How to survive an asthma attack if you’re caught without your inhaler

If you have asthma, you probably never go anywhere without your inhaler. But what if, due to negligence, you go out without it and have a sudden asthma attack?

"The importance of always carrying rescue medication cannot be understated", says associate professor Loo Chian Min, head and senior consultant, Department of Respiratory & Critical Care Medicine, Singapore General Hospital (SGH). "It is absolutely vital that you don't forget your inhaler wherever you go."

What happens during an asthma attack
Asthma occurs when the airways (bronchial tubes) in the lungs become inflamed and are blocked by mucus, making breathing difficult. The chest tightens and the lungs seem to produce a wheezing sound.

There could be many triggers for an asthma attack.Air pollution, exposure to irritants such as dust, cigarette smoke and pet dander, physical exertion and emotional outbursts can all trigger an asthma attack.

Related article: How well do you control your asthma? Take the test!

Six things to do if caught without an inhaler during an asthma attack
"Never, ever let up on your asthma medications even if you feel your condition has improved," says Loo. Asthma needs constant care and proper management at all times. Your very life depends on it.

However, should you be caught without your inhaler due to unforeseen circumstances, you could try these coping techniques:

• Sit upright

Stop whatever you are doing and sit upright. Bending over or lying down can constrict your breathing even more.

• Take long, deep breaths

This helps to slow down your breathing and prevent hyperventilation. Breathe in through your nose and breathe out through your mouth.

• Stay calm

Staying calm may prevent further tightening of your chest muscles and make your breathing easier.

• Get away from the trigger

The asthma attack could be triggered by dust, cigarette smoke or the smell of chemicals (e.g., ammonia, chlorine gas, sulphur dioxide). Get away from the trigger as soon as possible and go to an air-conditioned environment or any place with clean air.

Related article: How does air pollution affect your health?

• Take a hot caffeinated beverage

Hot caffeinated drinks like coffee can help to open up the airways slightly, providing some relief for an hour or two.

• Seek emergency medical help

If the wheezing, coughing and breathing difficulty do not subside after a period of rest, seek immediate medical attention.

Symptoms of an asthma attack
An asthma attack can be mild or severe. Be alert for these general symptoms:

• Difficulty breathing/breathlessness

• Wheezing

• Tightness in the chest

• Coughing

If you experience severe breathing difficulty, a rapid increase in your pulse rate, severe coughing, and notice that your nails and lips are turning bluish, get medical help immediately, as these are signs of a severe asthma attack.

Related video: Get answers to common questions on asthma

Treatment of asthma
Doctors treat asthma with a combination of long-term and quick-relief medications, and medications to treat allergy-induced asthma.

Long-term medications include:

• inhaled corticosteroids to reduce inflammation of the bronchial tubes,

• bronchodilators to open up the airways and

• leukotriene modifiers to reduce both airway inflammation and mucus production.

Quick-relief medications are prescribed to cope with sudden asthma attacks. These are inhaled medications such as ipratropium (Atrovent) and albuterol. They relax the airway muscles temporarily to make breathing easier.

Asthma inhalers are the asthma sufferer's mobile medical kit. The inhalers deliver medication directly to the lungs for immediate relief during a sudden asthma attack.

"Go and see a doctor even if you have recovered from an asthma attack. Asthma attacks are signs that your asthma is not well-controlled. You may need stronger medication for a worsening asthmatic condition," says Loo.

This article was written by Teresa Cheong for Health Xchange, with expert input from the Department of Respiratory & Critical Care Medicine, Singapore General Hospital.

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