The severity of an asthma attack (exacerbation) will determine the course of treatment. Mild asthma attacks are generally treatable outside the hospital setting while severe attacks are usually treated in a hospital, where closer monitoring is possible.
Mild asthma attacks have the following features:
- decrease in peak expiratory flow rate of less than 20%
- nighttime awakening
- increase in use of fast-acting bronchodilator
The goals of managing asthma attacks are to:
- relieve any obstructions in airflow and hypoxemia (low oxygen in the blood) as quickly as possible, as measured by a return to 80% of predicted or personal best peak expiratory flow rate
- prevent future attacks
The usual treatment for mild asthma attacks is repeated doses of a fast-acting bronchodilator, also called "reliever" medication. Ask your doctor how many puffs you should take, how often, and for how long. For example, a person might be instructed to take 2 to 4 puffs every 20 minutes for the first hour of a mild asthma attack, followed by 2 to 4 puffs every 3 to 4 hours. Make sure that you write your doctor's instructions down on your action plan, so that you know what to do in case of a mild asthma attack.
If a person responds to these doses (given via an inhaler and a spacer device), they will likely not need to go to the hospital. Instead, they will be advised to schedule an appointment with their regular doctor, who may prescribe oral steroid medication. In addition, people who have had a mild asthma attack should clarify with their health educator, doctor, nurse, or pharmacist that they are using their asthma medications (both controller and reliever) properly. Note that some people have their reliever and their controller medication together in a single inhaler. If this is the case for you, make sure you know how to use the inhaler correctly.
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