A person may notice visible asthma symptoms, such as a blue or gray tinge to the lips or fingernails. Potential silent signs include persistent shortness of breath or chest tightness. Knowing when to go to the hospital for asthma can be lifesaving for an adult or child.

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Asthma is a chronic disease that causes inflammation and narrowing of the airways.

Symptoms usually occur due to airway swelling or inflammation. A tightening of the muscles surrounding the airways may also occur, and some people produce extra mucus.

These factors combined cause asthma symptoms, which include:

A person should consult a doctor if they find that their usual treatment methods are not relieving symptoms. If left untreated, symptoms may worsen and lead to a medical emergency.

The article below looks at the symptoms of an asthma attack, including when to go to the hospital, asthma management, and preventing flare-ups.

Based on the results of a national survey from 2011–2016, 9.9% of working adults with asthma made an asthma-related visit to the emergency room during the preceding year.

And asthma accounts for over 700,000 annual emergency room visits by children and 2–5% of all pediatric hospitalizations.

There are both silent and visible signs and symptoms that a person should go to the hospital for asthma.

According to the American College of Emergency Physicians, warning signs that suggest a person should seek immediate medical help include:

  • persistent straining to breathe
  • inability to complete a sentence without pausing for breath
  • breathlessness even when lying down
  • chest tightness
  • agitation, confusion, or difficulty concentrating

Visible warning signs may include:

  • hunched shoulders
  • blue tinge to the lips or fingernails — or gray in darker skin tones
  • straining of abdominal and neck muscles
  • sitting or standing to take a breath

A person should not delay seeking immediate help if they or someone they know is experiencing any of the above symptoms.

If left untreated, an asthma attack can develop into status asthmatics. Status asthmaticus can lead to respiratory failure requiring support from a ventilator to breathe. About 10% of cases admitted to the intensive care unit for status asthmaticus prove fatal.

A child should go to the hospital for asthma if any of the above symptoms develop.

According to a 2020 review, doctors should focus on a child’s mental status and respiratory effort. These factors can also help parents and caregivers recognize when to take a child to the hospital.

Additionally, a caregiver should take a child to the hospital for asthma if they observe:

Before performing any tests, doctors will initiate treatment to stabilize breathing.

Treatment may vary depending on the severity of symptoms and the initial response to treatment. It may include:

  • Inhaled short-acting bronchodilators: This type of inhaled medication helps open the lungs by relaxing the muscles that surround the airways.
  • Oral, inhaled, or injected steroids: Steroids decrease inflammation and swelling in the airway.
  • Oxygen: A doctor may administer oxygen if a person’s oxygen saturation drops below their normal threshold. This therapy helps increase blood oxygen levels and may reduce shortness of breath.
  • Airway support, including intubation and mechanical ventilation: If someone develops respiratory failure, they may need assistance breathing via a mechanical ventilator.

Tests

Once doctors have stabilized breathing, they will conduct a physical exam, including listening to lung sounds. Tests may include:

The length of time a person spends in the hospital may vary depending on how fast they respond to treatment. Once symptoms improve, doctors may monitor someone for a few additional hours or days to ensure symptoms do not return.

After symptoms improve, an individual receives discharge instructions. These include when and how to take asthma medications and spot signs of a flare-up.

After leaving the hospital, a person should follow up with their doctor. They may suggest the following changes:

  • new medications
  • additional medications
  • possible symptom triggers

Learn more about common asthma triggers.

Long-term management of asthma often includes a combination of medication, lifestyle changes, and education.

According to the American Lung Association, asthma management may include:

  • becoming educated on causes of asthma and signs of a flare-up
  • creating an asthma action plan
  • monitoring symptoms
  • using inhalers to reduce flare-ups and treat sudden symptoms
  • not smoking
  • getting regular exercise

Read more about the treatments for asthma.

People with asthma have airways sensitive to certain substances or environmental conditions, known as triggers.

Other factors that can trigger flare-ups include:

Several strategies to help prevent flare-ups include the following:

  • Taking an asthma education class: Asthma education classes teach participants about:
    • the causes of asthma
    • early symptoms
    • ways to reduce flare-ups
    • how to develop an asthma action plan
  • Avoiding triggers: Asthma triggers cause a flare-up of symptoms. Triggers are different for everyone, but keeping a log of symptoms may help identify triggers. After determining triggers, doctors can suggest ways to avoid them as much as possible.
  • Using a long-acting bronchodilator: This inhaled medication keeps the airways open longer than a fast-acting inhaler. Steroids also help prevent inflammation and flare-ups.
  • Using a peak flow meter: A peak flow meter measures the air a person can blow out in one breath. When a person is symptom-free, measuring peak flow helps determine their personal best. Airways may narrow even before more obvious symptoms develop. A decrease in peak flow by 20–30% may mean the start of an asthma attack.

A person should consult a doctor to discuss any of the above strategies.

Learn more about asthma control tests.

According to the American Heart Association, people with persistent asthma may have a 1.5 times greater risk of developing atrial fibrillation — an abnormal heart rhythm.

People with severe asthma, which is difficult to manage, may develop bronchiectasis. This condition results from scarred and inflamed airways that produce excess mucus. This mucus builds up and can become infected.

Treatment options are available for this condition, including chest and oxygen therapy and antibiotic medication.

If a person has severe asthma attacks and flare-ups, they are also more at risk of developing chronic obstructive pulmonary disease (COPD). COPD causes the lungs to become inflamed and narrow.

People should speak with a doctor to explore possible risks and health conditions that a flare may trigger. They can provide suitable long-term treatment plans and prevention strategies.

Learn more about possible asthma complications.

Some warning signs that a person should go to the hospital for asthma may include persistent shortness of breath, blue or gray tinge to the nails or lips, and rapid breathing.

Getting prompt treatment may prevent serious complications. A person can speak with their doctor to learn about asthma triggers and prevention and formulate an asthma action plan.