When Santa Ana winds blow and the sky over El Cajon turns hazy, the first sign of trouble is often a cough that will not settle, or a child who suddenly needs an inhaler at bedtime. Wildfire smoke and asthma are a hard combination: the CDC lists asthma attacks, wheezing and trouble breathing among the immediate effects of breathing smoke. Here is how to spot a flare, protect the air at home, and know when a same-day visit or the emergency room is the right call.
From longtime East County households to the city's large Arabic-speaking and Chaldean community, everyone in the valley breathes the same air on a smoky day. Children, people who are pregnant and anyone with asthma, COPD or heart disease are among the groups the CDC identifies as higher risk, so watch them first.
How Santa Ana Winds Push Smoke Into East County
Santa Ana winds are warm, dry winds that blow from the east or northeast through the passes and canyons of the coastal ranges, as described in the San Diego County Air District's wildfire smoke plan. When a fire burns in the backcountry, those offshore winds carry smoke west toward the populated parts of the county, and inland valley communities like El Cajon sit between the fire and the coast. The plan also notes a second wave: once the winds ease, the sea breeze can push offshore smoke back inland, and later winds can stir up settled ash.
Smoke can arrive even when the fire is far away, so a clear view of the hills is not a reliable guide. The Air District posts an air quality forecast for each monitoring site, including El Cajon, and lists any active smoke advisories. Check both before school drop-off or an outdoor errand.
Wildfire Smoke and Asthma: Symptoms That Signal a Flare
Breathing smoke can cause coughing, wheezing, a scratchy throat, stinging eyes, a runny nose, irritated sinuses, headaches, tiredness, chest pain and a fast heartbeat, according to the CDC. Chest pain or a fast heartbeat is never something to wait out; see the 911 list below. For people with asthma, MedlinePlus, from the National Library of Medicine, lists the core signs of an attack:
- Coughing during the day, or coughing that wakes you up at night
- Wheezing, a whistling sound when you breathe
- Breathing problems, such as shortness of breath or gasping for air
- Chest tightness that can feel like pain, a heavy weight or pressure
Feeling nervous, edgy or irritable can be an early warning sign before an attack, which matters with children who cannot always describe what they feel. A smoke cough that keeps a child up at night is a cue to check the action plan. The CDC notes that children with asthma may have more symptoms when smoke is in the air, so watch for trouble breathing, shortness of breath or a cough that will not stop.
Following Your Asthma Action Plan at Home
The CDC recommends that everyone with asthma have their own written action plan, built with their health care provider. Most plans use three zones:
- Green zone: doing well, with no symptoms. Keep taking your daily controller medicine as prescribed.
- Yellow zone: getting worse, with cough, wheezing or trouble breathing. Add your reliever (rescue) medicine as your plan directs and continue your controller.
- Red zone: a medical alert, especially when reliever medicine is not helping. Take any other medicines your plan lists and call your doctor; if symptoms do not improve and you cannot reach your doctor, go to the hospital or call 911.
During a smoke event, follow the plan your clinician wrote rather than improvising doses. The CDC's guidance for people with chronic conditions also suggests keeping a 7 to 10-day supply of prescription medicines in a waterproof, childproof container you can grab if you need to evacuate. People with COPD should plan smoke protection with their provider ahead of time. No written plan yet? Ask for one.
Keeping Indoor Air Cleaner During Smoke Events
The CDC's wildfire smoke safety guidelines focus on lowering how much smoke you breathe at home:
- Stay inside with windows and doors closed as much as possible, as the CDC advises for people with asthma.
- Set up a clean room. Choose a room you can close off from outside air and run a portable air cleaner or filter there.
- Upgrade the HVAC filter. If your system can use it, a high-efficiency filter, preferably MERV 13 or higher, helps clean the air. If it has a fresh-air intake, set it to recirculate or close the outdoor intake damper.
- Do not add indoor smoke. Avoid burning candles, incense, wood, gas or propane indoors, and cut back on smoking, cooking on the stove and vacuuming.
- Wear a fitted respirator outdoors. A tight-fitting NIOSH Approved N95 or P100 gives the most protection.
Ordinary masks are not a substitute: the CDC states that dust masks, surgical masks and bandanas will not protect against smoke. NIOSH Approved respirators do not come in sizes that fit very young children, so keeping kids indoors in filtered air is the more reliable step.
ER Red Flags: When to Call 911
Some symptoms cannot wait for a clinic visit. Based on MedlinePlus and CDC guidance on children and chronic conditions, call 911 or go to the nearest emergency department right away if you or your child:
- Has so much trouble breathing that walking or talking is hard, such as not being able to finish a full sentence
- Has lips or fingernails that look blue or gray
- Is hunched over, working hard to breathe
- Seems confused, very sleepy or less responsive than usual
- Is in the red zone of the action plan and the rescue inhaler is not helping
- Has chest pain or pressure, or a racing or irregular heartbeat along with other signs of a heart attack or stroke, especially with heart disease or COPD
- Is a child who will not eat or drink
For situations in between, our guide to urgent care versus the emergency room walks through common examples.
Ran Out of Your Rescue Inhaler? Getting a Short Bridge Supply
A smoky stretch can drain a rescue inhaler faster than expected, and your regular doctor may be booked. If you are in the yellow zone, able to talk comfortably, and simply out of rescue medicine, a same-day urgent care visit is a reasonable option. If breathing gets harder before or during your visit, call 911.
At Palm Urgent Care on Mollison Avenue in El Cajon, walk-in urgent care and medication management work together. A clinician can listen to your lungs, review the medicines you already use and decide whether the flare can be managed safely outside the hospital. When appropriate, the clinician may prescribe a short bridge supply of rescue medication until you see your regular doctor, who stays in charge of your long-term asthma care. Bring your inhalers, your action plan and a list of current medicines, and review our full list of services before you come in.
Frequently Asked Questions
Can wildfire smoke trigger an asthma attack?
Yes. The CDC lists asthma attacks, wheezing and trouble breathing among the immediate effects of breathing smoke. Follow your action plan, stay indoors as much as possible and keep your rescue inhaler with you.
How can I check the air quality in El Cajon during a smoke event?
Check the San Diego County Air District's forecast for the El Cajon monitoring site and its list of active smoke advisories.
Can urgent care refill a rescue inhaler?
An urgent care clinician can evaluate your flare and, when it is safe and appropriate, may prescribe a short bridge supply until you can see your regular doctor. If your rescue inhaler is not relieving symptoms, call 911.
Does a regular face mask protect against wildfire smoke?
No. The CDC says dust masks, surgical masks and bandanas will not protect against smoke. Outdoors, a tightly fitted NIOSH Approved N95 or P100 respirator is the most protective option.
If wildfire smoke and asthma symptoms have your family coughing, or your rescue inhaler is running low, visit the El Cajon (Mollison) location page for directions, hours and contact details before you walk in.
This article is for general information and is not a substitute for medical advice from a licensed clinician.