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Asthma Health Center

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Severe Asthma Attacks

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What Causes a Severe Asthma Attack?

Whereas the causes of an acute, severe asthma attack are unknown, those people who have them may have a history of infrequent health care, which may result in poor treatment of asthma.

Some research shows that people who are at risk for a severe asthma attack have poor control of allergens or asthma triggers in the home and/or workplace. These people may also infrequently use their peak flow meter and inhaled corticosteroids. Inhaled steroids are potent anti-inflammatory drugs that are highly effective in reducing inflammation associated with asthma.

To prevent a severe asthma attack, it is important to monitor your lung function using a peak flow meter regularly and take your asthma medication as recommended by your health care provider.

How Is a Severe Asthma Attack Diagnosed?

To diagnose a severe asthma attack as actual status asthmaticus, your doctor will notice physical findings such as your consciousness, fatigue, and the use of accessory muscles of breathing. Your doctor will notice your respiration rate, wheezing during both inhalation and exhalation, and your pulse rate. Some other tests may include peak expiratory flow and oxygen saturation, among others. Other physical symptoms will be noticed with the chest, mouth, pharynx, and upper airway.

How Is a Severe Asthma Attack Treated?

A severe asthma attack may not respond quickly to routine treatment with asthma inhalers. Continuous use of an asthma nebulizer and injections of drugs such as epinephrine and corticosteroids for asthma are often necessary to stop the asthma attack. Other therapies may include terbutaline injections, magnesium sulfate (induces smooth muscle relaxation of the airways), and leukotriene inhibitors, which are anti-inflammatory drugs.

During a severe asthma attack that does not respond to asthma drugs, a mechanical ventilator may be needed to assist the lungs and respiratory muscles. A facemask is applied or a breathing tube is inserted in the nose or mouth for this asthma treatment. These breathing aids are temporary and are removed once the attack has subsided and the lungs have recovered sufficiently to resume the work of breathing on their own. A short hospital stay in an intensive care unit may be necessary with a severe asthma attack.

To avoid hospitalization with a severe asthma attack, it is imperative to begin immediate early treatment at the first sign of symptoms either at home or in your doctor's office. If you have asthma, it's also important to see your doctor frequently to monitor your lung function and to assess your asthma medications. Also, using your peak flow meter several times daily can help you monitor your breathing, so you can start treatment immediately if you notice a lower reading, even if you feel fine.

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