Allergic Asthma Attack: When Do You Need to Go to the Hospital?

Allergic asthma attacks

The first step in managing asthma is to regularly use both your controller and rescue inhalers, as well as other medication as recommended by your doctor. You should also do your best to avoid the sources of allergens or irritants if these are triggering your symptoms.

However, if you continue to have asthma flare-ups despite regular use of asthma control medication, you should seek medical help.

If you experience severe symptoms, call for emergency medical help. In the United States, that means dialing 911 to call for an ambulance.

Severe asthma attacks share many symptoms with mild to moderate asthma attacks. The key difference is that the symptoms of a severe allergic asthma attack do not improve after taking rescue medication.

When to go to the hospital for asthma attack symptoms

You might wonder how you can tell the difference between symptoms of a severe attack that requires emergency treatment versus a mild attack that you can treat on your own.

First thing’s first: Always seek emergency medical attention if your rescue medication does not seem to be working.

Additionally, you should go to the hospital if you notice any of the following symptoms that may indicate a life threatening asthma attack:

• intense shortness of breath and difficulty speaking
• very rapid breathing, coughing, or wheezing
• straining chest muscles and difficulty breathing
• a bluish color in the face, lips, or nails
• difficulty inhaling or exhaling completely
• gasping
• confusion or exhaustion
• fainting or collapsing

If you use a peak flow meter — a device that measures your peak airflow — you should go to the hospital if your readings are low and are not improving.

In a life threatening asthma attack, coughing or wheezing may disappear as the attack worsens. If you cannot speak a full sentence or you experience other breathing difficulties, seek medical attention.

If your symptoms respond quickly to your rescue medication, and you can walk and talk comfortably, you may not need to go to the hospital.

What to do during a severe allergic asthma attack

Everyone who lives with allergic asthma can help protect their health by learning the basics of asthma first aid.

A good preventive step is to create an asthma action plan with your doctor.

The American Lung Association provides an example worksheet to create an asthma action plan. An asthma action plan can help you be prepared if your symptoms flare up.

If you’re having an allergic asthma attack, address your symptoms right away. If your symptoms are mild, take your quick-relief medication. You should feel better after 20 minutes to an hour. If your symptoms get worse or do not improve, you should get help immediately.

Call for emergency medical help and take the following steps while you wait for help to arrive.

Take medication and move away from triggers

As soon as you notice symptoms of an asthma attack, such as wheezing or chest tightness, take your rescue inhaler. Pay attention to whether you may have been exposed to allergens that trigger your asthma, such as pets or irritants like cigarette smoke. Move away from any source of allergens.

Ask someone to stay with you

You shouldn’t be alone if you’re having an asthma attack. Let someone in your immediate area know what’s happening. Ask them to stay with you until your symptoms improve or emergency help arrives.

Sit upright and try to stay calm

During an asthma attack, it’s best to be in an upright posture. Do not lie down. It also helps to try to stay calm, since panic may worsen your symptoms. Try to take slow, steady breaths.

Continue using rescue medication as instructed

If your symptoms are severe, use your rescue medication while you wait for help. Follow the instructions that your doctor or pharmacist provided for using your rescue medication in an emergency. The maximum dosage will vary based on the medication.

Do not hesitate to call for emergency help if you’re experiencing asthma symptoms. An asthma attack can worsen quickly, especially in children.

Treatment at the hospital for an allergic asthma attack

If you’re admitted to a hospital emergency room with an allergic asthma attack, the most common treatments may include:

• short-acting beta-agonists, the same medications used in a rescue inhaler and often given via a nebulizer
• other types of bronchodilators to widen the bronchi
• oral, inhaled, or injected corticosteroids to reduce inflammation in the lungs and airways
• intubation to help pump oxygen into the lungs in severe cases

Even after your symptoms stabilize, your doctor may want to observe you for several hours to ensure there isn’t a subsequent asthma attack.

Recovery from a severe allergic asthma attack can take anywhere from a few hours to several days. It depends on the severity of the attack. If there was damage to the lungs, ongoing treatment may be needed.

Is it asthma or anaphylaxis?

Allergic asthma attacks are triggered by exposure to allergens. The symptoms can sometimes be confused with anaphylaxis, a systemic and other potentially life threatening condition.

Anaphylaxis is a severe allergic reaction to allergens such as:

• certain medications
• insect stings
• foods like peanuts, eggs, or shellfish

Some common symptoms of anaphylaxis include:

• swelling of the mouth, tongue, or throat
• hives
• shortness of breath, wheezing, and difficulty breathing or talking
• vomiting
• dizziness or fainting

Developing these symptoms after you’re exposed to an allergen usually suggests anaphylaxis, according to the Asthma and Allergy Foundation of America (AAFA).

If you’re unsure if you’re having a severe allergic asthma attack or anaphylaxis and you have injectable epinephrine with you, take it. Dial 911 to call for an ambulance immediately.

Epinephrine will help alleviate the symptoms of both allergic asthma and anaphylaxis until you can get to the hospital.

Severe allergic asthma attacks and anaphylaxis can be fatal, so it’s important to seek care at the first sign of symptoms.

Prevention and avoiding triggers

Inhaled allergens trigger most cases of allergic asthma. For example, the most common triggers are:

• pollen
• mold spores
• pet dander, saliva, and urine
• dust and dust mites
• cockroach droppings and fragments

Less commonly, some foods and medications can trigger asthma symptoms, including:

• eggs
• dairy products
• peanuts and tree nuts
• ibuprofen
• aspirin

You can manage allergic asthma and help prevent asthma attacks by avoiding triggers and taking your medication as prescribed. If you’re still experiencing symptoms on a regular basis, talk with your doctor. They may need to change your treatment plan or provide more guidance about avoiding triggers.

Long-term management of allergic asthma

Sticking to your treatment plan can help prevent your asthma symptoms from worsening. If you’re taking multiple treatments but still experiencing symptoms, you may need more help managing your condition.

Asthma is considered severe when it’s not managed or only partially managed, even if the person takes multiple treatments, such as inhaled corticosteroids, oral corticosteroids, or inhaled beta-agonists. According to the AAFA, about 5 to 10 percent of people with asthma typically will continue to have symptoms despite standard treatments.

A number of factors may contribute to your asthma symptoms worsening, including:

• not taking medication as prescribed
• difficulty managing allergies
• ongoing exposure to allergens
• chronic inflammation of the upper and lower respiratory tract
• other health conditions

If you have severe allergic asthma, your doctor may recommend a combination of prescription medications, complementary therapies, and lifestyle changes. These options may help you manage the condition more effectively.

The takeaway

A severe allergic asthma attack can be life threatening. It’s important to seek emergency help as soon as your symptoms start.

If you’re experiencing asthma symptoms on a regular basis, your doctor may suggest making a change to your treatment plan to help you better manage your condition.