How to Prevent an Asthma Attack

An asthma attack is a sudden worsening of asthma symptoms caused by bronchoconstriction (narrowing of the airways) as a result of inflammation, swelling, and mucus production. It can be a scary experience, causing you to feel as if a huge weight is resting on your chest and leaving you to struggle for breath.

Such an episode can be fatal, so knowing what to do in case of an asthma attack could save your life or that of your child or someone around you.

The Best Medications for Asthma
Verywell / Laura Porter

Create an Asthma Action Plan

For anyone who has asthma, an asthma action plan is essential for preventing symptoms that can progress to a full-on asthma attack. This is a written document you and your asthma specialist will develop together based on your asthma triggers, usual symptoms, peak flow readings, and what you should do at different stages of progressively worsening symptoms.

A typical asthma action plan uses the color coding of a traffic light and is divided into three zones.

 Green Your asthma is under control, your peak flow readings are within your healthy range, and you feel well.
 Yellow Your symptoms are worsening and/or your peak flow readings are declining.
 Red Your symptoms are dangerously severe and you should get emergency help right away.

In terms of prevention, the action plan will identify all of your known triggers and ways to avoid them. It also will list your medications and how you should be taking them.

Avoid Triggers

If you have allergic asthma, it means your symptoms are set off when you're exposed to certain substances. The allergens that trigger asthma are not the same for everyone—pollen might cause one person to wheeze, while another may be sensitive to pet dander.

Steering clear of your triggers as best you can is an important aspect of asthma prevention. For example, if secondhand smoke causes your symptoms, ask anyone in your life who smokes to not light up in your home, and stay away from situations in which people are smoking.

When it comes to indoor allergens, there are specific measures you can take to eliminate them. In December 2020, the National Institutes of Health (NIH) updated their guidelines for managing asthma and made specific recommendations regarding indoor allergen mitigation.

The first is to be certain you are allergic to an indoor allergen: If you have not been tested and found to be sensitive to, say, dust mites, there is no reason to attempt to protect yourself from them.

The second is to take a multicomponent approach to mitigating whatever it is that triggers your asthma. For example, if you are allergic to dust mites, simply encasing your pillows and mattresses in impermeable covers will not be sufficient. You should also take other measures, such as installing an air purifier and using a vacuum with a HEPA filter.

Learn to Recognize Symptoms

It is important to recognize the early warning signs of an asthma attack and treat them right away. Appropriate management early on may prevent a trip to the emergency room or keep you out of the hospital.

Early warning signs of worsening asthma and an impending asthma attack include:

  • A drop in peak expiratory flow rate
  • Increased cough/chronic cough
  • Wheezing
  • Shortness of breath
  • Chest tightness
  • Some difficulty performing normal daily activities
  • Individual factors noticed over time that indicate worsening asthma or an asthma attack

These symptoms are likely to be listed in the yellow zone of your asthma action plan, so you should deal with them accordingly. This may mean taking extra doses of rescue medication and starting a course of oral corticosteroids.

Monitor Your Peak Flow

Checking your peak expiratory flow rate (PEFR)—a measure of how quickly your lungs expel air during a forceful exhalation after you fully inhale—is key to asthma attack prevention. PEFR is determined using a simple handheld device called a peak flow meter.

Depending on the severity of your asthma, your healthcare provider may want you to check your peak flow several times a day, once a day, every few days, or just at certain times.

The most common recommendation is once a day in the morning before taking your asthma medication.

If your peak flow numbers are declining, your asthma is getting worse and you need to act quickly to prevent an attack. Follow the instructions in your asthma action plan to prevent the symptoms from becoming more severe and turning into a full-blown attack.

Use Medication as Directed

Most people with asthma are prescribed at least two types of medication: a controller medication that is used daily to prevent inflammation and a rescue medication that is used to treat acute symptoms when they occur. Most often, these drugs are breathed in via an inhaler or nebulizer so that they go directly to the airways and lungs.

Most controller inhalers contain an inhaled corticosteroid (ICS). Your healthcare provider will determine how often you should use one based on the severity of your asthma. If you have mild asthma, you may not need to use an ICS everyday, according to the 2020 NIH recommendations for asthma management.

If you have mild, moderate, or severe persistent asthma, you likely will need to use your controller inhaler daily to prevent symptoms.

When you begin to experience worsening of symptoms, you can use a rescue inhaler to try to nip a full-on attack in the bud. It will likely contain a short-term beta agonist (SABA) such as albuterol, which works as a bronchodilator to expand the airways.

Take a Deep Breath

An impending asthma attack is anxiety-provoking, which in turn can compound the worsening of your symptoms by causing your airways to constrict even more. A deep breathing exercise such as Buteyko may be helpful in such moments.

While it will not eliminate your need for a rescue inhaler, it can make a significant difference in your asthma management. This may also be a technique you can rely on if you feel an attack coming on and you don't have your inhaler.

Know When to Get Help

Symptoms that place you in the "red zone" of your asthma action plan are serious. If you experience any of these, follow the instructions in your plan and get emergency care right away:

  • Wheezing when you inhale and exhale
  • Nonstop coughing
  • Difficulty breathing/shortness of breath (dyspnea)
  • Pale skin
  • Anxiety

Immediately call 911 or your local emergency number if:

  • You can't talk in full sentences.
  • Your lips or fingernails turn blue (this is called cyanosis).
  • You begin breathing rapidly (tachypnea).
  • You aren't able to breathe in or out fully.
  • You feel confused or agitated.
  • Your rescue inhaler doesn't relieve your symptoms.

A Word From Verywell

There is no cure for asthma, but it can be managed. When you're first diagnosed, controlling the disease may feel like a daunting undertaking, but the measures you need to take to prevent symptoms from worsening will become second nature. If at any time you feel they aren't working, let your healthcare provider know. A few tweaks in your asthma action plan should keep you as safe as possible from having an asthma attack.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cloutier MM, Baptist AP, Blake KV, et al. 2020 focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program coordinating committee expert panel working group. Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003

  2. Asthma and Allergy Foundation of America. Peak flow meters.

  3. Global Allergy & Airways. Diagnose the need for emergency asthma treatment.

Additional Reading

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.