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What do YOU class as having an asthma attack?

Was just sitting here wondering, what do you class as having an asthma attack? To me, is when my home nebs aren't working and I have to go into A&E, not simply getting out of breath and needing to take a few puffs of inhlaher. I have brittle asthma so this may be why I have beceom ignorant to when I am having an 'attack', if that makes sense?

Just interested to know where everybody elses boundaries are!!


28 Replies

For me, it's when I'm so out of puff, I can't think or carry on a conversation. Sometimes my shoulders ache too. That's the time I need 5 - 8 puff of salbutamol. Other times it's endless cough to the point where reliever almost doesn't work. Sometimes think it would be easier decision if wheezer then I'd recognise and GP would recognise when need help or not.


at the moment when i cant talk properly and i have had 10puffs on my trusty blue.


I think there are three types of asthma attack.

1) being a little breathless and just needing to rest for a while.

2) not being able to breath properly or having a coughing fit when a bit of blue is needed.

3) a full blown attack which needs medical attention.

Anyone got any comments on this?


I feel the same as you, when nebs don't work and I need to get help - not sure when else I would consider it am asthma attack, but like you have brittle asthma often with no warning as to when an attack i sgoing to happen rest of the time I have grumbling asthma...always there in the background but don't class this an asthma attack. I could be very wrong though.

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good question... brittle myself too so do get the odd lil ones which i take puffs for when get symptoms but i call them blips! still mention them to cons and asthma nurse like been told to do though.

basically i suppose i class an attack as when i need medical help, or i am at home managing, just.

1. when breathless, unable to talk in full sentence, titeness, with/without wheeze

2. home nebs arent working as per plan

3. other asthma symptoms set in

need help simply!

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As a kid, an attack was when I needed hospital help. I still think thats true, so shed loads of ventolin doesn't count for me. Thats a clue that I might need to see the GP.

I think it will be different for others, I don't need or have nebs at home so some wouldn't agree with my view of an attack. Also, I suspect that if I was new to asthma, I might think that needing more than the standard ventolin dose was an attack. I guess this is a healthy attitude if you don't have experience with this stuff as things can get nasty quickly.


Requiring hospital admission.

Everything else I class as having symptoms ie: having asthma!


Anything that requires me to get extra help other than my nebs. If I need anything other than nebs then I'd class that as an attack.


I agree with most people and would say that upping blue and nebbing and pred etc is exacerbating and needing hospital is attack


This is interesting as it's something I often think about. I have different levels of asthma, from annoying to life threatening.

If I become wheezy, tight, breathless, which is relieved reasonably quickly with my inhaler, I don't really think of that as an attack, more so a symptom of living with asthma.

Annoying covers everything from being tight, wheezy, breathless, basically anything that effects me asthma wise, that inhalers don't relieve, and stops me from doing basic things.

Then I have the asthma attacks where I'm really struggling but don't feel bad enough to warrant calling an ambulance (if I called an ambulance every time I had one of these attacks, like I'm told that should do, I'd pretty much live in hospital!!).

Then there are the severe attacks where I need urgent medical attention, which often develop into life threatening attacks.

I should say, this is how I view my asthma, I don't apply these 'levels' to other people!

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Think this is an interesting question, and probably the answer does depend on how severe someone's asthma is normally - an 'attack' to someone with mild asthma would usually just be a relatively bad breathless/wheeze episode. This is what I considered to be an attack when I was younger and a mild asthmatic, but since coming on here have realised what an attack can mean for some people so now I qualify that by calling them 'mini-attacks' (my consultant called them 'wheezy episodes' though I did point out there was never much wheezing involved).

These days - no idea for myself but would probably agree with Dave re different types in general. Whether I have asthma or something else I don't have anything that could be called an attack these days, it's too persistent and yes, varies a little depending on time of day/activity but otherwise breathlessness, cough etc are just there pretty much always, and recent rib soreness lasts too long to be counted as an attack as well. (I do get 'sustained' exarcerbation for days/weeks after doing something idiotic).


I agree with Glitterdust. If somebody with milder asthma said they'd had an ""attack"", I wouldn't expect it to mean full-on hospital admission, but that's probably what I'd class as an ""attack"" for myself. Everything else I'd just put down to symptoms of asthma.


i would say an attack is when you have to to into hospital for treatment and everything else is just living with asthma!


True but for us with milder forms that have never seen the inside of A&E, sitting and coughing fit to burst or rushing for a train and becoming so out of breath once on it, that your companion actually contemplates pulling the cord - that, for me and my asthma nurse agrees, is an asthma attack.

True that so far (cross fingers) most blue puffs taken is around 10 - 12 and all is well again. So, for those of you with more than mild, yes, its a blip. For those of us, who are basically newbies or new adult-onset, its more than a blip. Deaths from asthma, we read everywhere on the web health sites occur most in 'mild' asthma cos either the person or those around them don't see mild asthma as a big deal.

Myself, I am hampered by not having a GP in the practice who has knowledge of asthma. That is partly why I come on the boards - to learn from others experiences. That should my asthma worsen and go up a step - I'm at stage four apparently - I might have half an idea of what to expect.


Interesting to read about the different levels of asthma. I've had mild asthma since childhood but recently have had daily exacerbations (likely a result of a changing work environment) and visited the asthma clinic to clarify some questions e.g. what to look out for that might lead to an attack. I also asked about the difference between asthma and COPD which is basically a chronic condition where the reliever inhaler has no effect. Many asthmatics can develop COPD, mainly as a result of smoking but also if they've worked with asbestos or other similar senstizers.

One question I have since reading some of the forum's comments is what is brittle asthma?


COPD is also from remodelling of lungs and fibrosis due to infections and responses from mast cells due to allergies


To me it is when u have accute symptoms that ur normal reliever dose does not improve nor control , resulting in a greater requirement of reliever or further assistance from medical people.... I don't think a and e attendance is necessary for it to b classed as an attack.... Tho if any one has any concerns about their asthma should seek medical attention.


Oh dear. Sorry everyone but this is the type of post I find really irritating. An asthma attack is when you need to take reliever medication to control symptoms....in my book. We are all going to have different definitions and given the wide disparity in severity some definitions could actually be very misleading to a newly diagnosed person or those who don't understand that ALL asthmatics can potentially be in a life threatening situation.

If you are unwell for YOU, if you have symptoms not being resolved by your reliever then seek medical advice please.


Well said, Feejay. Thanks.


Def well said. I think everyone is different and all of us are different in the way of asthma but we are united in having asthma! If that makes sense?!


I think FeeJay is right, but I also think that we should be aware that our asthma is likely to change without notice. For example, I had asthma for about 20 years, and an attack was sudden breathlessness, wheezing etc., which was dealt with by ventolin, peak flow back up to normal no problem. About 10 years ago that all changed and I was having trouble breathing all the time, peak flow was less than 50% of best and then an attack was when I had to sit down on the kitchen floor after I'd put the kettle on for a cup of tea. Now it's all change again - I cough and peak flow drops off, so now an attack is when I cough for about an hour without stopping and peak flow goes through the floor.

I found out the hard way that the fact that the asthma has always presented in one way doesn't mean that it will always present in that way, and twice I didn't realise that it was changing until I was in real trouble.


So true, can be brittle or just twitchy but many chronic diseases do it, morphing into something else !


for me it is my reliever not working.


I agree with you, I too have brittle asthma,I was hospitalised two weeks ago with an attack. I usually manage to sort myself out when I get wheezy and rarely claim to have had or be having an attack. I just say I'm really wheezy, this is probably not a good thing because those around us are not so vigilant to our needs if they think we're just wheezy! I'm lucky I work alongside a lovely lady who is probably as aware of my needs as I am.

I also agree that I too have become a little ignorant to my health but then when your wheezy most of the time it's too easy to not always recognise our condition deteriorateing until it's too late. I get very out of breath most of the time when I walk particularly if I'm carrying shopping or the air is cold. I often have to sit down and get my breath back.


I tend to think of asthma attacks by duration. Quick and easy, are the ones that are relieved swiftly with ventolin. But for me, the quick and easy attacks come closer and closer together until it is a long attack that tends to build into a worse state of normal. Then it kind of implodes on me. And my new normal is being short of breath, wheezy and barely breathing, and then anything that triggers it becomes a life threatening, scary attack. At the time, I tend to only acknowledge the big scary part. But when I step back and look at it, I see how the warning attacks built up and up. I do seek treatment Honest. But so often doctors say, watch and see, watch and see.... and then OMG why didn't you seek help more quickly. Which makes it very hard to judge what to do.


I too have brittle asthma. I don’t seem to follow any of the patterns reported to this thread. It’s only when I get a virus or infection I’m really ill. Right now I’m painting, walking 3 flights of stairs and (touches wood!) blew 400 yesterday at GPs. So my Asthma even after nearly 40 years where it’s been good/bad/good remains a mystery to me. 🙄


Ok so to me an attack is where I repeatedly need to take ventolin. Usually my attacks follow a trigger I haven't managed to avoid and come on suddenly. To explain what I mean.

When I was 15 years old I was with my mum at aunts house. My aunt and friends had been smoking and mum and I stayed to babysit my cousin. The room they had smoked in was small. Suddenly I could not breathe, I did not panic I tried taking slow breaths. In the end I had to stand outside for 4 hours before I felt OK. (this was 4years before I was diagnosed with Asthma). I believe this was my first asthma attack ever but at time had no idea what was going on. It was scary at the time but tried stay calm and removed self from trigger and eventually it eased off.

For the next 4 years I was in and out of hospital to try and find out why I was constantly getting infections and was tested for everything ie glandular fever and so on.

I had a few other attacks usually when around smokers or when doing PE at school or hayfever triggers. Always sudden usually struggling for breath.

Eventually, took going to Uni and changing Dr's who did a thorough new patient assessment to get tested for asthma. Questions on assessment do you have anyone with asthma in your family? Yes

How many infections have you had in last 6months? 6

They gave me a peak flow meter an a chart for a month and told to do 3x a day - went back after a month definitely asthma. Given Becotide and Ventolin.

For 2 years on inhalers no attacks and no infections felt wonderful. Then the infections started again and also had an asthma attack in my final exam at Uni peak flow went down below 200 and best always was around 430 - had to leave exam - sat taking Ventolin and after a few hours went back to normal. No panic, when felt ok went to see asthma nurse.

(thankfully let me go back to take a Viva voce in the summer). Meds got changed.

My inhalers only get changed after had lots of infections so been lucky now nearly 48 years old and been on same inhaler for about 10 years.

27/12/17 was ill for a month with chest infection and sinusitis felt really bad got put on prednisolone and antibiotics. Had to have 2 courses of prednisolone. Night's were so scary.

Since then had 1 staph aureus respiratory infection, 2 ear infections and 2 sinus infection and then on 5/12/18 came down with another infection which saw my friend calling ambulance and paramedics nebulising me but let me stay at home cos was seeing GP next day. GP sent me to A&E to be nebulised they gave me a further course of prednisolone and Co Amoxiclav (sputum results showed Moraxella catarrhalis a bacterial infection resistant to certain antibiotics and hits people with lung conditions) and they did chest x Ray and blood and thankfully decided I could go home after nebulised but booked me an appointment with Respiratory nurse after the weekend. The Respiratory Nurse changed Seretide to Duoresp Spiramax and gave me number for respiratory team. Got to go back 3 months


As is mentioned in many of the posts, the boundaries or signs are personal to each one of us having to live with asthma.

While that doesn't answer the question, it is important for us to each know the change and recognizer signs. I use to take a mad itchy feeling under my chin..... Yes bizarre. Now it's the fatigue and coughing.

Like many, however, I could end up as a permanent resident in A&E, and have many a battle with my family that I don't need hospital care.

My respiratory team refuse to issue nebulizer as they feel if in need of that level of intervention then it's best given under medical supervision. While I get their point, I have tried to explain its not that simple when you land up at an overstretched A&E having to go through your history.... And get a withering look..... Definitely feel there is a need of some type of official card your could present.... But that's another argument.

Having rambled on, I have just recovered from a chest infection. When I went for my last Xolair injection, granted I had a cold, pf had dropped slightly, not a worrying level, but the asthma nurse specialist sounded me and said it didn't sound good..... And started contemplating admission.

Tbh I didn't feel I was at that point, nor did I feel that bad, so I guess as I get used to my asthma presenting differently its getti g used to what is a "new indicator" for me.

As me tuoned by others it's all personal to each one of us, and us learning the combinations of indicators.

It's not easy and can be frustrating, for us and those around us.

Just don't get complacent and feel you can cope, better getting checked out if in doubt.


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