases, often when albuterol is ineffective. It may also be used in conjunction with albuterol.
- For very severe cases, intubation may be required. Intubation requires placing a tube into the airway, which allows a machine to assist with breathing. This is done when an asthma attack becomes life-threatening. A patient can be extubated once the inflammation has improved.
What to Do for an Asthma Attack Without an Inhaler
Someone with asthma should always carry a rescue inhaler. It should be used at the initial sign of an asthma attack. But what can be done to survive an asthma attack without an inhaler?
Here are some tips that may help reduce your asthma attack severity:
- Drink caffeine. A hot, caffeinated beverage, such as tea or coffee, is believed to act like the asthma medication theophylline. Theophylline acts by opening the airways. These caffeinated beverages may open the airways for up to four hours.
- Use essential oils. Eucalyptus oil has been used for centuries to treat a myriad of conditions – one of which is asthma. This oil helps by when diffused in the air. Other oils that are believed to be beneficial are lavender and basil.
- Mustard oil – the oil produced from mustard seeds – contains isothiocyanates. Massaging this warm oil plus salt on the chest is believed to promote the opening of airways, thus relieving asthma attacks.
- While having an asthma attack, ensure that posture is good by sitting upright. This allows for efficient breathing. It may be tempting to lie down, as this is a position of comfort – don’t do it! Find a chair that will guide your posture.
- Focus on your breathing. Likely breaths are shallow and ineffective; focus on taking slow, deep breaths. Although this may be easier said than done during an asthma attack, it prevents hyperventilation, which worsens the situation, and it also promotes calmness.
Of course, this is not the ideal situation – regularly check that your car, purse, backpack, or whatever your carry has a rescue inhaler. Follow your asthma action plan as recommended by your physician whenever possible.
The Bottom Line…
If you're still wondering what best way to treat an asthma attack, it's through prevention and identifying your asthma triggers. By practicing prevention, you will prevent asthma attacks from occurring in the first place.
However, even with the best of intentions, sometimes an asthma attack will occur. Knowing how to treat it is important – and potentially life-saving.