Asthma attack: emergency actions

Asthma is a disease that results in spasms of the muscles in the wall of the airways, leading to a narrowing of these which makes it difficult to breathe. When a crisis occurs, you have to act quickly. Doctissimo explains how to manage these sometimes impressive crises.

Most often,  asthmatics are able to self-treat their attack, using emergency medications ( short-acting bronchodilators or BDCAs) with which they are familiar. Nevertheless, sometimes they are unable to access their medication (because of the severity of the crisis, forgetfulness of medication, travel, etc.). How to react? What are the emergency actions? The answers.

What is an asthma attack?

An  asthma attack  is an episode of wheezing breathing discomfort ( dyspnea ). It is characterized by:

• Inflammation  of the bronchi;
• A contraction of the muscles surrounding the bronchi (which makes it more difficult for air to pass, especially on exhalation);
• A large secretion of mucus  (substance that protects the bronchi) which reduces the space for airflow.

• What triggers an asthma attack?

  Several factors can trigger an asthma attack. They differ from one asthmatic patient to another: 

  • Allergens  : dust mites, pollens, animal hair, moulds;
  • Tobacco  ; 
  • Stress and anxiety  ; 
  • physical activity  ;
  • Polluting or irritating substances  ;
  • Respiratory virus  ; 
  • Certain  medications  : aspirin, non-steroidal anti-inflammatory drugs;
  • Certain  foods  (in case of allergy). 

  To learn more , read our article  on the  factors that can trigger an asthma attack .

  Symptoms of an asthma attack 

  Depending on the person  , the asthma attack can manifest itself in different ways. So you can feel:

  • Breathing difficulties or discomfort , with a very prolonged exhalation phase;
  • wheezing ;
  • A  feeling of shortness of breath, tightness in the chest;
  • A dry cough .

  Note: Asthma often manifests at  night with coughing spells or wheezing . You may also  feel oppressed when you wake up , even if your sleep has not been disturbed.

• Treatment of asthma attack

  The  treatment for an asthma attack is to inhale short-acting bronchodilators  (or BDCAs). These allow the bronchi to open in a few minutes and provide rapid relief. As a precaution (in case an attack occurs), it is essential to always  keep a rescue inhaler  at hand. To learn more, read our article on  treating asthma attacks .

  Note: these  emergency medications  do not cure inflammation of the bronchi (cause of asthma).

  If one or some of the signs below recur frequently in the person affected, it means that the asthma is not well managed. It is then necessary to report it to your doctor, who will prescribe a basic  treatment in  order to better control the asthma:

  • If you use your rescue inhaler more than twice a week  ;
  • If you have  asthma symptoms that come back more than twice a week  ;
  • If you are having difficulty performing your usual daily activities ;
  • If you have  nocturnal awakenings caused by asthma. 

  Emergency measures in the face of an asthma attack 

  • Keep calm and reassure the victim . Indeed, anxiety can only aggravate the crisis;
  • Put the casualty in the position they feel most comfortable with  (often a seated position) and loosen their clothing . Above all, a patient who is having an asthma attack must  not be laid down;
  • Ask him to breathe slowly and deeply;
  • Ask her if she usually takes any medications (BDCA), get them to her and facilitate their self-administration;
  • If this is a first attack , the victim has no medication. In this case, do not give him any medicine without a medical prescription and call his doctor or, in his absence, the SAMU (15);
  • Then follow the advice given to you by the doctor. 

  In the event of an asthma attack, when should the emergency services be called?

  "You have to go to the emergency room or call the SAMU  if the crisis is unusual, or if the usually effective drugs do not work ", explains Pr Alain Didier, pulmonologist and allergist, head of the pulmonology department of the Toulouse University Hospital in an interview. for the Fondation du Souffle 1 . 

• Indeed, inhaling short-acting bronchodilators  once or twice  is supposed to stop the asthma attack. It is possible to take one or two puffs a few minutes later if the results are slow to be felt. If after 10 minutes or after two unsuccessful attempts at relief , the crisis continues,  immediately call the SAMU by dialing 15 or 112 from a mobile phone . 

  How to recognize an exacerbation?

  When an asthma attack lasts for  several hours or even several days , despite repeated use of an attack treatment: this is called an exacerbation .

  • They can be more or less severe;
  • The  repetition of attacks and the aggravation of symptoms become a hindrance in daily activities;
  • They can cause nocturnal awakenings .

  In this case,  consult your doctor as soon as possible . Depending on the severity of the exacerbation, you will be treated at home or in hospital and monitoring of your asthma will have to be reinforced.

  How to recognize a severe asthma attack? 

  Severe acute asthma manifests as an intense  and unusual attack . This form of asthma can have a sudden onset or follow the unfavorable course of an exacerbation . In this case,  the air no longer passes . Inhaling and exhaling requires intense effort, without being effective.

  Signs of severe acute asthma are:

  • Great difficulty in breathing , worsening shortness of breath (rapid and short breathing, space between the ribs and above the collarbones widens);
  • A  blue discoloration of the skin appears (lips and nails);
  • Sweats  appear;
  • A dilation of the nostrils;
  • The person's speech becomes impossible (difficulty speaking);
  • The victim shows signs of exhaustion . In this case, she may become drowsy or even lose consciousness and finally stop breathing .