An asthma emergency, also known as an asthma attack, can be a frightening experience. During an asthma attack, it becomes hard to breathe because muscles around your airways contract, narrowing your airways. Excess mucus or other triggers can make breathing even more difficult.

If you’re living with asthma or care for someone with the condition, you should work with a doctor or pediatrician to come up with a personalized asthma action plan — an asthma treatment plan for an asthma emergency. The plan includes information about your medicines and how to use them, what signs and symptoms to look for, and whom to contact if emergency assistance is needed.

You should make sure that you, age-appropriate family members, and any other caregivers are familiar with the plan. The same goes for teachers, nurses, and others who care for a child with asthma outside of the home.

An integral part of your plan is being certain that your rescue medications and chambers are accessible wherever you or your loved one might be, such as home, work, school, or anywhere else you or they frequent. Be sure the medications haven’t expired and there are enough in case an attack occurs. Storing a printed copy of the treatment plan with the medications can also be helpful.

1. Recognize the Signs and Symptoms of an Asthma Emergency

The most important step to take during an asthma emergency is recognizing when one is happening. An asthma attack can look different for everyone. The most common signs and symptoms include:

• Severe shortness of breath
• Chest tightness
• Chest pain
• Difficulty breathing
• Coughing and wheezing
• Rapid, shallow breathing
• Lightheadedness or dizziness
• Inability to speak more than one or two words at a time
• Feeling anxious or scared
• Peak flow meter readings less than 80 percent of your best score
• Little to no improvement after using quick-relief medication, or needing your medication again within a couple hours

Spotting signs of an asthma emergency in young children may be difficult, especially if they can’t tell you what’s wrong. Young children may exhibit the following behaviors during an asthma emergency:

• Restlessness
• Trouble eating and drinking
• Coughing
• Vomiting
• Difficulty sleeping or waking up
• Head bobbing
• Skin between their ribs and around the collarbone pulling with each breath
• Belly breathing (using their stomach to pull in a breath)
• Nostrils opening wider than usual with each inhale
• Breathing that’s faster than normal for longer than a few seconds
• Crying more softly than normal
• Difficulty sucking on a bottle or pacifier

2. Sit Upright and Stay Calm

Once you recognize the signs and symptoms of an asthma attack, you should get yourself or your loved one into a safe, comfortable position to make breathing easier. It may be easier to breathe from an upright sitting position, rather than in a hunched-over position or while lying down.

If you’re experiencing the attack, try to find someone to sit with you. They can help you in reaching out to a loved one or caregiver to let them know you’re feeling sick and where you are in case you need help.

If you are caring for someone experiencing the attack, don’t leave them alone. Stay with them and watch for worsening symptoms.

If the person with asthma is lying down, it may help for them to sit up, propped by pillows. Loosen any tight clothing around their neck, chest, or waist that may make breathing more difficult.

Try to keep yourself or your loved one as calm as possible. Asthma attacks can be scary, so this can be difficult. Anxiety can increase a person’s breathing and heart rate, worsening their asthma symptoms. A MyAsthmaTeam member shared, “I ended up in the hospital with an asthma attack that turned into a panic which caused the asthma attack to get worse.”

If you’re outside, you may want to go inside where there is air conditioning. If you’re driving, it is a good idea to pull over and roll up the windows.

3. Follow Your Asthma Action Plan

Make sure to fill out your or your loved one’s asthma action plan with a doctor before an emergency occurs. The plan will include important emergency numbers, medication doses, and next steps. An asthma action plan template is available from the Centers for Disease Control and Prevention (CDC).

Having a plan prepared in advance is very important, as you may feel too flustered or anxious during an asthma emergency to remember what to do. A MyAsthmaTeam member shared, “I am so glad I filled in my asthma action plan. It helped to remind me what to do when I was having another asthma attack.”

Importantly, make sure your or your loved one’s plan and medications are easy to access during an emergency — both for yourself and your caregivers.

An asthma action plan should specify exactly which medication to use, how much, and how often based on the symptoms you or your loved one is experiencing. Make sure to clarify this information with your doctor when filling out your plan.

The American Family Physician guidelines on managing acute asthma exacerbations suggest using a bronchodilator, such as albuterol, at the first sign of an asthma attack. You can use a metered dose inhaler or a nebulizer, depending on your preference and abilities. If you use a metered dose inhaler, a spacer device can help you get more medication into your lungs.

Be sure to follow the precise instructions on the asthma action plan. Check that you’re using the correct inhaler: It can be confusing during an asthma attack. Your asthma action plan will tell you how many puffs of quick-relief, or rescue, medication to take — usually between two and six. You can repeat this step after 20 minutes. If you or your loved one doesn’t feel better after two treatments of quick-relief medication, you should call your doctor immediately.

If your doctor has given you a combination inhaler, newer guidelines may have you use the same inhaler for prevention and treatment of asthma emergencies. Your doctor can tell if this is right for you.

4. Recognize Danger Signs and Seek Medical Attention

Your asthma action plan should note the danger signs of a life-threatening situation during an asthma emergency. Make sure you know these signs and watch closely for them.

Examples of danger signs to look out for include:

• Severe breathlessness
• Trouble walking due to shortness of breath
• Lips, gums, or fingernails turning blue, purple, or gray
• Drowsiness

Don’t be afraid to call for help during an asthma emergency. If you notice any danger signs during an asthma emergency, go to the emergency department of the nearest hospital, or call 911 right away.

After an Asthma Emergency

After an asthma attack, you should call your doctor or child’s pediatrician as soon as you can — within one or two days, at most — to discuss what happened and how to prevent future attacks. You may need to change your or your loved one’s asthma action plan or make medication adjustments.

Sometimes a person may not feel like themselves after an asthma attack. A doctor may be able to recommend ways to help with the recovery process. One member said, “I had an asthma attack this morning. Feeling better now, just very tired.”

Preventing Asthma Emergencies

Your prevention plan may include changes to your controller medications, reliever medications, and strategies to avoid asthma triggers.

It’s important to know what triggers your or your loved one’s asthma symptoms so you can take steps to avoid them. Your asthma triggers may be different from someone else’s. Some common triggers for asthma include:

• Allergens like pet dander and pollen
• Dust mites
• Cockroaches
• Mold
• Air pollution
• Respiratory infection
• Tobacco or vaping smoke
• Cleaning supplies like bleach
• Exercise
• High humidity
• Rapid weather changes

MyAsthmaTeam members have shared some of their triggers. One member said, “I have had two asthma attacks today. Bleach sets off my asthma badly. Where I am staying, they use bleach to clean.”

One member shared their strategy for avoiding high pollen counts, one of their triggers. “I decided to look up the allergy forecast for my city, and it said the risk of asthma is high,” they wrote. “I will only do what I need to do, then return to my air conditioning.”

Talk to your doctor about how to best prepare and respond to an asthma emergency. You should make sure you always have enough quick-relief medication and that it is easily accessible to you.

Talk With Others Who Understand

MyAsthmaTeam is the social network for people with asthma and their loved ones. On MyAsthmaTeam, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Have you or your child experienced an asthma emergency? Share your experience in the comments below, or start a conversation by posting on your Activities page.