What is asthma?
Asthma is a lifelong condition that affects the airways in the lungs. The airways get inflamed and swollen and the muscles that surround the airway tighten making it more difficult for air to enter the lungs.
People with asthma have airways that can be more sensitive to certain triggers.
Common symptoms are:
Asthma symptoms can come and go. But, even when you feel well, the asthma is there in the background. It is important to take medicines as prescribed to keep asthma under control. Symptoms may vary depending on the time of day and from season to season. Everyone’s asthma is different.
It is a chronic condition and if not treated properly, asthma can be serious and lead to life-threatening attacks.
According to Asthma and Lung UK 7.2 million people in the UK have asthma that is about 8 in every 100 living with asthma.
What will trigger my asthma?
A trigger is something which irritates your airways and makes your asthma symptoms worse. It is important to identify your triggers so that you can try to manage them to lower your risk of asthma symptoms or asthma attacks.
Triggers vary from person to person but common ones which can worsen your asthma include;
Asthma treatments
Asthma is a chronic long-term illness and there is currently no cure, but with correct management most people can enjoy an active lifestyle and carry out day to day activities with no symptoms. The way to achieve this is to take your preventer treatment every day as prescribed. This makes your airways less sensitive and inflamed. Your airways are then less likely to react to triggers. It reduces the chance of you having asthma symptoms or flare ups which can be very serious.
Taking your treatment exactly as prescribed means you will be more likely to stay symptom-free and able to do your usual activities. Most asthma treatments are inhalers, these are a very effective way of getting the medicine to exactly where needed in the lungs.
It is really important to know how to take your inhalers correctly to ensure the medication is reaching the small airways where it is needed. There are many different types of inhalers that need different inhaler techniques.
Your doctor / nurse or pharmacist should teach you how to use your inhalers. Further guidance showing exactly how to use each inhaler type can be found on the Asthma and Lung UK link below. Once there you can select your inhaler device and watch a video showing correct inhaler technique.
Most people will be managed well with a regular preventer inhaler and reliever when needed but other ‘add on therapies’ may be considered if you are taking this treatment every day with a good inhaler technique yet still having asthma symptoms.
In these circumstances, please speak to your GP or see the Practice nurse in your local asthma clinic. Referral to secondary care (seeing a specialist asthma doctor in a hospital setting) should be considered if you are having frequent flare ups of your asthma (requiring oral steroids tablets) or if you continue to have symptoms on prescribed treatments.
As asthma symptoms are variable an annual asthma review is recommended so that treatments can be adjusted accordingly. You should also be given a personal asthma action plan if you do not already have one so that you are aware of worsening symptoms and actions required including what to do in an emergency.
Should you require any additional advice or information Asthma and Lung UK have asthma nurses on hand for support via phone call / email or WhatsApp.
How do I know how well my asthma is controlled?
It is important for people with asthma to know when their asthma control is good (GREEN ZONE), getting worse (AMBER ZONE) or when they are having an asthma attack (RED ZONE).
A peak flow is simple breathing test that can help people with asthma know how well their asthma is controlled. You may wish to enquire about obtaining a peak flow meter to determine ‘best’ peak flow when well at your next asthma review.
| Symptoms | What should I do? | |
|---|---|---|
| GREEN ZONE | • I have no asthma symptoms (cough, wheeze, chest tightness, breathlessness) • I have no symptoms caused by exercise • I do not wake at night with my asthma • I do not need to use my reliever inhaler |
• Continue taking your preventer medication every day. It is important to use your preventer medication daily. This is usually twice a day even when you are well to keep your asthma under control. • If you have wheeze, chest tightness, breathlessness, and coughing you can use your reliever inhaler as needed. If your asthma is well controlled, you should not need to use your reliever medicine at all. |
| AMBER ZONE | • My reliever inhaler does not last as long as usual or work as well as it usually does • I am waking at night due to my asthma symptoms • My asthma symptoms are interfering with my normal activities • Variability or drop in my peak flow readings |
• Check your inhaler technique. Make sure you are using your inhalers as prescribed. Search inhaler on website: Asthma and Lung Website • If you have been prescribed a course of prednisolone tablets, make sure you are taking these • Tell your respiratory team that you are in the amber zone on the platform. They can make sure you are on the correct treatment |
| RED ZONE | • I am having an asthma attack if I have any of these symptoms: • I find it difficult to walk or talk (I cannot complete a sentence in one breath) • I find it difficult to breathe • I am wheezing a lot and have a very tight chest • My reliever inhaler is not helping |
• If you have these symptoms while you are on the asthma virtual ward, then please ring 999 immediately. • Use 1 to 2 puffs/doses of your reliever. If needed, repeat every 3 to 5 minutes up to a maximum of 10 puffs. • If you are on a single combination preventer and reliever inhaler (MART), you can use 1 dose/puff every 5 minutes for relief of symptoms if needed, up to a maximum of 6 doses • Let someone know how you are feeling. Sit upright. Try to stay as calm as possible. If you have steroid tablets at home and you have not already taken them, take 40mg of prednisolone now. |
Authors:
Karen Jackson, Leyla Pur