Your reliever is no longer as effective and you need to use it more frequently that every three hours
The wheeze starts to get less but there is no improvement in your ability to breathe
You have real difficulty in speaking
You start to go a blue - gray colour, especially around the lips and fingertips. This is a condition called cyanosis and indicates that you have insufficient oxygen
You become frightened
Thinking clearly becomes difficult
Every breath becomes increasingly difficult
See the Emergency Section for dealing with severe attacks. Never ignore an attack in the hope that it will get better and go away