In the United States, one in 13 people has asthma, a lung disease that causes coughing, chest tightness, wheezing, and breathlessness. While many have mild symptoms that are easy to control, you may experience frequent severe asthma attacks, or uncontrollable symptoms, that are frightening and unpredictable. This severe form of asthma can make breathing difficult on a daily basis. Fortunately, there are simple steps you can take to keep your symptoms from turning into a crisis. The exact cause of asthma isn’t known, but certain factors make it more likely you’ll develop the condition and experience asthma attacks. You could be more likely to have asthma if your parents have the condition or if you had certain allergies or respiratory infections in childhood. Regardless of the cause of your asthma, severe asthma attacks can be life-threatening. But with your doctor’s help, you can make an asthma action plan to help recognize asthma attacks early and receive the help you need. Understanding Asthma Attacks Asthma attacks result from inflammation and swelling in your airways. During an asthma attack, your airways also make extra mucus, which causes further narrowing of your bronchial (breathing) tubes. Asthma attacks can cause symptoms ranging from mild to severe. Signs and symptoms of an asthma attack include: Chest pain or tightness Severe shortness of breath Wheezing Coughing Symptoms that don’t respond to rescue inhaler use Low peak expiratory flow (PE) readings on a peak flow meter During a severe asthma attack, your body doesn’t respond to everyday asthma treatments, like rescue inhalers. Severe asthma attacks can become life-threatening emergencies and require immediate care from your doctor. Time is critical if you are experiencing difficulty breathing. If you have a severe asthma attack that doesn’t respond to treatment, call 911 immediately to go to your nearest hospital. For many people, severe asthma attacks are triggered by certain environmental and personal factors, including: Allergens in the workplace and home Lung irritants that are inhaled Exercise Infections Gastroesophageal reflux disease (GERD) Strong emotions Aspirin People of all ages have severe asthma attacks, which can place extreme limits on your ability to participate in normal daily activities. The key to managing severe asthma attacks is the development of a thorough asthma action plan with your doctor that details how to tell your symptoms are getting worse and when you should contact a healthcare professional. Asthma Action Plans It may not be possible to eliminate your symptoms, but your doctor can help you create a written asthma action plan to help keep track of how severe your symptoms are and when you should contact your care provider. Since your asthma may not respond to home asthma treatments, it’s critically important to follow your asthma action plan. Your personal asthma action plan will include information about reducing your exposure to asthma triggers and which asthma medications are most appropriate for use. Keep in mind that every person is different, and you may be prescribed different medications from another person with asthma. Also, even though you may not be likely to respond to medications, your doctor may recommend you take certain prescriptions in the event of a severe asthma attack as a first-line effort to bring your symptoms under control. If you begin to have an asthma attack, your action plan gives you step-by-step instructions for which medications you should take at home, how often you should take them, and when you should call your doctor. Your asthma action plan also lists the signs of a severe asthma attack so you can monitor your symptoms and recognize when they are getting worse. If you have a severe asthma attack, your plan provides instructions for any medications your doctor recommends, as well as when to call an ambulance or go to your local hospital. The plan lists your doctor’s phone number as well as your hospital and local emergency phone numbers. It's important to remember you can take steps to control your asthma, but severe asthma attacks are still possible even with the best medical management. By working closely with your doctor, you can create an asthma action plan that details the best treatment options for you and keeps all important phone numbers in one place. Severe asthma attacks are frightening, but with the right plan, you can help make an attack as manageable as possible.