Hi nickvitt,
I'd like to draw your attention to the disclaimer at the bottom of this page.
"Important Disclaimer: Answers and comments provided on Google Answers
are general information, and are not intended to substitute for
informed professional medical advice."
I am not a health care provider and can only provide general
information. Always consult your family doctor for advice and
treatment.
What if it is the first attack?
What if it is the first attack of asthma? If a person suddenly
collapses and/or has difficulty breathing, call an ambulance
immediately ... WHETHER OR NOT the student is known to have asthma.
Sit the person upright and remain calm to reassure the person. When a
person having an attack is anxious the airways constrict and spasm
even more so.
Remove the person from any trigger (e.g.. stop exercise, come in from
cold, take away from pets)
Do not leave the person alone except if you are the only person there
and you have to call an ambulance.
Stay calm and reassure the person
Sit the person leaning forward with arms supported on a table or chair
(do not have the person lie down)
Oxygen may be given by ambulance crew or doctors. Of course, if
resuscitation is necessary they would perform it, breathing for a
casualty who is in respiratory arrest.
Asthma
http://familyfun.go.com/parenting/child/health/childhealth/dony79enc_asthma/
"When a person with asthma comes into contact with an irritant (such
as cigarette smoke), allergen (such as dust, mold or pollen) or some
other trigger, the muscles that encircle the bronchial tubes go into
spasms and the lining of the tubes becomes inflamed, leading to
increased secretion of mucus. As a result, the bronchial tubes become
narrower, causing tightness in the chest, coughing, a hunger for air,
wheezing and an increase in respiratory and heart rate.
Early signs include slight coughing and a high-pitched wheezing sound
when the child exhales. Mild attacks may not get much worse than this.
In more severe cases, respiration becomes rapid, the skin pales and
the chest pulls inward with every breath. The child may vomit. As the
attack worsens, the wheezing may become louder, although in very
severe cases, little or no wheezing is heard because the breathing
tubes are so narrow."
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Asthma © David L. Hoffmann B.Sc. (Hons), M.N.I.M.H.
http://www.healthy.net/scr/article.asp?PageType=article&ID=1266
"The symptoms of people with asthma differ greatly in frequency and
degree. Some have an occasional episode that is mild and brief;
otherwise they are symptom free. Others have mild coughing and
wheezing much of the time, punctuated by severe exacerbation's of
symptoms following exposure to known allergies, viral infections,
exercise or nonspecific irritants. A series of stages have been
characterized for describing the severity of an acute asthma attack:
Mild - mild dyspnoea; diffuse wheezes; adequate air exchange.
Moderate - respiratory distress at rest; hypernea, use of accessory
muscles; marked wheezes.
Severe - marked respiratory distress; cyanosis; use of accessory
muscles; marked wheezes or absent breath sounds.
Respiratory failure - Severe respiratory distress; lethargy;
confusion; prominent pulsus paradoxus. Use of accessory muscles."
=================================================
What You Should Do During an Asthma Attack
http://health.yahoo.com/health/centers/asthma/461.html
If you're experiencing the early warning signs of an asthma attack you should:
"Follow the instructions in your Asthma Action Plan (An Asthma Action
Plan is an integral part of your long-term asthma management. It is a
written set of instructions that you and your doctor have created to
tell you what to do for different situations. If you've tried all of
the steps in your action plan and nothing seems to be working, then
you should seek immediate medical help.)
Take the appropriate asthma medication to relieve your symptoms
Cough to loosen the mucus in your airways
Relax your breathing
If symptoms do not improve--seek medical attention
Your Asthma Action Plan
Every asthma treatment program should include an Asthma Action Plan
that clearly instructs you what to do if your asthma flares up or
escalates into an attack.
Adherence to your daily treatment plan is your best defense against an
attack. However, if you recognize the early warning signs of an
impending episode or experience an attack, there are critical steps
you can take to bring your asthma symptoms under control and put you
back on track with your goals.
Three Zones - Three Action Plans
A standard action plan is divided into three zones that describe your
current condition and list the actions you should take.
Green Zone - on track - no asthma symptoms
You can perform your usual activities and sleep through the night
without coughing, wheezing, or shortness of breath. Your peak flow
meter readings are at 80 to 100 percent of your personal best.
Action: Stay the course. Continue to control your asthma with the
daily medications prescribed by your doctor. These usually include
both anti-Inflammatory drugs and long-acting bronchodilators. In some
cases the prescription may be for a medication that combines the two
types into one form. A list of these medications should be a part of
your action plan and include the dosage and the time of day to take
each one.
Yellow Zone - off track - you have symptoms.
You may be coughing, wheezing or experiencing some difficulty
breathing. Perhaps your sleep is interrupted and you are more
fatigued. Your peak flow meter readings are at 50 to 80 percent.
Action: Get quick relief. Add quick-relief medicine to your daily
green zone medications and don't delay! Prompt action can keep your
symptoms from becoming worse and help prevent an attack.
Your action plan should spell out which short-acting bronchodilator to
take as well as how to take it, with an inhaler, aerosol, or
nebulizer. Your action plan may say that you can take your medicine
every 4 hours as needed and list other medications to add if
necessary.
You should begin to feel relief within 5 to 15 minutes of taking your
quick relief medicine.If your symptoms are not completely alleviated,
you can repeat the treatment up to two more times, with five to
20-minute breaks between doses. Do not exceed three treatments in one
hour.
If you do not experience improvement, call your doctor for instructions.
If you improve completely after two to three treatments, continue to
take your quick relief medication at a rate of four times per day for
the next 24 hours and call your physician for further advice.
Red Zone - Emergency! You need immediate medical attention.
You may have a frequent, severe cough, wheezing, severe shortness of
breath, rapid breathing, or difficulty speaking and walking. Your peak
flow meter reading is less than 50 percent.
Action: Take your emergency medications. These may include any of your
quick relief, "rescue" drugs listed in the yellow zone.
If you do not experience an improvement, get to an emergency room
immediately. If you are gasping for air, cannot use your peak flow
meter, or your lips or fingernails are turning blue, dial 9-1-1 for
help.
If your symptoms decrease but do not disappear completely, continue
following your yellow zone instructions and call your doctor for
advice.
Know Your Warning Signs
Warning signs can appear days or minutes before an attack. A fall in
your peak flow meter readings often provides the earliest sign of an
impending episode. Learn to recognize your personal warning signs. If
you take prompt action, you are less likely to have a severe attack
and you won't need as much medication to control your symptoms.
When You Should You Go to the ER?
It is very important to know when to seek emergency care. Each year,
over 1.8 million visits are made to emergency rooms because of asthma.
Many of these patients have suffered unnecessarily or even risked
death because they waited too long to seek help.
Your Asthma Action Plan should define when to get emergency treatment.
For instance, your action plan probably tells you to get prompt help
if you are experiencing the symptoms of an impending attack and your
asthma medications are taking longer than usual to have an effect.
Your peak flow meter reading is another good indicator. You should
visit the ER if your peak flows drop into the "red zone" and don't
return to the "yellow" or "green zone" after taking your quick-relief
or rescue medications.
What Happens in the ER?
Registration - Your first stop is the registration desk. The desk is
often staffed by a Registered Nurse who determines how severe the
problem is and how fast you need medical attention. If you need help
right away, friends or family members can provide your health
insurance information and fill out the necessary paperwork or you can
do so later in the treatment area.
First Assessment - When you are in the treatment area a nurse will
assess your pulse, blood pressure, temperature, respiratory rate, and
with the help of a pulse oximeter, the oxygen saturation in your
blood. The nurse will also look at your general appearance; are you
pale, perspiring, wheezing, or are your fingernails turning blue. It
may be that blood will be drawn for blood work and you may be given
oxygen or put on a cardiac monitor.
Emergency Treatment - Treatment begins with nebulized (aerosol) rescue
medications that contain bronchodilators to relax the band of muscles
that surround the airways and anti-inflammatories to reduce swelling
in the lungs.
An IV (an apparatus used to administer medicine intravenously) may be
started to deliver rapid acting corticosteroids. If you haven't
already been given oxygen and test results show the need, it will be
provided at this time.
Chest x-rays and blood tests may be ordered to rule out other
conditions such as an infection or pneumonia. The blood tests can also
indicate the level of oxygen and carbon dioxide in the blood.
Second Assessment - A second assessment is usually performed in about
an hour. If your condition is improving, you will be monitored for 3
to 6 more hours to be sure that you will not suffer another attack and
that your asthma is under control before you are sent home.
If you are not improving, the attending medical personnel will
determine whether to perform another assessment within a short time or
admit you to the hospital for care
Treatment as an In-Patient
If your symptoms do not improve after ER treatment, you will be
admitted to the hospital. This type of case is known as Status
Asthmaticus.
Treatment with IV medications, nebulizers, and oxygen will be
continued. A Respiratory Therapist will monitor your breathing
pattern, listen to your chest, and observe your oxygen saturation on
the pulse oximeter. When you are better able to use a peak flow meter,
the doctor or therapist will use the readings to assess the
effectiveness of your treatment
When you no longer need IV medications and can use oral medications to
maintain control of your symptoms, you will be able to return home.
Outpatient Follow-Up
Make an appointment with your doctor. He or she should have the
results of your hospital tests and treatments. Together review your
Asthma Action Plan and discuss what changes should be made to better
manage your asthma and to avoid acute symptoms or attacks.
Asthma is a potentially life threatening condition. You should take
all the necessary steps to control and manage your asthma and to
prevent severe episodes. If you do not have an Asthma Action Plan,
call your doctor and make one now."
=================================================
A typical case history profiled at the following site:
ASTHMA - Full extract
http://www.nevdgp.org.au/Pattison/Asthma/full.htm
"Karen is 14 and has had asthma since she was a young child. Until a
few months ago, her asthma had been fairly well controlled. Around
that time she started to become tight in the chest and very wheezy
during her netball games. She found that she needed to use her
asthma-relieving inhaler several times during the game, as well as
beforehand.
Previously she had been on a preventive inhaler but had run out of it
several months earlier. We had discussed doing peak flow measurements
some time ago but she had not got around to picking up her flowmeter.
I used to see her every few months, but it had been almost a year
since she had been in for a check-up. Apparently, she had been picking
up asthma inhalers without a prescription and also using her older
brother's medication.
One evening after a netball final, she walked out into the cool night
air and suddenly became very short of breath. She reached for her
inhaler and had several puffs, with no effect. She became so short of
breath that she began to panic. She staggered inside and her coach
called an ambulance. Our practice being only around the corner, they
gave us a call too.
When I entered the stadium I saw Karen lying on the floor surrounded
by several people. She was pale, sweating and had rapid shallow
breathing. She was unable to talk and barely conscious. We gave her
nebulised Ventolin as well as oxygen by a face mask. The Mobile
Intensive Care Ambulance arrived within minutes. An intravenous line
was inserted, and oxygen and Ventolin were continued as she was taken
to the nearest casualty department. She was already feeling a little
easier before she arrived at the hospital.
She was in hospital for three days and made a complete recovery. The
whole episode was a difficult learning experience, to say the least.
She now takes more interest in her asthma, and manages it much better.
She is on long-term preventive medications and just uses relievers
when necessary. She has had no significant attacks of asthma since."
[edit]
"In hospital, treatment can be continued with oxygen, frequent
nebulized bronchodilators and intravenous hydrocortisone. The person's
condition can be closely monitored under the care of specialist
respiratory physicians and nursing staff. Transfer to the intensive
care unit can also be arranged if necessary."
=================================================
Taking Asthma Seriously - What you need to know to breathe easier by Cindi MacAulay
http://www.srhs.org/betterhealth3.asp?StoryID=184
=================================================
Asthma Attack - WHAT YOU SHOULD DO
http://www.healthsquare.com/asthma2.htm
If you use a medicine that you inhale, here are some tips:
"First, shake the inhaler.
Breathe out slowly, all the way.
Put the mouthpiece of the inhaler in your mouth or 2 inches away
(about half a finger's length), or use the spacer (a piece of
plastic-like tubing that attaches to the inhaler).
Breathe in and push down on the inhaler at the same time (to create the mist).
Hold your breath for about 10 seconds.
Breathe out slowly through puckered lips or through your nose.
If you need to take 2 puffs, wait 2 to 5 seconds before taking the second one.
Gargling after using your inhaler may reduce the amount of burning in your throat.
When you have an attack:
Use your inhaler. If this does not help, repeat the inhaler one more
time after waiting the number of minutes recommended by your doctor.
If the second try doesn't work, check to see whether the inhaler is
empty. It's empty if it floats in a bowl of water.
It may help your breathing if you straddle a chair backwards, placing
your elbows up on the back of the chair.
If you do not know what causes your attacks:
Keep writing down the time of your attack. Also notice what is around
you when it occurs."
=================================================
Asthma - Call Your Doctor If
http://www.healthsquare.com/asthma3.htm
"You have wheezing and trouble breathing even when taking your medicine regularly.
You develop a high temperature.
You have muscle aches or chest pain.
Your sputum turns yellow, green, gray, or bloody, or becomes too thick
to cough up.
You have any problems that may be caused by your medicine (such as a
rash, itching, swelling, or trouble breathing).
Wheezing, trouble breathing, or coughing gets worse, even though you
are taking your medicine.
You have followed directions above and still cannot breathe, Call 911
or 0 (operator) to get to the nearest hospital or clinic. Do not drive
yourself!"
=================================================
Asthma - IF YOU'RE HEADING FOR THE HOSPITAL - What to Expect While You're There
http://www.healthsquare.com/asthma4.htm
You may encounter the following procedures and equipment during your stay.
"Taking Vital Signs: These include your temperature, blood pressure,
pulse (counting your heartbeats), and respirations (counting your
breaths). A stethoscope is used to listen to your heart and lungs.
Your blood pressure is taken by wrapping a cuff around your arm.
Oxygen: Your body may need extra oxygen at this time. It is given
either by a mask or nasal prongs. Tell your doctor if the oxygen is
drying out your nose or if the nasal prongs bother you.
Pulse Oximeter: While you are getting oxygen, you may be hooked up to
a pulse oximeter (ox-IM-ih-ter). It is placed on your ear, finger, or
toe and is connected to a machine that measures the oxygen in your
blood.
Breathing Treatments: A machine will be used to help you inhale
medicine. A therapist will help with these treatments. They will help
open your airways so you can breathe easier. At first you may need
them frequently. As you get better, you may only need them when you
are having trouble breathing.
IV: A tube placed in your vein for giving medicine or liquids. It will
be capped or have tubing connected to it.
Blood: Usually taken from a vein in your hand or from the bend in your
elbow. Tests will be done on the blood.
Blood Gases: Blood is taken from an artery in your wrist, elbow, or
groin. It is tested for the amount of oxygen it contains.
ECG: Also called a heart monitor, an electrocardiograph
(e-LEK-tro-CAR-dee-o-graf), or EKG. The patches on your chest are
hooked up to a TV-type screen or a small portable box (telemetry
unit). This screen shows a tracing of each heartbeat. Your heart will
be watched for signs of injury or damage that could be related to your
illness.
12 Lead ECG: This test makes tracings from different parts of your
heart. It can help your doctor decide whether there is a heart
problem.
Chest X-ray: This picture of your lungs and heart shows how they are
handling the illness.
Medicine: Many different kinds of medicines may be needed.
Inhalants: These medicines are breathed in to help open your airways.
Antibiotics: If an infection is causing breathing problems, you'll be
given antibiotics to clear it up.
Breathing Medicine: This medicine may be given in your IV first, and
then in pill form. Like an inhalant, it will open your airways.
Activity: It is best to stay in bed until you are breathing easier.
Then you can slowly increase your exercise."
=================================================
AIM - Asthma Initiative of Michigan For Healthy Lungs
http://www.getasthmahelp.org/userasthmaeducationmenu.asp
=================================================
American Lung Association
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=22542
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Best regards,
tlspiegel |
