What is Asthma?
Asthma is a chronic airway inflammation of the lungs resulting in narrowing, swelling and mucous production of the airways.
Quickcare or ER
Red flags that will send you to the ER:
- Tiring out and having a low level of consciousness
- No improvement with home breathing treatments
- Low oxygen level
- A Severe Asthma Attack
What will your doctor ask?
Your doctor will want to know your SYMPTOMS.
Remember, a “symptom” is your assessment of your illness. It is what you say that you have. It is your story
Symptoms of asthma range from coughing episodes to wheezing to shortness of breath.
Answering the following will help your physician get better picture of your asthma symptoms.
When did it start?
What makes it better?
What makes it worse? Was it exercise induced asthma?
Is there fever or phlegm associated?
What medications have you taken? This is key. A doctor will want to know if you have taken just an inhaler like Albuterol or if you have been on steroids also.
What will your doctor look for?
Your doctor will look for signs. Remember that a “sign” is a clear, objective evidence of your illness.
Observation is everything.
How is the patient sitting? Someone who is having difficulty breathing is “tripodding.” That is, bracing themselves so that the trunk (thorax) is opened up.
How is the patient speaking? Someone with difficulty breathing is usually speaking in short sentences with only one word at a time. Why? Because they do not have enough air.
Breathing patterns. Is the breathing labored? Are you using the accessory muscles? Are the nares flaring?
A peak flow meter is an objective measure of asthma severity. This calculated number measures lung function.
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called a differential diagnosis.
Other medical conditions that are similar to asthma include:
- An allergic reaction
- Pneumonia (bacterial, viral or fungal)
- Chronic Obstructive Pulmonary Disease (COPD)
Most persons who present with asthma know they are having one of their asthma attacks.
What caused the asthma attack? Was there an allergy and asthma followed.
What is the treatment of Asthma?
Asthma treatment depends of the signs and symptoms of the patient
Is the patient safe to get air treatments or does he need to be intubated?
Most patients do just fine with breathing vapors such as Albuterol and Atrovent treatments.
An asthma action plan may include steroids such as Prednisone which help to decrease the inflammation around the tubes.
If those treatments do not help then your physician will ask himself,”Will he tire out and then need intubation?”It is a bit scary when the patient tuckers out and needs to be intubated.
Thank God that there are masks that push air into the lungs (BiPap). So, instead of jumping to intubation, BiPap can assist with airways without the complications of intubation.
If the asthma flare up is prolonged, a doctor may place a patient in an Observation Unit. Not quite an admission, an “obs unit” may be used after three nebulizers had been administered, oxygen level is greater than 89% and the patient is alert and oriented.
How long will you be sick with Asthma?
Asthma control usually gets better within a few days. The inhaler is used and steroids (if needed) help.
Assisting with the underlying cause such as an infection or allergen is key. Other triggers to be removed may include a group of medications called Beta blockers
Let me tell you a story
Otto ran to the clinic entrance with his hands on his chest. “I can’t catch my breath. I can’t catch my breath” The adrenaline starts to pump. The heart starts to speed up. This is what all the doctor train is for. This is where the rubber meets the road. Protecting the airway is paramount. Last I heard, breathing is important.
“I’ve had asthma for years. This time it’s real bad,” said Otto. The location of his hands suggested severe chest tightness.
During a critical case, all eyes are on the physician. The key is to take control. Show leadership. Be calm.
In the case of Otto, he had his flare up after a brief exposure to pollen during his weekend bike ride. He tried his Albuteral inhaler but ran out during the night.
He needed to be away from all that pollen which triggered his asthma.
After using both Albuterol and Atrovent, Otto made progress. I added in an injection of Depomedrol( 80 mg) and a few grams of magnesium.
The Bipap machine was placed on right away.
When the medications and machine kicked in, his breathing relaxed and the staff relaxed too.
I hope this helps