If you go to the emergency department for an asthma attack, the health care provider will first assess how severe the attack is. Attacks are usually classified as mild, moderate, or severe.
This assessment is based on several factors:
Symptom severity and duration
Degree of airway obstruction
Extent to which the attack is interfering with regular activities
Mild and moderate attacks usually involve the following symptoms, which may come on gradually:
Coughing or spitting up mucus
Restlessness or trouble sleeping
Severe attacks are less common. They may involve the following symptoms:
Tightness in neck muscles
Slight gray or bluish color in your lips and fingernail beds
Skin appear "sucked in" around the rib cage
"Silent" chest - No wheezing on inhalation or exhalation
If you are able to speak, the health care provider will ask you questions about your symptoms, your medical history, and your medications. Answer as completely as you can. He or she will also examine you and observe you as you breathe.
If this is your first attack, or the first time you have sought medical attention for your symptoms, the health care provider will ask questions and perform tests to search for and rule out other causes of the symptoms.
Measurements of how well you are breathing include the following:
Spirometer: This device measures how much air you can exhale and how forcefully you can breathe out. The test may be done before and after you take inhaled medication. Spirometry is a good way to see how much your breathing is impaired during an attack.
Peak flow meter: This is another way of measuring how forcefully you can breathe out during an attack.
Oximetry: A painless probe, called a pulse oximeter, will be placed on your fingertip to measure the amount of oxygen in your bloodstream.
There is no blood test than can pinpoint the cause of asthma.
Your blood may be checked for signs of an infection that might be contributing to this attack.
In severe attacks, it may be necessary to sample blood from an artery to determine exactly how much oxygen and carbon dioxide are present in your body.
A chest x-ray may also be taken. This is mostly to rule out other conditions that can cause similar symptoms.