Asthma Attack Warning Signs – do you know yours?

Prevention of acute asthma attack is a major goal of treatment. An acute asthma attack usually causes extreme agony and misery to the patient. Remember, a severe asthma attack may be fatal. Therefore, it is important to recognize early signs of asthma worsening. If the warning signs are detected early, prompt action is required to prevent a full fledged asthma attack from developing. This may be ensured by increasing the drug dose or by adding another drug to the medication.

• Most asthma episodes or attacks start slowly.

• You often can stop an approaching asthma attack if you can catch it early and are able to take proper medications on time. If you fail to do this, your symptoms may tend to get worse.

• You must learn what your warning signs are.

• You must make an action plan with your physician or nurse about what to do when you notice your warning signs.

Traffic sign analogy
There are three traffic light signs: red, yellow and green. Red means stop, green means go, and yellow means careful, slow down. Yellow is a warning sign that tells us that the light is about to change to red. Our bodies also give us signs like the yellow traffic light. For example, how does our body tell us when we are hungry? When we are hungry our stomach growls which makes us realize that we are indeed hungry. This is a warning sign.

Asthma patients usually say that they often get warning signs that tell them that they are soon going to have an asthma attack. These signs are just like the yellow light. They warn you to be careful and do something special to manage the approaching asthma attack. You may have different signs at different times.

Knowing your warning signs is the first step in learning how to take care of your asthma attack from getting worse. Having an action plan to take care of your asthma will help you stay calm and relaxed at the time of an emergency.

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Some of the asthma warning signs are discussed below with analogy of traffic lights:

Green: Your asthma is stable, Congratulations!
• Symptom free: No coughing, wheezing or dyspnoea.

• PEFR: > 80% of personal best. Click here to know about PEFR.

• PEFR variability: < 20%. Click here to know about PEFR variability.

This means that your treatment plan is working fine, hence you can pursue your regular activities and medication.  If symptoms are controlled or peak flow reading persists in the green zone for two weeks you may reduce medicines after consulting your physician, but keep distance from your identified asthma triggers.

Yellow: Your emerging signs of asthma,
• Chest tightness.

• Nasal congestion or sneezing.

• Pits in the neck during inhalation.

• Intermittent deep breathing.

• Coughing or wheezing after climbing one floor stairs.

• Excessive perspiration.

• Uncomfortable or restlessness.

• Tightness in neck, shoulder or chest muscles.

• Change in voice.

• Faltering of the tongue.

• Itchy, scratchy throat.

• Difficulty in breathing or shortness of breath.

• PEFR: 50–80% of best (20% or more decrease in personal best peak flow).

• PEFR variability: 20-30%.

This indicates varying degree of airway obstruction. Yellow zone is the caution zone. In this zone asthma triggers (personally identified) can precipitate asthma. PEFR in Yellow zone indicates that you should add more medicines or increase dose of medicines after consulting your physician so that you can come back again in green zone.

Red: You must visit a physician when,
• Sleep is frequently disturbed by asthma.

• Routine house work can not be carried out or with great difficulty.

• Effect of bronchodilator spray lasts for less than 3 hours.

• PEFR: < 50% of personal best.

• PEFR variability: > 30 %.

Red is the crisis zone. At this time do not delay medication. If you know what medicines are to be taken, start these immediately. If you do not know, consult your physician right away.

Emergency Signs: You must go straight to hospital when,
• Asthma ties him to chair or cot.

• Too breathless to feed.

• Cannot speak, or speak only single words.

• Too distressed to measure PEFR.

• Temporary confusion or loss of consciousness.

• PEFR < 33% of best.

• Turns blue and exhausted.

Please note that there may sometimes be some variations to the above conditions as every individual is different.

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