Normally, the shortness of breath caused by activity in asthmatics gets better with rest. However, when severe symptoms are present or when you're experiencing an asthma attack, breathlessness occurs even when you're resting because of triggers activating the inflammatory process. If the inflammation is serious enough, you will suddenly find yourself severely short of breath or taking deep gasps of air.  You may also feel like you can't fully exhale. When the body needs the oxygen from inhalation, it shortens exhalation so it can get to oxygen more quickly. You may find that you can’t speak in full sentences, but are using short words and sentences between gasps. Even mild and moderate asthma attacks can make you breathe rapidly, but severe attacks are worse. The constriction in your airways is preventing you bringing enough fresh air into your body, starving it of oxygen. The rapid breathing is your body's attempt to get as much oxygen as possible to correct the situation before it suffers damage.  Place your palm over your chest and note how many times your chest rises and falls in one minute. Use a stopwatch or clock with a second hand to time out an accurate minute. In severe episodes, your respiration rate will be over 30 breaths per minute. To get oxygen to your tissues and organs, blood picks up oxygen from the air in your lungs and carries it to different parts of the body. During a severe attack, when there's not enough oxygen being brought in, the heart must pump blood faster to get as much oxygen to tissues and organs as possible. You may feel your heart racing without explanation during severe attacks.  Hold your hand out, palm up. Place the tips of the index and middle fingers of your other hand on the outer part of your wrist, below the thumb. You will feel a rapid, beating pulse from the radial artery. Calculate your heart rate by counting how many times your heart beats in one minute. A normal heart rate is less than 100 beats per minute, but in severe asthma symptoms you may get rates over 120.  Some smart phones now have heartbeat monitors built right in. If yours does, you can use that. Blood is only bright red when it's carrying oxygen — otherwise it's much darker. Whenever we see it, it's hit the open air outside of our bodies and turned bright with oxygen, so we're not used to thinking of it any other way. But during a severe asthma attack, you may experience "cyanosis" caused by dark, oxygen-starved blood traveling through your arteries. This causes the skin to appear bluish or grayish, especially on the lips, fingers, nails, gums, or the thin skin around the eyes. When we breathe heavily or are in respiratory distress, we engage accessory (not usually central to breathing) muscles. The muscles we bring into the breathing process in these situations are on the sides of the neck: the sternocleidomastoid and scalene muscles. Look for deep outlines in the neck muscles if you're having trouble breathing.  Furthermore, the muscles between our ribs (the intercostals) get pulled inward. These muscles help lift the rib cage during inhalation, and may be able to see this retraction between your ribs in serious conditions. Look in the mirror to see both the deeply outlined neck muscles and the retracted muscles between your ribs. When you're working too hard to breathe, the muscles involved with respiration get overworked. This results in muscle fatigue in the chest, which feels like tightness and pain. The pain might feel dull, sharp, or stabbing, and can around the middle of the chest (sternal) or slightly off center (parasternal). This requires immediate medical attention and a visit to the emergency room to rule out heart issues. In mild and moderate symptoms, the whistling and wheezing is only heard on exhalation. However, in severe episodes, you can hear it both on exhalation and inhalation. The whistling noise we hear on inhalation is known as "stridor," and is caused by constriction of the throat muscles in the upper respiratory tract. Wheezing tends to occur on exhalation, and is caused by constriction of muscles in the lower respiratory tract.  Noise on inhalation can be a symptom both of asthma and of severe allergic reaction. You need to be able to distinguish between them so you can treat the cause appropriately. Look for hives or red rashes on the chest, which indicate an allergic reaction instead of an asthma attack. Swelling of the lips or tongue also point to allergies. If you have a severe attack that makes it hard to breathe, call 911 and get to an emergency room immediately. If you're undiagnosed, you likely don't have a rescue inhaler. If you have one, though, use it.  Albuterol inhaler pumps should only be used 4 times a day, but in a attack it's ok to use it as often as every 20 minutes for 2 hours.  Take slow deep breaths, counting to 3 in your head on inhalation and exhalation. This can help reduce stress and your breathing rate. Remove the trigger if you can identify it. Asthma will get better when you use steroids prescribed by your physician. These drugs can be inhaled through a pump or taken as a tablet. Take a puff of the medication or a tablet with water. It takes a few hours to start working, but will control asthma symptoms. These symptoms suggest you're having an acute attack, and your body is struggling to draw enough air to function. This is considered a medical emergency that could prove potentially fatal if not treated immediately.
ابحث عن الرعاية الطبّية إن لم تتمكن من التنفّس، حتى دون جهد. تفقّد معدّل تنفّسك. قسْ نبضك. راقب تحوّل البشرة إلى لون مائل للزرقة. لاحظ ما إن كنت ترهق عضلات رقبتك وصدرك. تفقّد ضيق الصدر أو الألم. استمع لزيادة سوء الصوت أثناء التنفّس. عالج أعراض الربو في أقرب وقت ممكن. ابحث عن رعاية طبّية طارئة عند ظهور أعراض الربو الشديدة.