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  Sep 30, 2018

What If My Asthma Gets Worse?

Asthma can be kept under control using a variety of measures such as routine checkups, regular peak flow monitoring, following the asthma action plan and avoiding triggers that cause asthma. However, asthma does flare up sometimes without warning.

Sudden cough or shortness of breath can happen, usually triggered by some common allergen such as dust or pollen. Asthma can also get worse over a period of time in which you see that more quick-relief medicine than usual is needed to control asthma symptoms. An asthma attack needs to be treated quickly using the right medicine. If left unattended, asthma attacks and related symptoms worsen and can even become fatal.

What to Do When Symptoms Worsen?

Symptoms of asthma can vary in different situations. To effectively track the symptoms and act when they get worse, you need to work with your doctor to develop a clear asthma action plan. To determine if your asthma is getting worse, you will need to understand the importance of the three zones of asthma control – green zone, yellow zone and red zone.

The Green Zone

The green zone indicates full control of your asthma.

  • You have up to 90% normal breathing ability and remain largely asymptomatic.
  • You are able to be active and take part in day to day activities at work or school.
  • Your sleep is not disturbed by asthma symptoms such as cough or chest tightness.
  • You don’t use your controller or reliever medication except for the pre-exercise dose.

In this stage, continue your controller medications as per your doctor’s directions. If your symptoms are in the green zone for over 3 months, you can discuss with your doctor about decreasing the dose of your controller medications. However, do not stop taking your medications without consulting your doctor.

The Yellow Zone

  • You have 60 to 80% of normal breathing ability and have mild asthma symptoms that interfere with your routine activities or exercise.
  • Symptoms make it difficult to sleep and you may also have a cold or chest infection.
  • Frequency of reliever medication intake is 4 or more times in a week
  • You are forced to miss work or school because of your symptoms.

If you see that you are in the yellow zone, speak to your physician and seek modification of your asthma medications and updation of asthma action plan. If asthma symptoms in the yellow zone are left untreated they might worsen and move to the red zone.


The red zone indicates a medical emergency. People in the red zone experience severe asthma symptoms such as:

  • Extreme wheezing
  • Chest tightness
  • Very difficult breathing
  • Orofuse sweating
  • Gasping
  • Blue or pale fingernails or lips
  • Anxiety

Reliever medications may not work effectively towards easing these symptoms. Make a note of these signs and make sure you recognize them.

If you have any of these symptoms, immediate medical attention is required. Call your local emergency service immediately and get to the ER as soon as possible.

Treatment of Asthma Symptoms

At the emergency room, healthcare professionals will treat you with oral or intravenous corticosteroids, inhalation of reliever medications such as bronchodilators, and oxygen masks. They also use peak flow monitoring, oximetry, and spirometry to assess the progress of asthma post medication.

Remember that delays in getting medical attention when you have red zone asthma symptoms can be fatal. Note down important phone numbers of your doctor, local emergency service, and local ambulance service. Always be alert about your symptoms and follow your doctor’s action plan for managing asthma.