Asthma in Teens and Adults

When to Call a Doctor

If you have been diagnosed with asthma and have an asthma action plan, do the following:

Call911or other emergency services immediately if you are having severe asthma symptoms (in the red zone of your asthma action plan) and you have followed the plan, but:

• You are having severe difficulty breathing.
• 20 to 30 minutes after taking the extra medication, you do not feel better and/or your peak expiratory flow (PEF) is still less than 50% of your personal best measurement.

Call your health professional immediately if you:

• Are in the red zone, and 6 hours after taking the extra medication the following are true:
  • You still require inhaler medication every 1 to 3 hours.
  • Your PEF is below 70% of your personal best measurement.
• Are in the yellow zone of the asthma action plan and continue to have a PEF below 70% of your personal best measurement in spite of home treatment using your asthma action plan.
• Have mild asthma symptoms that get worse, and you feel there is nothing else you can do at home.
• Are having a first attack of asthma symptoms, and your symptoms include wheezing, chest tightness, and moderate difficulty breathing.
• Are coughing up green, dark brown, or bloody mucus.

Call your health professional if you:

• Have asthma symptoms, you do not have an asthma action plan, and your symptoms are mild (chest tightness, cough, and slight shortness of breath or tiring easily during exercise).
• Are having symptoms in the yellow zone almost every day, and you need to use your inhaler medication to control your symptoms.
• Have asthma and your PEF has been getting worse for 2 to 3 days.

If you have not been diagnosed with asthma but have mild asthma symptoms, call your health professional and make an appointment for an evaluation.

If your teenager has symptoms of asthma, it is important to see a health professional. A large portion of teens with frequent wheezing may have asthma but are not diagnosed with the disease. Teens who have asthma but are less likely to be diagnosed are most often:¹⁷

• Girls.
• Smokers, or teens who are exposed to household cigarette smoke.
• Those with low socioeconomic status.
• Those who have allergies.
• African Americans, Native Americans, or Mexican Americans.

Watchful Waiting

Watchful waiting is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment. Self-treatment is not appropriate if you have asthma symptoms. See your health professional, even if you are taking nonprescription medications and they relieve your symptoms.

If you have been getting treatment for 1 to 3 months but are not improving, ask your health professional whether you need to see an asthma specialist.

Watchful waiting may be appropriate if you follow your asthma daily treatment and action plans and stay within the green zone. Watch the symptoms and continue to avoid asthma triggers.

Who to See

Health professionals who can diagnose and treat asthma include:

• Pediatricians.
• Family medicine physicians.
• Nurse practitioners.
• Physician assistants.
• Internists.

You may need to see a specialist (allergist or pulmonologist) if you have:

• Unusual symptoms, or there are problems deciding whether you have asthma.
• Other medical conditions that make it hard to treat asthma.
• A need for additional education or have difficulty following your daily asthma treatment and action plans.
• Not met the goals of treatment after 3 to 6 months of therapy.
• Had a life-threatening asthma attack.

Other reasons to see a specialist include:

• Having severe persistent asthma.
• Needing to take continuous oral corticosteroid medications or high-dose inhaled corticosteroids or having had more than two treatments with oral corticosteroids in 1 year.
• Having asthma because of your workplace (occupational asthma).
• Needing skin testing for allergy.
• Thinking about starting treatment with allergy shots (immunotherapy).

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Author:	Maria G. Essig, MS, ELS	Last Updated: May 15, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Harold S. Nelson, MD - Allergy and Immunology
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