Asthma Attack: When Urgent Care Can Help (and When to Call 911)

An asthma flare-up can range from mildly uncomfortable to genuinely frightening. Understanding when to seek urgent care for asthma — and when to call 911 — can protect your health. CityHealth Oakland offers same-day urgent care for asthma, including nebulizer treatments and breathing evaluations.

Understanding Asthma: What’s Actually Happening

Asthma is a chronic condition where the airways become inflamed and narrowed in response to triggers. During an asthma attack (also called an exacerbation or flare), three things happen simultaneously:

• Bronchospasm — the muscles around the airways contract, narrowing the airway
• Inflammation — the airway lining swells, further reducing the opening
• Mucus production — extra mucus clogs the already-narrowed airways

The result is the classic asthma symptom: wheezing, chest tightness, shortness of breath, and coughing — especially at night or early morning, or after exercise.

Common Asthma Triggers

Knowing your triggers is the most effective way to prevent attacks. The most common include:

• Respiratory infections (colds, flu, COVID-19) — the #1 trigger for most people
• Allergens: pollen, pet dander, dust mites, mold
• Air pollution, smoke (tobacco, wildfire), and strong odors
• Exercise (exercise-induced bronchoconstriction)
• Cold air or weather changes
• Gastroesophageal reflux (GERD)
• Stress and strong emotions
• Aspirin and NSAIDs in some patients
• Occupational exposures (chemicals, dust, fumes)

When to Go to Urgent Care for Asthma

Urgent care is appropriate for mild to moderate asthma flares — situations where your breathing is significantly compromised but not immediately life-threatening. CityHealth urgent care can evaluate you, administer nebulizer treatments, and prescribe the medications you need to recover.

Come to urgent care if:

• Your rescue inhaler isn’t providing relief — or relief lasts less than 4 hours
• You’ve used your rescue inhaler more than twice in the past 24 hours
• Wheezing, coughing, or chest tightness is getting worse despite medication
• Asthma is disrupting sleep — nighttime symptoms more than twice per week suggests poor control
• You need a refill on your controller inhaler (ICS or ICS/LABA) or rescue inhaler
• You suspect a respiratory infection is triggering your asthma — we can test for flu and COVID and treat both
• Symptoms came on suddenly but you’re still able to speak in full sentences and your breathing is not severe

When to Call 911 / Go to the ER

Some asthma emergencies go beyond urgent care. Call 911 if:

• You can’t speak in full sentences — too breathless to complete a sentence
• You’re using accessory muscles to breathe — neck muscles, between ribs visibly pulling in
• Oxygen saturation below 92% on a pulse oximeter
• Lips or fingernails turning bluish (cyanosis)
• No improvement after 2 back-to-back rescue inhaler treatments — 8–12 puffs or 2 nebulizer treatments
• Altered mental status — confusion, drowsiness, unable to follow instructions
• Rapid deterioration — getting markedly worse within minutes

Never drive yourself to the ER during a severe asthma attack. Call 911.

What Urgent Care Does for an Asthma Flare

When you come to CityHealth for asthma, you’ll receive:

1. Pulse oximetry — immediate check of your oxygen saturation
2. Lung auscultation — listening for wheeze, air entry, and signs of severity
3. Peak flow measurement if available — objective measure of airway obstruction
4. Nebulizer treatment — albuterol (and ipratropium if needed) delivered through a mist for maximum airway penetration; often more effective than an MDI during a flare
5. Systemic corticosteroids — oral prednisone or methylprednisolone to reduce airway inflammation; a standard part of treating moderate flares
6. Re-assessment after treatment — we check your response before deciding next steps
7. Prescriptions for home — rescue inhaler refill, prednisone taper, and evaluation of whether you need a controller medication adjustment
8. Referral to pulmonologist or allergist if your asthma isn’t well-controlled

Asthma Action Plan: The Traffic Light System

If you have asthma, every patient should have an individualized asthma action plan. Most use a traffic light framework:

• 🟢 Green Zone (doing well) — no symptoms, peak flow 80–100% of personal best; continue controller medications
• 🟡 Yellow Zone (caution) — coughing, wheezing, tight chest, or peak flow 50–79%; use rescue inhaler, call provider if not improving in 24 hours, consider urgent care
• 🔴 Red Zone (medical alert) — rescue inhaler not helping, can’t do normal activities, peak flow under 50%; use rescue inhaler and go to urgent care or ER immediately

Preventing Future Attacks

Acute care treats the flare; the real goal is preventing the next one. Work with your provider to:

• Use your controller medication consistently — inhaled corticosteroids (ICS) like fluticasone (Flovent) or budesonide (Pulmicort) reduce baseline inflammation and are the cornerstone of asthma management. Don’t skip them when you’re feeling well.
• Get your flu shot annually — respiratory infections are the leading trigger for asthma flares
• Identify and minimize your triggers — dust covers for mattresses, HEPA air filters, quitting smoking
• Check your inhaler technique — a majority of inhaler users have poor technique; a provider or pharmacist can show you the right way
• Monitor peak flow at home — especially if you have moderate-to-severe asthma

Same-Day Asthma Care at CityHealth

Whether you need a nebulizer treatment, a prednisone prescription, an inhaler refill, or a lung evaluation after a respiratory infection — CityHealth handles it same day at our Oakland Montclair and San Leandro locations. Walk in anytime or book an appointment online.

Resources: the CDC on asthma