With severe asthmatics it’s important to have a written programme displayed in a prominent place so everyone knows what to do when an asthma attack occurs. Severe asthmatics are also advised to have oxygen at hand and to get to the emergency service at the local hospital as quickly as possible.

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In milder attacks, the sufferer can get relief by using their bronchodilator. If you live far away from medical services, or where transport modalities are not easy to come by, an emergency course of oral cortisone may be commenced. However, consult with your doctor before taking it.

There are usually many warning signs of an impending asthma attack, and one of them is lowered peak flow measurement. You can monitor your condition by regularly checking your peak flow. Other symptoms may not be as obvious and you may want to give a list of these symptoms to friends, family and work colleagues, together with an action plan and a set of instructions on what to do in an emergency. Look out for the following symptoms:

• cough;
• sweatiness;
• paleness;
• flared nostrils;
• fast breathing;
• vomiting;
• anxious look;
• hunched-over posture;
• restlessness during sleep;
• fatigue;
• spaces between ribs visible when sucking in air;
• clearing throat;
• wheezing;
• noisy and irregular breathing.

Rush to your closest hospital if:

• Your symptoms get worse even after taking extra medication;
• You’re having a hard time breathing (or your peak flow has dropped below 50%);
• You’re struggling to walk or talk;
• Your lips and fingernails are turning blue-gray.

Don’t forget to have the telephone numbers of your doctor and the local hospitals readily available in the event of an emergency.

Risk factors for death from asthma

You may be at greater risk of death from asthma if you:

• have a past history of sudden, severe asthma attacks;
• have been admitted to an intensive care unit for asthma;
• have been hospitalised for asthma two or more times in the last 12 months;
• have had three or more emergency care visits for asthma in the past 12 months;
• have been hospitalised or have had an emergency care visit for asthma in the past month;
• use more than 2 canisters of inhaled short-acting beta2-agonist each month;
• have difficulty perceiving airflow obstruction or its severity;
• are poor and live in an urban setting;
• use illegal drugs;
• have a serious psychiatric disease or have psychosocial problems;
• are allergic to outdoor mold.

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