How To Help Someone Having An Asthma Attack
What is asthma?
After years of helping a younger sister through these frightening episodes, it's easy to forget how distressing it can be for the person trying to help the asthma sufferer especially if they have never dealt with it before. I hope this guide will give some useful information about asthma and how to assist someone having an asthma attack.
What is asthma?
This is a condition that affects one of the smaller units in the lung called the bronchioles - these are tiny air passages. They end in bulb like, elastic sacks, called the aveoli. When someone has asthma the bronchioles constrict, leading to the main symptoms of asthma. This usually happens due to these passages becoming inflamed. Why this inflammation occurs is not yet fully understood. However, when this happens, muscles and the linings of the air-ways constrict causing apertures to narrow significantly. In addition, the inflammation also causes excess mucus to be secreted, blocking the air passages further. This makes breathing difficult and you can also often hear a wheezing sound. However, as we shall see later, the signs and symptoms can vary depending on the severity of the asthma.
Asthma is a fairly common condition affecting both adults and children. It can first appear in adulthood, but it's most often a childhood development. According to NHS (National Health Service) UK Patient Information, about 1 in 20 adults have the condition and about 1 in 10 children. Asthma may also run in families but this is not always the case.
Most people have a treatment plan that is agreed with their doctor and often a specialist asthma nurse. The most common form of treatment is by inhalers that deliver a small dose of medicine into the lungs. Inhalers - for the majority of the time - do control the symptoms of asthma.
There are three different types of inhalers:
- Reliever inhaler - to stop symptoms of asthma
- Preventative - aims to prevent asthma symptoms developing
- Bronchodilator - this inhaler helps to increase the spaces of the airways so allowing more air to get through and works much longer than the other inhalers. However, they are not always required by people suffering from asthma.
- Tablets/liquid medication - these can be prescribed, especially for young children, where the inhalers are not effective enough to control all symptoms.
- Steroids - although steroids are present in the inhalers, occasionally additional steroids - such as prednisolone - are required in a severe flare up and/or when an a person with asthma develops a chest infection or cold.
Lets look now at what triggers asthma and the signs and symptoms.
How to use an asthma inhaler
Symptoms of an asthma attack.
The signs and symptoms can vary depending on the severity of the asthma and also if the asthma is treated or untreated. NHS UK gives the following guidelines for what to look for and/or what might be experienced by people:
Asthma - untreated:
The symptoms range from very mild to severe. Even within an individual person the range can be quite extensive and may last anything from an hour to a number of weeks:
- Tightness in chest
In addition, with mild untreated asthma the symptoms may appear more frequently when the person suffers from a cold, chest infection or in the hay fever season. However, for the majority of the time there are no symptoms at all. In children, there could be a persistent cough at night, generally clearing during the day when the child is up and about.
Astham untreated - moderate to severe
the following symptoms may occur:
- Although there will be periods with no symptoms, there will be more frequency than with mild asthma. It is also common with moderate to severe to have at least some symptoms on a daily basis when asthma is untreated.
- The symptoms are the same as with mild asthma but will appear often at night and first thing in the morning for prolonged spells. In addition, people will often wake up during the night with a coughing spell and feelings of tightness in the chest. With children, it can be very difficult to tell the difference between recurring chest infections and the symptoms of asthma, so have them checked out by a doctor to establish the cause of any symptoms.
- With a severe asthma attack it's very obvious what is going on - breathing is sounds harsh and laboured. The person's chest is rising and falling deeply and rapidly as they try to get more air into their lungs. They often lean forward, shoulders hunched and head forward and down as they try to take in more air. Their colour is anything from white, grey to bluish. They are unable to speak and many are even unable to gesticulate with their hands or head. There is an unmistakable look of distress/fear on their faces.
A person who suffers from asthma will get to know the signs of a severe attack coming on. Often they will experience:
- The usual symptoms such as tightness, breathless, cough. However, the reliever inhaler does not help the symptoms or the effect wears off very quickly, so they have to use it more frequently.
- Despite using the reliever inhaler, symptoms continue to get worse.
- People often become too breathless to sleep, eat or speak.
If this happens then what should you do to help?
How to help with an asthma attack
When an attack happens take the following steps:
- Stay calm and determine what type of attack is happening - mild, moderate or severe.
- With mild to moderate the person is having difficulty breathing but can still usually speak and indicate with their hands and head.
- In severe attacks, as stated previously, they will not usually be able to speak and may not even be able to indicate with hands or head. It is possible that unless they have a spacer - a device that helps the medicine to get into the lungs more easily - they may not be able to take their medicine using their normal inhaler.
- With a severe attack, don't waste any time, your first action is to call for emergency medical back up.
- Keep calm and reassure the person, get them into a position that is comfortable for them usually in an upright, sitting position - they may also be able to breath more easily if they are sitting slightly forward as this opens up airways.
- Loosen any tight clothing, buttons around the neck and chest area.
- Direct the person to take even deep breaths and try to relax their muscles. An asthma attack is terrifying and can lead onto panic attacks, so deep breathing can help to stop the escalation of the asthma attack and panic building up. Having said this, and I'm very grateful to fellow hubbers LucidDreams and Rosemay50, for raising this important point - when a person is having a severe asthma attack, it's sometimes just not possible for them to deep breath and relax, basically because of the struggle they are having to breath and the fear this causes. If you're the person looking after them, you need to be aware of this but it's also essential that you stay calm and just be with them until help arrives.
- In a mild or moderate attack, ask the person if they have medication with them. If they have get it for them and help them to inhale the medicine - as with a severe attack, if they have a spacer, then use this. Normal directions are usually for the person to take one or two puffs, every two minutes - up to 10 puffs. Alternatively, they may have a regime already agreed with their doctor or nurse. If they still don't feel things are improving - usually within 5 to 10 minutes - then call for medical assistance. They will usually give further instructions over the telephone until they arrive.
- If a person suffering an asthma attack doesn't have medicine with them, then call immediately for medical assistance whether the attack is severe or not and explain that the person has no medication.
- Stay with them until you and the patient are sure the medicine is working or until medical help arrives.
- If at any time with mild or moderate attacks, you are in doubt about the effectiveness of the medicine or the person indicates it's not working, call for immediate medical assistance.
For a person who has asthma and they are on their own, Asthma UK recommend you take the following steps:
- Take one to two puffs of your reliever inhaler (usually blue), immediately.
- Sit down and try to take slow, steady breaths.
- If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
- If you do not feel better after taking your inhaler as above, or if you are worried at any time, call 999.
- If an ambulance does not arrive within 10 minutes and you are still feeling unwell, repeat step 3. See the website - Asthma UK - for further information. For other countries see the links at the end of this hub.
To finish off I've collected a list of triggers that can lead to asthma attacks developing. If you have any others to add to the list, then feel free to let us all know through the comments section.
A simple breathing exercise for people with asthma
Common triggers for asthma
There are a number of triggers that have been identified that can start an asthma attack. The triggers are different in each person and most asthmatics learn to avoid the ones whenever they can, that are harmful to them. It's also known that some triggers can cause a reaction immediately while others only cause irritation some time after contact with the trigger was made. Again every person is different.
This list is compiled from both Asthma UK and NHS UK Patient Information. However, if you have a trigger that's not listed, then let us know about it in the comments section.
Triggers found mostly indoors:
- Dust mites
- Pets - especially fur and feathers
- Household chemicals
- Mould and fungi
- Workplace substances and chemicals
Triggers found mostly outdoors:
- Air pollution
- Weather - such as sudden changes in the weather, humid conditions. windy, cold and poor air quality are all known to be triggers for asthma.
- Chest infections, flu, colds can trigger an asthma attack
- Medicines - medicines such as non-steroidal anti-inflammatory are known to be triggers, for example ibuprofen and aspirin.
- Foods - some foods can be triggers for asthma, such as food containing sulphides and some wines. In addition, other people are allergic to foods such as nuts and can experience a reaction called an 'anaphylactic reaction' which also leads to an asthma attack.
- Emotional state - anxiety and distress can also cause an asthma attack to develop. In addition it's also known that laughing can trigger an attack.
I hope this hub has been useful in giving you at least some ideas on how to help someone who is having an asthma attack and the basics of what asthma is. Thankfully most inhalers do stop attacks from happening often and these medicines - combined with increasing medical knowledge - will hopefully continue to improve conditions for people with asthma.
© 2013 Helen Murphy Howell
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