Anatomy of an Asthma Attack

Photo of boy using nebulizer.

How to Avoid an Asthma Emergency

Asthma attacks rarely happen without warning. Knowing the signs of a pending attack could help you prevent an asthma emergency. In fact, acting quickly could save your life.

Click on the next slide to see the warning signs to watch out for.

Photo of distressed woman.

Asthma Early Warning Signs

  • A lack of appetite, fatigue, headache, or coughing often comes before an asthma attack.
  • Trouble sleeping and feeling tired are other typical signs.
  • So are dark circles under the eyes and less tolerance for exercise.

Photo of boy holding chest.

A Persistent Cough

Signs of an asthma attack can change from one attack to the next. One time there may be little or no coughing before an attack. The next time, there may be a persistent cough, especially at night.

An asthma cough is usually dry and hacking. A chronic or persistent cough that doesn't disappear after other cold symptoms are gone could point to asthma.

Avoid taking cough medicine. Cough medicine won't help the asthma.

Photo of man breathing into spirometer.

Measurable Changes in Breathing

A peak flow meter can alert you to a pending attack. Be sure you always know your baseline measurement that reflects your best breathing.

  • If your peak flow meter shows numbers between 50% and 80% of your personal best, an asthma attack has probably started.
  • A number below 50% means an emergency that needs immediate attention, call 911.
  • Call 911 if you have trouble walking or talking due to shortness of breath, or if your lips are blue or gray.

Photo of girl taking lung infection test.

Follow Your Asthma Action Plan

An action plan tells you how to deal with symptoms of an asthma attack.

  • Based on peak flow measures, an action plan shows you what medicines to take and when. It's important to follow the plan and use the medications exactly as prescribed.
  • If the symptoms still get worse after following the plan, call your asthma doctor. Also, follow the plan's emergency instructions.

Illustration of respiratory system.

Breathing Difficulties

During an asthma attack, muscles around the airways tighten, and the airway linings swell.

  • Too much mucus secretion is produced in the airways and can block the air tubes in the lungs.
  • Air is trapped in the lungs and breathing becomes difficult.

You might notice symptoms of wheezing at first. But as attacks get worse there's more chest tightness and shortness of breath. Eventually, you might feel like you can't get enough air.

Photo of man clutching his chest.

Posture Changes

The effort to breathe may make someone with severe breathing difficulties lean forward, speak in words instead of sentences, and become noticeably agitated.

As the severity increases, an asthma sufferer may increasingly move into a hunched-over sitting position with their hands supporting their upper body. This is called the tripod position.

Photo of boy breathing.

Chest and Neck Retractions

When it's hard to breathe, the tissue in the chest and neck may sink in with each breath. This is called retraction.

Retractions mean that not enough air is getting into the lungs, and are signs of a medical emergency. Call 911 or see a doctor right away.

In children other signs of deterioration in breathing are:

  • poor appetite
  • fatigue
  • decreased activity

Photo of woman feeling faint.

Blue Lips or Fingernails

Blue or gray lips or fingernails are a sign of not enough oxygen in the blood. The condition is called cyanosis.

Cyanosis is an emergency situation. Call 911 as soon as possible.

Photo of doctors examining patient.

Other Signs of Asthma Emergencies

If you notice any of the following, get emergency help at once:

  • difficulty talking
  • inability to exhale or inhale
  • shortness of breath
  • feelings of anxiety or panic
  • coughing that won't stop
  • pale, sweaty face



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  • American Lung Association: "Asthma Attacks," "Early Warning Signs."
  • Cleveland Clinic: "Symptoms of Asthma."
  • Duke University Health System. "Coughing 'til Morning, Parents Take Warning: Asthma Can Sneak Up on Some Kids."
  • KidsHealth: "What’s an Asthma Flare-up?"
  • Medscape Reference: "Asthma – Overview," "Asthma – Physical Examination."
  • National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services. NIH Publication No. 07-5251, October 2006.
  • National Jewish Health: "Asthma: Symptoms."
  • Regional Asthma Management & Prevention: "Asthma Action Plans."
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