Asthma Attack / Exacerbation
- By sahlhealth
- May 18, 2021
- 24 views
During an Asthma Attack, also called an Asthma Exacerbation, your airways become swollen and inflamed. The muscles around the airways contract and the airways also produce extra mucus, causing your breathing (bronchial) tubes to narrow.During an attack, you may cough, wheeze and have trouble breathing. An Asthma attack may be minor, with symptoms that get better with prompt home treatment, or it may be more serious. A severe Asthma attack that doesn’t improve with home treatment can become a life-threatening emergency.The key to stopping an Asthma attack is recognizing and treating an Asthma flare-up early. Follow the treatment plan you worked out with your doctor ahead of time. Your treatment plan should include what to do when your Asthma starts getting worse, and how to deal with an asthma attack in progress.
Asthma attack signs and symptoms include:
- Severe shortness of breath, chest tightness or pain, and coughing or wheezing
- Low peak expiratory flow (PEF) readings, if you use a peak flow meter
- Symptoms that fail to respond to use of a quick-acting (rescue) inhaler
-For adults and children over 5 years old, lung (pulmonary) function tests are used to check how well the lungs are working. Poor lung function is a sign that your Asthma isn't well-controlled. In some cases, lung function tests are also used in Asthma emergencies to help check the severity of an Asthma attack or how well treatment is working.
-Lung function tests include:
- Peak flow. Your doctor may take a peak flow reading when you come in for a scheduled visit or for emergency treatment during an asthma attack. This test measures how quickly you can breathe out. You also may use a peak flow meter at home to monitor your lung function.The results of this test are known as peak expiratory flow (PEF). A peak flow test is done by blowing into a mouthpiece as hard and as fast as you can with a single breath (expiration).
- Spirometry. During spirometry, you take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. A common spirometry measurement is forced expiratory volume, which measures how much air you can breathe out in one second.The results of this test are known as forced expiratory volume (FEV). Spirometry can also measure how much air your lungs can hold and the rate at which you can inhale and exhale.
- Nitric oxide measurement. A newer diagnostic test, this exam measures the amount of nitric oxide gas you have in your breath when you exhale. High nitric oxide readings indicate inflammation of the bronchial tubes.Exhaled nitric oxide can be measured by having a patient exhale directly into an analyzer. Exhaled air may be captured in a nitric-oxide-impervious container for measurement later.
- Pulse oximetry. This test is used during a severe Asthma attack. It measures the amount of oxygen in your blood. It's measured through your fingernail and only takes seconds.
-If you and your doctor have worked out an Asthma plan, follow its directions at the first sign of an Asthma attack.This generally means taking two to six puffs of a quick-acting (rescue) inhaler to get airway-expanding medication, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others), deep into your lungs. Small children and those who have trouble with inhalers can use a nebulizer. After 20 minutes, you can repeat the treatment one time if necessary.For an Asthma attack with severe symptoms, such as difficulty speaking because you're so short of breath, start with the same initial step of using quick-acting medication â€” but instead of waiting for the drug to work, get to a doctor's office or urgent care immediately. Same-day medical care is also warranted if you continue to wheeze and feel at all breathless after initial treatment.Your doctor may recommend that you continue to use quick-acting medication every three to four hours for a day or two after the attack. You might also need to take oral corticosteroid medication for a short time.
-If you go to the emergency room for an asthma attack in progress, you'll need medications to get your Asthma under immediate control. These can include:
- Short-acting beta agonists, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others). These are the same medications as those in your quick-acting (rescue) inhaler. You may need to use a machine called a nebulizer, which turns the medication into a mist that can be inhaled deep into your lungs.
- Oral corticosteroids. Taken in pill form, these medications help reduce lung inflammation and get your Asthma symptoms under control. Corticosteroids can also be given intravenously, typically to patients who are vomiting or under respiratory failure.
- Ipratropium (Atrovent). Ipratropium is sometimes used as a bronchodilator to treat a severe Asthma attack, especially if albuterol is not fully effective.
- Intubation, mechanical ventilation and oxygen. If your asthma attack is life-threatening, your doctor may put a breathing tube down your throat into your upper airway. Using a machine that pumps oxygen into your lungs will help you breathe while your doctor gives you medications to bring your asthma under control.
-After your asthma symptoms improve, your doctor may want you to stay in the emergency room for a few hours or longer to make sure you don't have another asthma attack. When your doctor feels your asthma is sufficiently under control, you'll be able to go home. Your doctor will give you instructions on what to do if you have another asthma attack.
-If your asthma symptoms don't improve after emergency treatment, your doctor may admit you to the hospital and give you medications every hour or every few hours. If you're having severe asthma symptoms, you may need to breathe oxygen through a mask. In some cases, a severe, persistent asthma attack requires a stay in the intensive care unit (ICU).