Asthma isn’t one-size-fits-all. There are different levels of severity, and it’s important to know the signs. That way, you’ll know what to do if it happens to you.

A severe asthma attack is a potentially life threatening event. Symptoms of a severe attack might be similar to the symptoms of a minor asthma attack, especially at first.

The difference is that severe attacks don’t improve with home treatment. These events need emergency medical treatment to prevent death. If you suspect you or a loved one is having a severe asthma attack, go to an emergency room right away.

By contrast, amild asthma attackmay only last a few minutes and will respond to rescue medication.

Amoderate asthma attack将持续更长的时间，并且可能不会立即回应救援药物。

If quick-relief medication fails to work after 10 to 15 minutes, go to the emergency room.

A severe asthma attack starts a lot like a minor asthma attack.

哮喘的早期迹象attacks include:

  • 严重的咳嗽
  • wheezing
  • 呼吸急促
  • chest tightness
  • fatigue
  • 发痒
  • nervousness
  • irritability

Symptoms of a severe asthma attack may include:

  • discolored lips, face, or nails that might be blue or gray
  • extreme difficulty breathing
  • 很难说话或走路
  • mental confusion
  • extreme anxiety caused by breathing difficulty
  • 胸痛
  • rapid pulse
  • chest retractions
  • drowsiness

You might feel mucus buildup and some chest pain due to yourbronchial tubes变窄。您可能会喘息和咳嗽。呼吸是一个挑战，尤其是在步行等活动中。也很难说话。

Given that these symptoms are like a minor asthma attack, what makes a severe asthma attack different?

关键是治疗反应。

You’ll know your asthma attack is severe if your symptoms don’t improve with your routine treatment measures, such as your rescue (“quick-acting”) inhaler.

In addition to an inhaler, a peak flow meter can show you how open the airways are in your lungs with a reading calledpeak expiratory flow (PEF). Lower readings from a peak flow meter can show the severity of an asthma attack.

Although no single parameter defines a severe asthma attack, lung function is a useful method of assessment. According to a2011 study, a PEF of 40 percent or less of typical function indicates a severe attack in people 5 years and older.

This scale uses four designations that include:

  • Mildis a PEF greater than 70 percent that can be treated at home.
  • 缓和is a PEF of 40 to 69 percent that usually requires an office or emergency room visit.
  • 严重的is a PEF lower than 40 percent that usually requires a visit to the emergency room and hospitalization.
  • Life threateningis a PEF under 25 percent that usually requires hospitalization and possibly intensive care.

On the other hand, Johns Hopkins Medicine uses colors to indicate three peak flow zones: green, yellow, and red.

  • Greenmeans “go,” and is 80 to 100 percent of your highest peak flow reading, or personal best.
  • Yellowmeans “caution,” and involves 50 to 80 percent of your personal best.
  • Redrefers to anything below 50 percent. This means “stop.” Get help right away.

According toJohns Hopkins Medicine, a PEF reading below 50 percent of full lung function indicates a medical emergency. If you receive this reading, get help right away.

您的哮喘治疗取决于定期症状的严重程度。如果您患有严重的哮喘，则可能已经服用了长期控制药物。如果发生哮喘发作，您可能还会有救援吸入器。

严重的asthma attacks don’t respond to regular asthma treatment, so you need emergency medical treatment if your rescue medications aren’t working. At the emergency room, your medical team may:

  • use a test calledpulse oximetryto tell how much oxygen is in your blood
  • measure your PEF to determine how much and how fast you exhale
  • take anitric oxidemeasurement to determine bronchial tube inflammation
  • measure your forced expiratory volume with aspirometrytest
  • perform a chest X-ray

Once your doctor confirms that you’re having a severe asthma attack, they may administer one or more of the following:

  • albuterol, an inhaled aerosol or powder
  • ipratropium (Atrovent), a type of inhaled bronchodilator used when rescue inhalers alone are not enough
  • oral or intravenous corticosteroids to control inflammation
  • oxygen
  • 一个剂量的intravenous硫酸镁
  • intubation machines to help you breathe

After an asthma attack, there arethings you can do to help your body recoveras well as lower the likelihood of another attack. These include:

  • getting lots of rest
  • cleaning your sleep space
  • adjusting medications
  • practicing breathing techniques
  • eating anti-inflammatory foods

First, it’s important to get lots of rest post-attack. Your body needs to recover from the stress of an asthma attack, and you may also feel emotionally drained. Take time off work if needed and put chores on the back burner while you recover. Ask for help from friends and family for anything that can’t wait.

To ensure you’re getting the most from your rest time, clean your sleep space often to get rid of potential allergens that may aggravate asthma. This is a good practice even when not recovering from an attack. If your asthma medications are keeping you awake at night, ask your doctor if you can use them earlier in the day.

You may also want to take a look at your medication lineup in general. Was the attack a one-off, or has it become a pattern? If so, talk with your doctor about potentially adjusting your medications to better support you.

If you rely on your rescue inhaler two or more times per week, this is a sign that you and your doctor need to look at more long-term forms of asthma treatment.

You can also practicebreathing techniques结合药物，可以帮助您更轻松地呼吸。与您的医生一起检查哪些做法适合您。

An anti-inflammatory diet may help reduce asthma symptoms, according to a 2016 study . Focus on foods that are high in:

  • omega-3 fatty acids, like fish, berries, nuts, and seeds
  • vitamin A, like liver, fish, eggs, cheese, squash, sweet potato, and dark leafy greens
  • vitamin E, like seeds, nut oils, and fruits, including avocado, mango, and kiwis

治疗and recovery are important after a severe asthma attack, as these are both life-saving measures. But the best way to avoid severe asthma attacks is to prevent them from happening altogether. Learning your asthma attack triggers is key to prevention.

并不是每个人的哮喘症状都是一样的，每个人都有不同的哮喘触发因素。学习自己的知识很重要，因此您可以知道要避免什么。可能加剧与哮喘相关的炎症的触发因素包括：

  • animal dander
  • 化学药品，例如清洁剂
  • cold temperatures
  • dry air
  • dust mites
  • heartburn
  • mold
  • perfumes and other fragrances
  • 花粉
  • respiratory infections
  • smoke (from tobacco, wood, chemicals, etc.)
  • stress

It’s not realistic to assume that you’ll never come into contact with an asthma trigger. The key is to do your best to avoid any known triggers if possible.

某些危险因素也可能会增加您发生严重哮喘发作的机会。这些包括：

  • lung disease
  • cardiovascular disease
  • having a history of severe asthma attacks

If you have a suspected trigger that hasn’t yet been formally identified, talk with your doctor about testing.

Have your rescue inhalerwith you at all timesand considerusing an inhaler spacer. A 2018 research review found that having a spacer can make your inhaler as effective as some emergency room treatments.

It’s important to remember that there’s no cure for asthma. Severe asthma attacks are a significant health risk, as these events can quickly turn fatal. What’s more, asthma attacks can interrupt your daily schedule, taking time away from family, work, and leisure activities.

好消息是，许多治疗方法都可以帮助您控制和防止严重的哮喘发作。管理哮喘不仅意味着更好的生活质量，还意味着改善了肺部健康的前景。