Reviewing Asthma Management: Inhaler Technique, Identifying Triggers & Asthma Action Plan
Asthma is a chronic respiratory condition that affects thousands of Australians, causing breathlessness, wheezing, chest tightness, and persistent coughing. While asthma is a chronic condition that can persist into adulthood, proper asthma management can significantly reduce symptom burden and improve your quality of life.
For many people, asthma flare ups can feel unpredictable and management of such attacks can be overwhelming. However, with correct inhaler technique, trigger identification, and a well-structured asthma action plan, you can effectively control asthma symptoms and prevent exacerbations and need for hospitalization.
If you or someone you know struggles with asthma, reviewing your inhaler technique, avoiding known triggers, and following a personalized Asthma Action Plan can reduce your risk of a serious asthma exacerbation, through commencing early treatment and reducing the risk and need for hospitalisation.
Understanding Asthma: Why Proper Management Matters
Asthma occurs when the airways become inflamed and constrict in response to a noxious stimuli, making it difficult to breathe. Symptoms can vary from mild to severe, and in some cases, asthma attacks can become life-threatening. Common symptoms include:
- Shortness of breath
- Persistent coughing, especially at night or early morning
- Wheezing or whistling sounds while breathing
- Tightness or discomfort in the chest
- Increased breathlessness during physical activity
Asthma symptoms can fluctuate, but without proper management, they can worsen over time. That’s why learning how to control asthma through inhaler use, trigger avoidance, and a structured treatment plan is essential.
1. Mastering Proper Inhaler Technique
Inhalers are the most effective way to deliver asthma medication directly to the lungs. Incorrect inhaler technique, however, results in the medication not being delivered deep into the lower airways and reduce their effectiveness in managing your asthma symptoms and reducing exacerbation risk.
Types of Asthma Inhalers
There are two main types of inhalers used in asthma management:
Reliever Inhalers (Short-acting bronchodilators) – Provide rapid relief during asthma symptoms or attacks (e.g., Ventolin, Atrovent, Salbutamol, Ipratropium).
Preventer inhalers (which contain a combination of medications that reduce risk of asthma exacerbations including long-acting bronchodilators, antimuscarinics and inhaled corticosteroids) – When used daily, they reduce localised airway inflammation and bronchoconstriction (e.g. Flixotide, Pulmicort, Seretide, Symbicort, Trelegy, Trimbow, Breztri).
A MDI should be attached to a spacer (i.e. a plastic chamber) to improve the delivery of the medication to the lower airways and improve their effectiveness. Correct use of MDI with a spacer is just as effective as administrating asthma medications via a nebulizer.
How to Use a Metered-Dose Inhaler (MDI) Correctly
- Shake the inhaler well before each use. Check the medication expiry date to make sure it hasn’t expired.
- Attach the inhaler to the spacer.
- Exhale (take a deep breath out) completely.
- Press the inhaler once. Take 4 normal breaths, ensuring you have a tight mouth seal over the spacer to allow the medication to slowly diffuse into the lower airways.
- Exhale slowly and wait 15–30 seconds before taking another inhaler dose, if required. Repeat this step for each puff/inhaler dose.
- Rinse your mouth after using preventer inhalers containing corticosteroids to prevent oral thrush and throat irritation.
2. Identifying and Managing Asthma Triggers
Identifying asthma triggers is crucial in preventing flare-ups. Common asthma triggers include:
Environmental Triggers
- Pollen – Common in spring and summer, causing seasonal asthma flare-ups.
- Dust mites – Found in bedding, carpets, and soft furnishings.
- Mould and damp air – Found in wet and poorly ventilated environments.
- Smoke and air pollution – Includes cigarette smoke, bushfires, and vehicle fumes.
Respiratory Infections & Weather
- Colds, flu, and sinus infections – Particularly common during winter.
- Cold air and humidity – Sudden temperature changes can irritate the airways..
Irritants & Lifestyle Triggers
- Strong odours from perfumes, cleaning products, or chemicals.
- Exercise-induced asthma – Caused by increased breathing rate during strenuous activity.
- Emotional stress or anxiety – Can trigger hyperventilation and tighten the airways.
How to Reduce Exposure to Triggers
- Keep indoor air clean by vacuuming regularly and using air purifiers.
- Avoid smoking and second-hand smoke exposure.
- Use dust-proof covers on bedding and wash sheets frequently.
- Monitor pollen levels and stay indoors during peak seasons.
- Warm up before exercise and carry a reliever inhaler when needed.
3. Maintaining an Effective Asthma Management Plan
Having a structured asthma action plan can help you control symptoms, prevent attacks, and know when to seek emergency care. This can be developed in consultation with your GP or local Respiratory Physician.
What Should an Asthma Action Plan Include?
- Daily medication schedule – Preventers, relievers, and dosages.
- How to recognise worsening symptoms – Increased breathlessness or frequent inhaler use.
- Emergency asthma action plan – • Steps to follow during an asthma attack. • Contact details for your doctor or respiratory specialist.
When to See a Respiratory Specialist
If your asthma symptoms are frequent, worsening, or not controlled with your current medication, a local Respiratory Physician can provide you with a tailored management plan. A Respiratory Physician can:
- Arrange and interpret lung function tests to assess the presence and severity of asthma.
- Identify treatable traits and identify triggers for your asthma.
- Develop tailored treatment plans and an Asthma Action Plan to improve your symptom control.
- Recommend and prescribe advanced therapies for treatment of severe asthma.
Long-Term Asthma Management Tips
- Take preventer medication regularly, even when feeling well.
- Use a peak flow meter to monitor lung function and detect early warning signs of an asthma flare up.
- Attend regular check-ups with your GP or Respiratory Physician to review your treatment plan.
- Keep an asthma diary to track symptoms, triggers, and medication use.
Final Thoughts
Managing asthma effectively requires correct inhaler use, avoiding triggers, and following a structured asthma action plan. By taking these steps, you can reduce flare-ups, prevent attacks, and improve your overall lung health.
