Recognising asthma symptoms early is crucial as it is a chronic lung condition that affects millions of Australians, and anyone can develop asthma at any stage of life. While there’s no cure for asthma, proper recognition of warning signs and quick response can prevent minor symptoms from escalating into a serious asthma emergency.
Whether you’re a parent, teacher, carer, or someone recently diagnosed with asthma, understanding these symptoms and response strategies can be life-saving. Even if your symptoms are usually mild or well controlled, asthma symptoms can become worse unexpectedly, which is why everyone with asthma needs to be prepared.
Signs and Symptoms of Asthma to Watch For
Understanding the full spectrum of asthma symptoms helps ensure early intervention and proper management of this chronic condition.
Obvious Asthma Symptoms
The most common symptoms of asthma include a persistent cough, wheeze (a whistling sound when breathing), shortness of breath, and chest tightness. These symptoms of asthma often get worse at night, a condition called nighttime asthma, and may worsen during physical activity or when exposed to asthma triggers.
A dry, persistent cough is often the first asthma symptom people notice, particularly in children. This cough may produce mucus and typically worsens when lying down. The wheeze may be audible during breathing out, though some people with asthma wheeze when breathing in as well.
Subtle Warning Signs
Not all asthma symptoms are obvious. Some signs or symptoms include feeling unusually tired after normal activities, changes in sleep patterns, or difficulty speaking in full sentences during mild exertion. People with asthma might also notice they’re using their reliever medication more frequently than usual.
Changes in mood, concentration difficulties, or feeling anxious can also be warning signs that asthma symptoms may be developing. These subtle changes often occur before more obvious symptoms appear, making them important early indicators.
Non-verbal Cues in Children
Children who might have asthma often can’t articulate how they’re feeling, so it’s crucial to watch for physical signs. Look for chest retractions (skin pulling in around the ribs when breathing), flared nostrils, rapid breathing when at rest, or difficulty feeding and eating.
Young children may become unusually quiet during play, avoid physical activities they normally enjoy, or seem more clingy than usual. These behavioural changes can be early warning signs of worsening asthma symptoms.
Exercise-induced Symptoms
Exercise-induced asthma is common, with symptoms typically appearing during or shortly after physical activity. People get asthma symptoms like coughing, wheezing, chest tightness, or shortness of breath when their airways react to increased breathing during exercise.
Unlike normal breathlessness from exertion, exercise-induced asthma symptoms include prolonged coughing fits, wheezing that continues after stopping activity, or feeling unusually fatigued compared to others doing the same activity. These symptoms usually develop within 5-10 minutes of starting exercise or may appear after finishing.
How to Respond: Step-by-Step Treatment for Asthma
When asthma symptoms appear, the first step is to help the person sit upright and stay calm. Panic can make symptoms worse, so reassuring communication is essential. Locate their reliever medication (usually a blue or grey inhaler) immediately.
Follow your asthma action plan if you have one, or help the person follow theirs. Remove or avoid any obvious asthma triggers in the immediate environment, such as strong perfumes, dust, or cigarette smoke.
Immediate Response
When asthma symptoms appear, the first step is to help the person sit upright and stay calm. Panic can make symptoms worse, so reassuring communication is essential. Locate their reliever medication (usually a blue or grey inhaler) immediately.
Follow your asthma action plan if you have one, or help the person follow theirs. Remove or avoid any obvious asthma triggers in the immediate environment, such as strong perfumes, dust, or cigarette smoke.
Medication Administration
Proper inhaler technique is essential when treating asthma symptoms with reliever medication. If using a puffer, shake it well, remove the cap, and if available, attach a spacer device. Have the person breathe out gently, then place lips firmly around the mouthpiece.
Press down on the inhaler while breathing in slowly and deeply, then hold breath for 10 seconds if possible. Wait 30-60 seconds between puffs if multiple doses are needed. Most asthma action plans recommend 4 puffs initially, waiting 4 minutes, then another 4 puffs if symptoms persist.
What NOT to Do
Never leave someone alone during an asthma attack, even if they seem to be improving. Don’t give water during an attack as it may cause choking. Avoid strong-smelling substances like eucalyptus or menthol, which can be asthma triggers for some people.
Don’t assume the attack is over just because asthma symptoms seem to improve. Asthma symptoms can return hours later, so continued monitoring is essential.
When It's an Emergency: Red Flags
Recognising when asthma symptoms have escalated to a medical emergency can be life-saving and requires immediate professional intervention.
Severe Breathing Difficulty
When asthma symptoms progress to severe breathing difficulty, immediate emergency treatment is required. Look for signs like using stomach muscles to breathe, chest and neck muscles pulling in with each breath, or breathing becoming increasingly rapid and shallow.
If someone is struggling to breathe despite using their reliever medication correctly, this indicates their asthma is not under control and emergency intervention is needed. Uncontrolled asthma can be life-threatening.
Blue Lips or Fingernails
Bluish colouring around the lips, fingernails, or face indicates insufficient oxygen levels and represents severe asthma symptoms requiring immediate emergency care. This is a clear sign that the person’s airways are severely restricted and their lung function is compromised.
Can’t Speak in Full Sentences
During a severe asthma attack, breathing becomes so difficult that speaking becomes impossible. If someone can only say a few words before needing to catch their breath, their asthma symptoms are serious and require emergency treatment.
No Improvement After Medication
If reliever medication doesn’t provide improvement within 15 minutes, or if asthma symptoms return quickly after temporary improvement, emergency care is essential. This suggests the current asthma treatment isn’t sufficient for the severity of the attack.
Prevention and Preparedness
Effective management involves understanding your personal asthma symptoms and having a comprehensive plan to prevent and respond to flare-ups.
Common Asthma Triggers to Avoid
Understanding what triggers your personal asthma symptoms is crucial for effective management. Common triggers include allergens like dust mites, pollen, pet dander, and mould. Environmental factors such as cold air, strong odours, smoke, and air pollution can also trigger symptoms.
Some people with asthma and allergies find their symptoms are triggered by specific foods, medications, or weather changes. In Australia, thunderstorm asthma is a recognised phenomenon where pollen particles are broken into smaller pieces during storms, triggering severe symptoms in susceptible people.
Essential Supplies to Have on Hand
Being prepared with the right supplies helps ensure quick response when asthma symptoms develop. Everyone with asthma should carry their reliever medication at all times and ensure it’s not expired. Keep spare inhalers at home, work, and school. Spacer devices improve medication delivery and should be available wherever inhalers are kept.
Ensure your written asthma action plan is easily accessible and that family members, colleagues, or carers know where to find it. Keep emergency contact numbers readily available.
Creating an Asthma Action Plan
A well-developed action plan helps you recognise and respond appropriately to changing asthma symptoms. Work with your doctor to develop an asthma action plan that outlines your normal medications, how to recognise worsening symptoms, and specific steps to take during an asthma attack. This plan should include medication doses, when to seek help, and emergency contact information.
Your asthma action plan should be reviewed regularly with your healthcare provider, especially if your symptoms change or if you’re using reliever medication more than twice a week. Proper asthma management requires ongoing monitoring and adjustment.
Environmental Modifications
To help control your asthma, identify and minimise exposure to your personal triggers. This might involve using allergen-proof bedding covers, regular vacuuming with HEPA filters, or avoiding outdoor activities during high pollen days.
Indoor air quality improvements like using air purifiers, maintaining low humidity levels, and ensuring good ventilation can help prevent asthma symptoms. Regular cleaning to reduce dust mites and mould is particularly important for people with asthma and allergies.
FAQs
What Can Cause Asthma?
The exact causes of asthma aren’t fully understood, but it typically develops from a combination of genetic and environmental factors that can eventually lead to asthma symptoms. People with family history of asthma and allergies are more likely to develop asthma, though anyone can get asthma at any age. Common contributing factors include early childhood respiratory infections, exposure to allergens like dust mites or pet dander, air pollution, viral infections, and occupational chemicals.
When Does Asthma Become an Asthma Attack?
An asthma flare-up becomes an asthma attack when asthma symptoms worsen beyond your usual level and don’t respond to your normal reliever medication. Warning signs include needing your reliever medication more frequently, symptoms disrupting sleep or daily activities, or airways becoming more inflamed and producing excess mucus. Follow your asthma action plan immediately when symptoms get worse, as early treatment can prevent a full asthma attack.
What Causes My Asthma Flare-Up?
Individual asthma symptoms can be triggered by various factors unique to each person, including respiratory infections, allergens (pollen, dust mites, mould), irritants like smoke or strong odours, weather changes, exercise, and emotional stress. To identify your personal triggers, keep a symptom diary noting when your asthma flare-ups occur and what you were exposed to beforehand, then work with your doctor to develop strategies to avoid them and adjust your asthma treatment accordingly.