What is Asthma?
Asthma is a chronic lung condition that affects the airways—tubes that transport air in and out of the lungs. It causes the airways to become inflamed and swollen, making them narrower and reducing airflow.
It can affect people of all ages and often begins in childhood, though some individuals may develop it for the first time as adults.
For better understanding please watch video about Asthma prepared by Asthma and Lung UK, “The UK’s lung charity fighting for your right to breathe”. https://www.youtube.com/watch?v=aFmL7QLy758&t=5s
What are the symptoms of Asthma?
People with asthma typically experience symptoms intermittently rather than constantly. Various factors, including exercise, allergens, and weather changes, can trigger asthma symptoms. Since triggers vary from person to person, each individual with asthma may react to different environmental or lifestyle factors.
People with asthma may experience symptoms such as wheezing, breathlessness, coughing, or a tight feeling in the chest. In some cases, these symptoms can rapidly worsen, leading to an asthma attack.
Asthma is more likely if:
· You experience multiple symptoms
· Your symptoms occur frequently
· They worsen at night or early in the morning
· They are triggered by factors such as pollen, cold air, or animals.
What are the symptoms of asthma attack?
Signs that you may be experiencing an asthma attack include:
· Worsening symptoms such as coughing, breathlessness, wheezing, or a tight chest
· Little or no relief from your reliever inhaler (usually blue one : Salbutamol /Ventolin)
· Being too breathless to speak, eat, or sleep
· Rapid breathing and a feeling of being unable to catch your breath
· A lower-than-normal peak flow score
· In children, complaints of a tummy ache or chest pain
Symptoms don’t always appear suddenly; they often develop gradually over several hours or even days.
Although there is currently no cure for asthma, most people can effectively manage their symptoms with inhalers and other medications. Some individuals may go weeks or even months without experiencing any symptoms.
It can affect people of all ages and often begins in childhood, though some individuals may develop it for the first time as adults.
For better understanding please watch video about Asthma prepared by Asthma and Lung UK, “The UK’s lung charity fighting for your right to breathe”. https://www.youtube.com/watch?v=aFmL7QLy758&t=5s
What are the symptoms of Asthma?
People with asthma typically experience symptoms intermittently rather than constantly. Various factors, including exercise, allergens, and weather changes, can trigger asthma symptoms. Since triggers vary from person to person, each individual with asthma may react to different environmental or lifestyle factors.
People with asthma may experience symptoms such as wheezing, breathlessness, coughing, or a tight feeling in the chest. In some cases, these symptoms can rapidly worsen, leading to an asthma attack.
Asthma is more likely if:
· You experience multiple symptoms
· Your symptoms occur frequently
· They worsen at night or early in the morning
· They are triggered by factors such as pollen, cold air, or animals.
What are the symptoms of asthma attack?
Signs that you may be experiencing an asthma attack include:
· Worsening symptoms such as coughing, breathlessness, wheezing, or a tight chest
· Little or no relief from your reliever inhaler (usually blue one : Salbutamol /Ventolin)
· Being too breathless to speak, eat, or sleep
· Rapid breathing and a feeling of being unable to catch your breath
· A lower-than-normal peak flow score
· In children, complaints of a tummy ache or chest pain
Symptoms don’t always appear suddenly; they often develop gradually over several hours or even days.
Although there is currently no cure for asthma, most people can effectively manage their symptoms with inhalers and other medications. Some individuals may go weeks or even months without experiencing any symptoms.
Asthma Attack Advice
Preventing Asthma Attacks
It’s very important that your friends and family are aware of how to assist you in an emergency.
One helpful step is to share copies of your personal asthma action plan with those who may need to know what to do in the event of an asthma attack. This ensures they are prepared to act quickly and effectively if needed.
What Your asthma action plan tells you or your friends and family which medicines to take every day, what to do if your asthma symptoms get worse, what to do if you have an asthma attack.
You can either photocopy your existing asthma action plan or download a blank personal asthma action plan from Asthma + Lung UK. Once downloaded, you can fill it in with your specific details and share it with anyone who may need a copy to help in case of an emergency.
https://www.asthmaandlung.org.uk/conditions/asthma/manage/your-asthma-action-plan
Children’s asthma action plan can be downloaded from link
https://shop.asthmaandlung.org.uk/collections/health-advice-resources/products/child-asthma-action-plan
To reduce the risk of having an asthma attack, consider the following steps:
Follow your personal asthma action plan and take all your prescribed medications as directed.
Have regular asthma reviews with a GP or asthma nurse at least once a year.
Ensure proper inhaler use. Check with a GP or asthma nurse to make sure you’re using your inhaler correctly.
Avoid triggers that worsen your symptoms whenever possible.
Don’t ignore worsening symptoms. If you find yourself needing to use your reliever inhaler more often than usual, seek advice.
Always follow your action plan and schedule an urgent appointment with your GP or asthma nurse if your symptoms continue to worsen.
Asthma Attack Advice for Using a Blue Reliever Inhaler
Sit upright and stay calm. Try to relax your breathing.
Use your blue reliever inhaler. Take one puff every 30–60 seconds, up to a maximum of 10 puffs.
Call 999 if needed. If your symptoms worsen at any point or do not improve after 10 puffs, dial 999 for an ambulance.
Repeat if necessary. If the ambulance hasn’t arrived after 10 minutes and your symptoms are still not improving, repeat step 2.
Seek urgent help. If your symptoms remain severe after repeating step 2 and the ambulance has not yet arrived, call 999 again immediately.
🚨 If you do not have your blue reliever inhaler, call 999 straight away.
What to do in an asthma attack if you have a blue reliever
Find out what to do during an asthma attack from Naomi, one of Asthma + Lung UK’s respiratory specialist nurses.
https://www.youtube.com/watch?v=pt53nH_dX1Y&t=74s
What to Do If You DON’T Have Your Reliever Inhaler
If you are struggling to breathe and do not have your reliever inhaler, call 999 immediately.
🚨 Do not wait to see if your symptoms improve on their own. An asthma attack is a medical emergency, and you need urgent treatment.
Steps to take:
Sit up and stay as calm as possible. Try to control your breathing.
Call 999 for an ambulance.
Inform the call handler that you do not have your reliever inhaler with you.
Getting treatment quickly is essential, so seek help without delay.
Asthma Attack Advice for a MART and AIR Inhaler
Sit up and try to stay calm. Keep your breathing as steady as possible.
Use your MART inhaler. Take one puff every 1 to 3 minutes, up to a maximum of 6 puffs.
Call 999 if needed. If your symptoms worsen at any point or do not improve after 6 puffs, call 999 for an ambulance.
Repeat if necessary. If the ambulance hasn’t arrived after 10 minutes and your symptoms are still not improving, repeat step 2.
Seek urgent help. If your symptoms remain severe after repeating step 2 and the ambulance has still not arrived, call 999 again immediately.
🚨 If you do not have your MART or AIR inhaler, call 999 straight away.
If you’re struggling to breathe and don’t have your reliever inhaler, call 999 immediately.
🚨 Do not wait to see if your symptoms improve. An asthma attack is a medical emergency, and you need immediate treatment.
Steps to take:
Sit up and stay calm. Focus on controlling your breathing.
Call 999 for an ambulance.
Inform the call handler that you do not have your reliever inhaler with you.
After an Asthma Attack
It’s important to contact GP or asthma nurse within 48 hours of leaving the hospital, or ideally on the same day if you didn’t need hospital treatment. GP Surgery will organise a follow up appointment.
Around 1 in 6 people treated in the hospital for an asthma attack require further care within 2 weeks, so it’s essential to discuss how to reduce the risk of future attacks.
Make sure to talk to your doctor or nurse about any adjustments needed to safely manage your condition, such as:
Adjusting the dose of your medication.
Learning or reviewing how to use your inhaler properly.
It’s very important that your friends and family are aware of how to assist you in an emergency.
One helpful step is to share copies of your personal asthma action plan with those who may need to know what to do in the event of an asthma attack. This ensures they are prepared to act quickly and effectively if needed.
What Your asthma action plan tells you or your friends and family which medicines to take every day, what to do if your asthma symptoms get worse, what to do if you have an asthma attack.
You can either photocopy your existing asthma action plan or download a blank personal asthma action plan from Asthma + Lung UK. Once downloaded, you can fill it in with your specific details and share it with anyone who may need a copy to help in case of an emergency.
https://www.asthmaandlung.org.uk/conditions/asthma/manage/your-asthma-action-plan
Children’s asthma action plan can be downloaded from link
https://shop.asthmaandlung.org.uk/collections/health-advice-resources/products/child-asthma-action-plan
To reduce the risk of having an asthma attack, consider the following steps:
Follow your personal asthma action plan and take all your prescribed medications as directed.
Have regular asthma reviews with a GP or asthma nurse at least once a year.
Ensure proper inhaler use. Check with a GP or asthma nurse to make sure you’re using your inhaler correctly.
Avoid triggers that worsen your symptoms whenever possible.
Don’t ignore worsening symptoms. If you find yourself needing to use your reliever inhaler more often than usual, seek advice.
Always follow your action plan and schedule an urgent appointment with your GP or asthma nurse if your symptoms continue to worsen.
Asthma Attack Advice for Using a Blue Reliever Inhaler
Sit upright and stay calm. Try to relax your breathing.
Use your blue reliever inhaler. Take one puff every 30–60 seconds, up to a maximum of 10 puffs.
Call 999 if needed. If your symptoms worsen at any point or do not improve after 10 puffs, dial 999 for an ambulance.
Repeat if necessary. If the ambulance hasn’t arrived after 10 minutes and your symptoms are still not improving, repeat step 2.
Seek urgent help. If your symptoms remain severe after repeating step 2 and the ambulance has not yet arrived, call 999 again immediately.
🚨 If you do not have your blue reliever inhaler, call 999 straight away.
What to do in an asthma attack if you have a blue reliever
Find out what to do during an asthma attack from Naomi, one of Asthma + Lung UK’s respiratory specialist nurses.
https://www.youtube.com/watch?v=pt53nH_dX1Y&t=74s
What to Do If You DON’T Have Your Reliever Inhaler
If you are struggling to breathe and do not have your reliever inhaler, call 999 immediately.
🚨 Do not wait to see if your symptoms improve on their own. An asthma attack is a medical emergency, and you need urgent treatment.
Steps to take:
Sit up and stay as calm as possible. Try to control your breathing.
Call 999 for an ambulance.
Inform the call handler that you do not have your reliever inhaler with you.
Getting treatment quickly is essential, so seek help without delay.
Asthma Attack Advice for a MART and AIR Inhaler
Sit up and try to stay calm. Keep your breathing as steady as possible.
Use your MART inhaler. Take one puff every 1 to 3 minutes, up to a maximum of 6 puffs.
Call 999 if needed. If your symptoms worsen at any point or do not improve after 6 puffs, call 999 for an ambulance.
Repeat if necessary. If the ambulance hasn’t arrived after 10 minutes and your symptoms are still not improving, repeat step 2.
Seek urgent help. If your symptoms remain severe after repeating step 2 and the ambulance has still not arrived, call 999 again immediately.
🚨 If you do not have your MART or AIR inhaler, call 999 straight away.
If you’re struggling to breathe and don’t have your reliever inhaler, call 999 immediately.
🚨 Do not wait to see if your symptoms improve. An asthma attack is a medical emergency, and you need immediate treatment.
Steps to take:
Sit up and stay calm. Focus on controlling your breathing.
Call 999 for an ambulance.
Inform the call handler that you do not have your reliever inhaler with you.
After an Asthma Attack
It’s important to contact GP or asthma nurse within 48 hours of leaving the hospital, or ideally on the same day if you didn’t need hospital treatment. GP Surgery will organise a follow up appointment.
Around 1 in 6 people treated in the hospital for an asthma attack require further care within 2 weeks, so it’s essential to discuss how to reduce the risk of future attacks.
Make sure to talk to your doctor or nurse about any adjustments needed to safely manage your condition, such as:
Adjusting the dose of your medication.
Learning or reviewing how to use your inhaler properly.
Importance of Updating Peak Flow Diary
Peak Flow Measurement and why it is important
Peak flow is a measurement of how quickly you can exhale air from your lungs. To measure it, you blow forcefully into a plastic tube called a peak flow meter.
Your Asthma Nurse or trained healthcare worker can show you the best way to use the peak flow meter. You can purchase a peak flow meter from most pharmacies, or you may be able to get one on prescription, please contact us if you do not have a peak flow meter.
Monitoring your peak flow regularly can help you track how well your asthma is controlled.
In addition to tracking your peak flow, a clinical history and other tests, such as spirometry (measuring lung function) and FeNO (measuring nitric oxide levels in your breath), can help your GP confirm how asthma is controlled .
Peak flow diary can be downloaded and printed from
https://shop.asthmaandlung.org.uk/products/peak-flow-diary#
Please watch video on how to use peak flow meter properly prepared by Asthma + Lung UK
https://www.youtube.com/watch?v=UQa74XtQXf8
Normal Peak Flow Values
A normal peak flow depends on your age, size, and lung health. For adults, a typical peak flow is between 400 and 700 L/min. For children, normal values generally range from 150 to 450 L/min.
It’s important to regularly track your peak flow readings. By monitoring these, your healthcare provider can observe any changes over time and make adjustments to your asthma treatment if necessary.
How to Measure Peak Expiratory Flow Rate (PEFR) for Your Child
To help your child measure their PEFR, follow these steps:
Find a comfortable position – Have your child sit or stand, using the same position each time.
Prepare the peak flow meter – Push the pointer back to the first line of the scale nearest the mouthpiece.
Hold the meter correctly – Ask your child to hold the peak flow meter horizontally, making sure their fingers do not block the measurement scale.
Breathing in – Your child should take a deep breath in as deeply as possible.
Sealing the mouthpiece – They should place their lips tightly around the mouthpiece to create a seal.
Exhale forcefully – They should breathe out quickly and as hard as they can.
Record the reading – After they finish breathing out, note the reading on the meter.
This process should be repeated three times, and the highest of the three measurements should be recorded as the peak flow score in their chart.
Tracking Peak Flow
PEFR can vary at different times of the day. It’s helpful to record PEFR morning and evening for a couple of weeks to understand what normal scores are when they are well and identify any changes that could suggest asthma is worsening.
Please alert your GP Surgery if you need any help
Peak expiratory flow prediction
You can calculate PEFR here. It can be used in those patients with asthma from ages 5 to 80.
Peak flow is a measurement of how quickly you can exhale air from your lungs. To measure it, you blow forcefully into a plastic tube called a peak flow meter.
Your Asthma Nurse or trained healthcare worker can show you the best way to use the peak flow meter. You can purchase a peak flow meter from most pharmacies, or you may be able to get one on prescription, please contact us if you do not have a peak flow meter.
Monitoring your peak flow regularly can help you track how well your asthma is controlled.
In addition to tracking your peak flow, a clinical history and other tests, such as spirometry (measuring lung function) and FeNO (measuring nitric oxide levels in your breath), can help your GP confirm how asthma is controlled .
Peak flow diary can be downloaded and printed from
https://shop.asthmaandlung.org.uk/products/peak-flow-diary#
Please watch video on how to use peak flow meter properly prepared by Asthma + Lung UK
https://www.youtube.com/watch?v=UQa74XtQXf8
Normal Peak Flow Values
A normal peak flow depends on your age, size, and lung health. For adults, a typical peak flow is between 400 and 700 L/min. For children, normal values generally range from 150 to 450 L/min.
It’s important to regularly track your peak flow readings. By monitoring these, your healthcare provider can observe any changes over time and make adjustments to your asthma treatment if necessary.
How to Measure Peak Expiratory Flow Rate (PEFR) for Your Child
To help your child measure their PEFR, follow these steps:
Find a comfortable position – Have your child sit or stand, using the same position each time.
Prepare the peak flow meter – Push the pointer back to the first line of the scale nearest the mouthpiece.
Hold the meter correctly – Ask your child to hold the peak flow meter horizontally, making sure their fingers do not block the measurement scale.
Breathing in – Your child should take a deep breath in as deeply as possible.
Sealing the mouthpiece – They should place their lips tightly around the mouthpiece to create a seal.
Exhale forcefully – They should breathe out quickly and as hard as they can.
Record the reading – After they finish breathing out, note the reading on the meter.
This process should be repeated three times, and the highest of the three measurements should be recorded as the peak flow score in their chart.
Tracking Peak Flow
PEFR can vary at different times of the day. It’s helpful to record PEFR morning and evening for a couple of weeks to understand what normal scores are when they are well and identify any changes that could suggest asthma is worsening.
Please alert your GP Surgery if you need any help
Peak expiratory flow prediction
You can calculate PEFR here. It can be used in those patients with asthma from ages 5 to 80.
Treatment of Asthma
If you’re experiencing symptoms and your GP suspects asthma, you may begin treatment while awaiting further tests to confirm the diagnosis.
This is called a ‘trial of treatment’. During this time, you’ll be given an asthma preventer inhaler to see if it helps alleviate your symptoms. It may take a few weeks to notice any improvement.
If your symptoms improve and asthma is confirmed, you’ll likely continue with these treatments.
It’s important to note that it might take time to find the treatment plan that works best for you. You may need to try different inhalers or adjust the dosage.
Your GP will start you on the lowest possible dose to achieve good control and will aim to find the most effective treatment for your asthma.
Types of Inhalers and Their Purposes
Inhalers can help in different ways depending on the type:
Reliever inhalers help relieve symptoms when they occur, providing quick relief for wheezing, breathlessness, or tightness in the chest.
Most people with asthma are prescribed a reliever inhaler, which is usually blue.
You use a reliever inhaler to treat symptoms when they occur. It should help relieve your symptoms within a few minutes.
If you find that you need to use your reliever inhaler 3 or more times a week, it’s important to talk to your GP or asthma nurse. They may recommend additional treatment, such as a preventer inhaler, to help better control your asthma.
While reliever inhalers typically have few side effects, they can sometimes cause shaking or a fast heartbeat for a short time after use.
Preventer inhalers help stop symptoms from developing by reducing inflammation and keeping the airways clear over time.
If you find yourself using a reliever inhaler frequently, you may also need a preventer inhaler.
A preventer inhaler is used every day, even when you don’t have symptoms. It works by reducing the inflammation and sensitivity of your airways, preventing symptoms from developing.
If you continue to have symptoms while using a preventer inhaler, talk to your GP or asthma nurse.
Preventer inhalers typically contain steroid medication. While they generally have few side effects, they can occasionally cause:
Oral thrush (a fungal infection of the mouth or throat)
A hoarse voice
A sore throat
To help reduce these side effects, use a spacer (a hollow plastic tube that attaches to your inhaler) and rinse your mouth after using your inhaler.
Combination inhalers do both: they act as both relievers and preventers, helping manage symptoms and prevent future flare-ups.
If using both reliever and preventer inhalers does not fully control your asthma, you may need a combination inhaler.
A combination inhaler is used every day to both prevent symptoms and provide long-lasting relief if symptoms do occur.
It’s important to use the combination inhaler regularly, even if you don’t have symptoms, to keep your asthma under control.
The side effects of combination inhalers are similar to those of both reliever and preventer inhalers, such as possible shaking, fast heartbeat, oral thrush, or a hoarse voice.
Steroid Tablets
Steroid tablets may be prescribed if other treatments are not effectively controlling your asthma symptoms.
They can be used in two ways:
As an immediate treatment during an asthma attack
As a long-term treatment to prevent symptoms, typically only for those with severe asthma when inhalers alone are not enough
Long-term or frequent use of steroid tablets can occasionally cause side effects such as:
Increased appetite, which may lead to weight gain
Easy bruising
Mood changes
Fragile bones (osteoporosis)
High blood pressure
You will be monitored regularly while taking steroid tablets to check for any potential issues.
This is called a ‘trial of treatment’. During this time, you’ll be given an asthma preventer inhaler to see if it helps alleviate your symptoms. It may take a few weeks to notice any improvement.
If your symptoms improve and asthma is confirmed, you’ll likely continue with these treatments.
It’s important to note that it might take time to find the treatment plan that works best for you. You may need to try different inhalers or adjust the dosage.
Your GP will start you on the lowest possible dose to achieve good control and will aim to find the most effective treatment for your asthma.
Types of Inhalers and Their Purposes
Inhalers can help in different ways depending on the type:
Reliever inhalers help relieve symptoms when they occur, providing quick relief for wheezing, breathlessness, or tightness in the chest.
Most people with asthma are prescribed a reliever inhaler, which is usually blue.
You use a reliever inhaler to treat symptoms when they occur. It should help relieve your symptoms within a few minutes.
If you find that you need to use your reliever inhaler 3 or more times a week, it’s important to talk to your GP or asthma nurse. They may recommend additional treatment, such as a preventer inhaler, to help better control your asthma.
While reliever inhalers typically have few side effects, they can sometimes cause shaking or a fast heartbeat for a short time after use.
Preventer inhalers help stop symptoms from developing by reducing inflammation and keeping the airways clear over time.
If you find yourself using a reliever inhaler frequently, you may also need a preventer inhaler.
A preventer inhaler is used every day, even when you don’t have symptoms. It works by reducing the inflammation and sensitivity of your airways, preventing symptoms from developing.
If you continue to have symptoms while using a preventer inhaler, talk to your GP or asthma nurse.
Preventer inhalers typically contain steroid medication. While they generally have few side effects, they can occasionally cause:
Oral thrush (a fungal infection of the mouth or throat)
A hoarse voice
A sore throat
To help reduce these side effects, use a spacer (a hollow plastic tube that attaches to your inhaler) and rinse your mouth after using your inhaler.
Combination inhalers do both: they act as both relievers and preventers, helping manage symptoms and prevent future flare-ups.
If using both reliever and preventer inhalers does not fully control your asthma, you may need a combination inhaler.
A combination inhaler is used every day to both prevent symptoms and provide long-lasting relief if symptoms do occur.
It’s important to use the combination inhaler regularly, even if you don’t have symptoms, to keep your asthma under control.
The side effects of combination inhalers are similar to those of both reliever and preventer inhalers, such as possible shaking, fast heartbeat, oral thrush, or a hoarse voice.
Steroid Tablets
Steroid tablets may be prescribed if other treatments are not effectively controlling your asthma symptoms.
They can be used in two ways:
As an immediate treatment during an asthma attack
As a long-term treatment to prevent symptoms, typically only for those with severe asthma when inhalers alone are not enough
Long-term or frequent use of steroid tablets can occasionally cause side effects such as:
Increased appetite, which may lead to weight gain
Easy bruising
Mood changes
Fragile bones (osteoporosis)
High blood pressure
You will be monitored regularly while taking steroid tablets to check for any potential issues.