Warning! Asthma gets worse in cold weather

Asthma is a chronic condition affecting millions and can be life-threatening during severe attacks, which are more likely to happen in cold weather. An ER24 paramedic explains why.

“As ER24 paramedics, we aim to provide important information that helps both the public and medical professionals respond quickly and confidently in asthma emergencies,” says Leslie-Anne van Zyl, an Emergency Care Practitioner at ER24 Southern Cape in George. “This is particularly important in the colder months when asthma symptoms tend to get worse.”

Why does asthma worsen in cold weather?

Cold air is a common trigger for asthma. Breathing in cold, dry air can cause your airways to tighten, leading to wheezing, coughing, and shortness of breath. Cold weather also makes the airways more inflamed and increases mucus production, making it harder to breathe

“In addition, you’re more likely to get respiratory infections during the colder months, which can make asthma symptoms worse,” says Van Zyl. Recognising the warning signs of worsening/severe? asthma in colder conditions is vital.

“Watch for symptoms like a persistent cough, chest tightness, difficulty breathing, and audible wheezing. In children, symptoms may also include fatigue, reluctance to play, or a cough that gets worse at night.”

Dangers of a severe asthma attack

A major asthma attack happens when your airways get really tight, making it hard for air to reach your lungs. If not treated quickly, this can cause low oxygen levels, difficulty breathing, and in the worst case, your heart may stop.

“Children are particularly vulnerable because their airways are smaller, and they can deteriorate more rapidly during an attack,” says Van Zyl.

What are the symptoms?

• Trouble speaking in full sentences
• Breathing quickly and struggling to breathe (using extra muscles)
• Bluish colour on lips or fingernails
• Feeling sleepy or confused because of low oxygen levels.

How to respond to an asthma attack

Van Zyl recommends the following four steps if you come across someone having a severe asthma attack:

1. Stay calm and reassure them: Panic can worsen symptoms. Help the person remain calm and encourage slow, steady breaths.

2. Help them use their reliever inhaler: If they have an inhaler (like salbutamol), help them take two puffs. If possible, use a spacer to make sure the medicine works better (a spacer is a tube that attaches to the inhaler, allowing slower and deeper inhalation). If they don't feel better, give them one puff every 30-60 seconds, up to 10 puffs.

3. Call emergency services: Dial 084 124 or 10177 immediately if symptoms persist, if they don’t have an inhaler, or if they show signs of severe distress. These include drowsiness, or the person’s skin, lips, or fingernails turning a bluish colour.

4. Monitor their condition: Stay with the person, keep an eye on their breathing, and keep them sitting up until help arrives. If they stop breathing and lose consciousness, start CPR if you know how to do it.

Helping families and caregivers manage asthma

Children are more at risk for severe asthma attacks, and caregivers are key in preventing and handling them early. Van Zyl suggests that parents and guardians watch for early signs, such as coughing at night, wheezing, or tiredness during play.

“Make sure the child’s asthma medication is current and easy to reach,” she says, adding that it’s also best to avoid triggers such as smoke, dust, and pet dander in the home. “Parents should also speak to teachers and coaches to ensure they understand the child’s asthma action plan.”

Asthma is a serious condition that needs careful management. Whether you're a caregiver, a bystander, or a medical professional, knowing how to act during an asthma attack is crucial.

With the right tools, education, and support, we can work together to ensure better outcomes for asthma patients across South Africa. Stay safe and always remember: Early action saves lives.