Additional risk factors include prior asthma hospitalisations, current use of oral corticosteroids or recent withdrawal from oral corticosteroids, problems with treatment compliances and serious psychiatric or psychosocial problems. Studies have also suggested that regular use of bronchodilators may be associated with an unfavorable outcome in asthma. In an acute attack, however, the symptoms persist, and become more marked or even change in nature. The asthmatic often becomes quiet and withdrawn, focusing on the struggle to breathe. She sits hunched over, which enables the muscles of the upper body to help expand the chest and consequently the lungs.
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. 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.