Asthma Attacks

Bronchospasm is the end result of an inflammatory process in the lungs. This is often caused by exposure to an allergen such as house dust mite and results from the immune system over-reacting to this normally harmless stimulus. The inflamed airways also make the airway linings produce more mucus than usual, which contributes to airway narrowing. Meanwhile, inflamed airways also send out nerve impulses to the airway muscles and the resulting 'twitchiness' sets off the process of bronchospasm. Inasthma, there is always underlying inflammation of the airways, even in the absence of an attack. It is the presence of a trigger which escalates this inflammation, resulting in an attack.

The triggers for an asthma attack are many and various. They include:

Classical allergens such as:

• House dust mite
• Cat dander (40 per cent of people with asthma are allergic to cats)
• Pollen
• Mould spores

Workplace allergens, known as asthmagens, such as:

• Flour dust
• Wood dust
• Latex
• Chemicals
• Moulds

Irritants such as:

• Cigarette smoke
• Traffic pollution
• Sulphur dioxide from preservatives such as in wines
• Nitrogen dioxide from gas cookers

Other triggers for an asthma attack can also include:

• Thunderstorms
• Cold or dry air
• Colds, flu and chest infections. This is why it is so important to get a flu jab every year if you have asthma
• Strong odours
• Exercise
• Anxiety or stress

When experiencing an asthma attack, Asthma UK recommends the following steps:

1. Take one or two puffs of your reliever inhaler immediately
2. Sit down and take slow, steady breaths
3. If you do not start to feel better, continue to take 1-2 puffs of the inhaler every two minutes (up to ten puffs in all)
4. If you still do not feel better, call 999 for medical help. Do this anyway if you feel concerned at any time
5. If help does not arrive within 10 minutes of your call, then resume with the inhaler as above
6. After an attack, be sure to see your doctor or asthma nurse within 24 hours

The key to avoiding an asthma attack is to avoid the triggers. This can include a range of strategies, such as:

• Avoiding going outdoors when pollution levels are high
• Keep an eye on pollen count
• Reducing indoor allergens with a HEPA air purifier
• Regular damp dusting
• Mite-proof bed covers
• At the same time, make sure you have a written personal asthma action plan as research shows this is one of the best ways of managing your asthma.

The bronchospasm underlying an asthma attack is reversible so most attacks do subside. But an asthma attack should always be taken seriously. Asthma UK says that three people a day die from an asthma attack and most of these deaths were preventable.