Overview of acute asthma

Acute asthma (also known as an asthma exacerbation, attack or flare up) is an acute worsening of lung function and asthma symptoms. Typical symptoms include shortness of breath, wheeze, cough and chest tightness.

Acute asthma usually occurs in response to a trigger, such as a viral respiratory tract infection or an irritant (eg pollen, pollution, cold air). Lack of adherence with preventer therapy is also a common factor.

First aid treatment administered by the patient, parents, carers or community members is often the first intervention—see First aid for acute asthma. Educate all patients with asthma (and parents and carers) to recognise the early symptoms of asthma deterioration, and to start reliever therapy according to their asthma action plan. For information about self-management and action plans, see Self-management and asthma action plans for adults and Supported self-management and asthma action plans in children.

In a clinical setting, management is determined by the severity of the exacerbation. A rapid preliminary severity assessment determines initial treatment; a more detailed secondary severity assessment guides ongoing management. See Summary of management of acute asthma.

The information in this topic is not relevant for infants younger than 12 months as asthma cannot be diagnosed in this age group—see here for more information. Infants younger than 12 months should be urgently referred if they have sudden-onset wheeze, and foreign body aspiration or anaphylaxis is suspected; infants should not be treated with asthma medication.