Breathing becomes laboured. The expiration is longer, the wheeze becomes louder, and the inspiration is a short harsh gulp. Recession will become marked.
The wheeze, cough or chest tightness continues after they using reliever medication, or returns very quickly after using it. A peakflow reading of 50% or less of the normal reading indicates an acute attack. The asthmatic may not be able to use the peak flow and there is no point forcing them to try - using a peak flow under these circumstances can often make asthma worse.
As the situation worsens, their airways become more clogged and the movement of air lessens. At this point, often the wheezing ceases. This "silent chest" type asthma without any improvement in breathing is not a good sign. It indicates that the airways are extremely narrow and very little air is moving in and out. The asthmatic needs immediate medical attention - an ambulance must be called. Unfortunately, many people interpret the wheeze and gulp disappearing as a sign that asthma is improving, and this has resulted in avoidable deaths.
The asthmatic is unable to speak comfortably, no more than two or three words at a time. As less and less oxygen gets into the bloodstream, the lips will turn blue (cyanosis) and eventually the asthmatic will pass out.
(published with permission in writing from:http://www.buteyko.co.nz)
