Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms triggers Evaluation peak flow testing Treatment drug therapy specialist Home Care proper inhaler use warning signs Prevention Underlying Cause Anatomy

Attacks of Wheezing Home Care

Home care for mild wheezing includes:

  • Stop smoking.
  • Avoid exposure to secondary smoke.
  • Avoid exposure to pollen.
  • Avoid exposure to mold.
  • Avoid cough medicine.
  • Avoid medications that make you sleepy.
  • Avoid substances that trigger wheezing.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.

Home care for those who take medication for wheezing includes:
  • Follow asthma home care instructions.
  • Learn to use prescribed inhalers correctly.
  • Use short-acting inhalers every 20 minutes, or as directed by your doctor.
  • Long-acting medications must be used regularly.
  • Learn to use a peak flow meter.
  • Know the peak flow danger zones.
  • Develop a strategy for using your inhaler based on your PEFR reading
  • Stay calm during a wheezing attack.

Peak Flow Zones:
  • Green Zone: a PEFR that is 80-100% of personal best represents good control
  • Yellow Zone: a PEFR that is 50-80% of personal best represents a moderate attack
  • Red Zone: a PEFR that is less than 50% of personal best represents a severe attack and may identify the need for treatment in an emergency department

Attacks of Wheezing Proper Inhaler Use

Inhaler use for wheezing:

  • Remove the cap from the inhaler.
  • Hold the inhaler with the mouthpiece at the bottom.
  • Shake the inhaler. This mixes the medication properly.
  • Hold the mouthpiece 1-1/2 - 2 inches (2 - 3 finger widths) in front of your mouth. This improves medication delivery by slowing mist delivery and only allowing small particles to be inhaled. Note that your mouth should not be actually touching the mouthpiece.
  • Tilt your head back slightly and open your mouth wide.
  • Gently exhale.
  • Press the inhaler and at the same time begin a slow, deep breath.
  • Continue to breathe in slowly and deeply over 3 - 5 seconds. Breathing slowly delivers the medication deeply into the airways.
  • Hold your breath for up to ten seconds. This allows the medication time to deposit in the airways.
  • Resume normal breathing.
  • Repeat steps 3 - 10 when more than one puff is prescribed.

Additional tips:
  • Keep your inhaler with you at all times, and use it at the first sign of coughing, chest tightness or wheezing.
  • Use an inhaler and spacer as directed.
  • Use the inhaler every 20 minutes for 1 hour during an attack. Continue the medication every 4 hours for 24 to 48 hours.
  • Older children and adults may need a long-acting inhaler medicine (Serevent) if frequent attacks occur.

Attacks of Wheezing Warning Signs

Notify your doctor if you have wheezing and any of the following:

Continue to Attacks of Wheezing Prevention

Last Updated: Jan 7, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Attacks of Wheezing References
  1. Castro-Rodriguez JA, Rodrigo GJ. beta-agonists through metered-dose inhaler with valved holding chamber versus nebulizer for acute exacerbation of wheezing or asthma in children under 5 years of age: a systematic review with meta-analysis. J Pediatr. 2004 Aug;145(2):172-7. [15289762]
  2. Hypersensitivity pneumonitis. Allergy Asthma Proc. 2004 Jul-Aug;25(4 Suppl 1):S40-1. [15515377]
  3. Keeley D, McKean M. Asthma and other wheezing disorders of childhood. Clin Evid. 2003 Jun;(9):287-317. [15366138]
  4. Miranowski AC, Grammer LC. Occupational immunologic lung disease. Allergy Asthma Proc. 2004 Jul-Aug;25(4 Suppl 1):S36-7. [15515375]
  5. Roback MG, Dreitlein DA. Chest radiograph in the evaluation of first time wheezing episodes: review of current clinical practice and efficacy. Pediatr Emerg Care. 1998 Jun;14(3):181-4. [9655657]
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