Many people think that asthma attacks happen suddenly, but they’re wrong. Doctors recognize, however, that usually there is a gradual increase in inflammation in the lungs that slowly makes breathing more difficult. The increasing inflammation in the lungs finally leads to wheezing and marked difficulty breathing–an asthma attack. This gradual worsening usually occurs over days to weeks. The best way to help people who have asthma attacks is to help them get frequent and adequate medical care, which is extremely helpful in preventing severe attacks. Patients should learn to monitor and treat their asthma so that they seek medical care and increase their anti-inflammatory medicines before attacks occur.
Patients who are in the midst of a severe asthma attack have tremendous inflammation in the small airways of their lungs. This inflammation shrinks the airways and breathing becomes very difficult. In a severe attack, patients are unable to take deep breaths or may appear to stop breathing. Inhaled medicines, like albuterol, make it easier for a patient to breathe. Sometimes multiple doses, given back to back, are necessary in life-threatening situations while an ambulance is coming. Unfortunately, multiple doses of albuterol have usually been tried without success before an ambulance was called. Inhaled steroids, which are important in the long-term treatment of asthma, should not be used in emergency situations, because they can make breathing problems worse. Injected medicines, like epinephrine, can be helpful but need to be arranged with a doctor in advance.
Inhaled albuterol is the main medicine that could be the most helpful in an emergency. Obtaining medical care to prevent attacks is a much better way to care for asthmatics who are having problems with frequent attacks.