Which sign indicates an acute severe asthma attack in adults?

• A. Inability to complete sentences in one breath.
• B. Wheezing.
• C. Respiratory rate > 25 per minute.
• D. Tachycardia (heart rate > 110 per minute)

Answer: (A)

The main idea here is recognizing how speech relates to the level of airway obstruction in an acute asthma attack. When asthma becomes acutely severe, airflow is so limited that talking becomes extremely hard. The ability to complete a full sentence in one breath requires a steady, enough airflow, which is no longer available in a severe flare. So being unable to finish a sentence in one breath is a clear, immediate sign that the obstruction has become life-threateningly severe and warrants urgent evaluation and treatment.

Wheezing can occur at various levels of obstruction and may even be quiet in very severe cases, so it isn’t as specific for severity. A fast breathing rate and a rapid heart rate show distress but can result from many conditions and aren’t as tightly linked to the current degree of airway obstruction as the spoken-phrase test. That’s why the inability to complete sentences in one breath stands out as the best indicator of an acute severe attack.