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Asthma Attack Treatment In Hospital

What To Do If You Have An Asthma Attack

Mayo Clinic Minute: When asthma attacks

If you think you’re having an asthma attack, you should:

  • Sit up straight try to keep calm.
  • Take one puff of your reliever inhaler every 30 to 60 seconds up to 10 puffs.
  • If you feel worse at any point, or you do not feel better after 10 puffs, call 999 for an ambulance.
  • If the ambulance has not arrived after 10 minutes and your symptoms are not improving, repeat step 2.
  • If your symptoms are no better after repeating step 2, and the ambulance has still not arrived, contact 999 again immediately.
  • Never be frightened of calling for help in an emergency.

    Try to take the details of your medicines with you to hospital if possible.

    If your symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP or asthma nurse.

    This advice is not for people on SMART or MART treatment. If this applies to you, ask a GP or asthma nurse what to do if you have an asthma attack.

    What Types Of Asthma Are There

    Asthma is broken down into types based on the cause and the severity of symptoms. Healthcare providers identify asthma as:

    • Intermittent: This type of asthma comes and goes so you can feel normal in between asthma flares.
    • Persistent: Persistent asthma means you have symptoms much of the time. Symptoms can be mild, moderate or severe. Healthcare providers base asthma severity on how often you have symptoms. They also consider how well you can do things during an attack.

    Asthma has multiple causes:

    • Allergic: Some peoples allergies can cause an asthma attack. Allergens include things like molds, pollens and pet dander.
    • Non-allergic: Outside factors can cause asthma to flare up. Exercise, stress, illness and weather may cause a flare.

    Asthma can also be:

    • Adult-onset: This type of asthma starts after the age of 18.
    • Pediatric: Also called childhood asthma, this type of asthma often begins before the age of 5, and can occur in infants and toddlers. Children may outgrow asthma. You should make sure that you discuss it with your provider before you decide whether your child needs to have an inhaler available in case they have an asthma attack. Your childs healthcare provider can help you understand the risks.

    In addition, there are these types of asthma:

    Are You Suffering A Severe Asthma Attack

    In an emergency, you need to act fast. Heres a list of emergency contact numbers around the world:

    • In the UK, dial 999.
    • In the US, dial 911.
    • In Canada, dial 911.
    • In New Zealand, dial 111.
    • In South Africa, dial 10 177.

    Note that 112 also works in any European Union country and the UK.

    You can find a comprehensive list of worldwide emergency contact numbers here.

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    Does Asthma Cause Copd

    Asthma and COPD are diseases of different spectrum, although the symptoms for both of them are almost the same. The causes for both diseases also vary greatly. It has been seen in a number of cases where the diagnosis have been confused in the above diseases. The treatment is almost the same in both of them, but the complication rate and lung damage is much more severe in COPD when compared to asthma.

    In recent studies, it has been observed that poorly controlled asthma for a long time can sometimes convert to COPD. Thereâs a special disease calledAsthma-COPD Overlap Syndrome where the symptoms and findings of both asthma and COPD are present and is a borderline between asthma and COPD.

    What Causes An Asthma Attack

    MD City Hospital

    During an asthma attack the muscles in your airways tighten up, making the airways narrower. The airways also get inflamed and produce more mucus, making them narrower still. Air flows less easily through your airways, leaving you breathless and unable to take in enough air.

    Many different things can cause your airways to act in this way – these are known as asthma triggers. Common triggers can include dust, cigarette smoke, animal hair, pollen, colds & flus, and strenuous exercise.

    If you have an asthma attack, or have asthma symptoms, you should work with your doctor to find out what triggers your asthma. If you can work out what sets if off, you will find it easier to control your asthma and avoid the symptoms.

    For more information, see what is asthma?

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    Management Of Refractory Cases

    Three randomized controlled trials and a systematic review72 showed additional benefit when magnesium was given to patients with severe asthma exacerbations who had not responded to standard -agonist therapy. Two level I studies that found no such benefit did not limit treatment to unresponsive cases. The safety of magnesium and the potential benefit justify its use in people with severe asthma who fail to respond to titrated bronchodilators and glucocorticosteroids.

    Parenteral bronchodilator therapy may be indicated when the inhaled route is not practical: for example, in patients who are coughing excessively, are too weak to inspire adequately or are moribund.

    Intubated patients with asthma who do not respond to conventional bronchodilator therapy may benefit from an inhaled anesthetic agent with bronchodilating properties, such as ether,75 halothane, enflurane79 or isoflurane. Hypotension and cardiac dysrhythmias are associated with the use of these agents and are more likely to occur in hypoxemic patients.

    The efficacy of heliox has not been confirmed in a randomized controlled trial. Benefit was reported in an observational study86 and some believe that it has a role in refractory asthma.87

    In children, pretreatment with atropine is recommended to prevent bradycardia that may occur with the use of succinylcholine.

    Care Advice For Asthma Attack

  • What You Should Know About Asthma:
  • Over 10% of children have asthma.
  • Your child’s asthma can flare up at any time.
  • When you are away from your home, always take your child’s medicines with you.
  • The sooner you start treatment, the faster your child will feel better.
  • Here is some care advice that should help.
  • Asthma Quick-Relief Medicine:
  • Your child’s quick-relief medicine is albuterol or xopenex.
  • Start it at the first sign of any wheezing, shortness of breath or hard coughing.
  • Give by inhaler with a spacer or use a neb machine.
  • Repeat it every 4 hours if your child is having any asthma symptoms.
  • Never give it more often than 4 hours without talking with your child’s doctor.
  • Coughing. The best “cough med” for a child with asthma is always the asthma medicine. Caution: don’t use cough suppressants. If over 6 years old, cough drops may help a tickly cough.
  • Caution: if the inhaler hasn’t been used in over 7 days, prime it. Test spray it twice into the air before using it for treatment. Also, do this if it is new.
  • Use the medicine until your child has not wheezed or coughed for 48 hours.
  • Spacer. Always use inhalers with a spacer. It will get twice the amount of medicine into the lungs.
  • Asthma Controller Medicine:
  • Your child may have been told to use a controller drug. An example is an inhaled steroid.
  • It’s for preventing attacks and must be used daily.
  • During asthma attacks, keep giving this medicine to your child as ordered.
  • Allergy Medicine for Hay Fever:
  • Fluids – Offer More:
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    Management Of Acute Asthma In Hospital

    Response to emergency treatment, clinical features that reflect the current attack and past disease severity, socioeconomic risk factors and pulmonary function tests are all used to determine the need for admission to hospital. Normally, patients over 5 years of age who achieve 60%-70% of predicted or previous best lung function will not require admission to hospital unless clinical factors indicating risk of relapse are significant. Important factors that define a patient at high risk for relapse include admission to hospital or a visit to the emergency department in the previous 12 months, recent use of systemic glucocorticosteroids, use of multiple categories of asthma medication, previous severe or life-threatening asthma attack, presence of psychosocial problems and the frequent, regular use of inhaled 2-agonists.

    The principles of inpatient management incorporate the spectrum of treatment options that are used in both acute and long-term phases of asthma management. Opportunities exist to evaluate the need for education and to review barriers to compliance with treatment plans.

    Inpatient management with an MDI or DPI allows for dose titration, reinforcement of drug delivery technique, greater involvement of the patient in self-management and lower fixed and variable cost to hospitals.105

    Respiratory therapy time is more efficiently spent carrying out objective measurements and educating patients than simply administering wet nebulization treatments.

    What To Do After An Asthma Attack:


    One in six people who receive treatment at the hospital needs emergency treatment again within two weeks. Asthma attacks are not normal and you should not tolerate them.

    Take the following key steps to prevent you having another attack in the future:

    • Book an urgent appointment with your healthcare provider
    • Keep taking your asthma medication as prescribed
    • Take the rest of the day to recover after the attack

    It is important to know that the majority of severe asthma episodes can be avoided by having good asthma control.

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    What Is An Asthma Attack

    When you breathe normally, muscles around your airways are relaxed, letting air move easily and quietly. During an asthma attack, three things can happen:

    • Bronchospasm: The muscles around the airways constrict . When they tighten, it makes your airways narrow. Air cannot flow freely through constricted airways.
    • Inflammation: The lining of your airways becomes swollen. Swollen airways dont let as much air in or out of your lungs.
    • Mucus production: During the attack, your body creates more mucus. This thick mucus clogs airways.

    When your airways get tighter, you make a sound called wheezing when you breathe, a noise your airways make when you breathe out. You might also hear an asthma attack called an exacerbation or a flare-up. Its the term for when your asthma isnt controlled.

    When To Go To The Hospital For Asthma Attack Symptoms

    You might wonder how you can tell the difference between symptoms of a severe attack that requires emergency treatment versus a mild attack that you can treat on your own.

    First things first: Always seek emergency medical attention if your rescue medication does not seem to be working.

    Additionally, you should go to the hospital if you notice any of the following symptoms that may indicate a life threatening asthma attack:

    • intense shortness of breath and difficulty speaking
    • very rapid breathing, coughing, or wheezing
    • straining chest muscles and difficulty breathing
    • a bluish color in the face, lips, or nails
    • difficulty inhaling or exhaling completely
    • confusion or exhaustion
    • fainting or collapsing

    If you use a peak flow meter a device that measures your peak airflow you should go to the hospital if your readings are low and are not improving.

    In a life threatening asthma attack, coughing or wheezing may disappear as the attack worsens. If you cannot speak a full sentence or you experience other breathing difficulties, seek medical attention.

    If your symptoms respond quickly to your rescue medication, and you can walk and talk comfortably, you may not need to go to the hospital.

    Everyone who lives with allergic asthma can help protect their health by learning the basics of asthma first aid.

    A good preventive step is to create an asthma action plan with your doctor.

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    Check Your Asthma Action Plan

    The plan you wrote with your doctor to help control your asthma does more than tell you what medications to take. It also lists the symptoms to watch for and when to call your doctor or go to the ER if they get worse.

    You should call 911 or get to a hospital right away if you:

    • Have wheezing or shortness of breath that doesnât get better when you use your rescue inhaler
    • Are so short of breath you canât talk or walk normally
    • Have blue lips or fingernails
    • Take more than 25-30 breaths a minute
    • Need to strain your chest muscles to breathe
    • Have a heartbeat higher than 120 beats per minute

    Very few people need a hospital stay for asthma treatment. Itâs more likely to be necessary if you:

    • Have had a bad asthma attack before
    • Went to the ER or stayed in the hospital because of your asthma within the last 10 days
    • Got diagnosed with asthma after age 40
    • Take steroid medications regularly to control your asthma
    • Use your rescue inhaler more than twice a month
    • Have other long-term health problems, such as heart or lung disease

    Can Asthma Patients Travel In Flights

    Asthma is a serious condition that can be dangerous when a person was ...

    Asthma patients can travel in flights provided their symptoms are under control. In case of symptoms persisting, they need to take advice of the pulmonologist before going on journey.

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    Can Smoking Cause Asthma Attacks

    Anything that irritates the normal airways of the lung can cause or precipitate an asthma attack. As smoking of cigarettes causes irritation and inflammation of the airways it definitely increases both the onset and increase in frequency of asthma attacks. The attacks can be much more severe when compared to a non smoking person.

    What Asthma Treatment Options Are There

    You have options to help manage your asthma. Your healthcare provider may prescribe medications to control symptoms. These include:

    • Bronchodilators: These medicines relax the muscles around your airways. The relaxed muscles let the airways move air. They also let mucus move more easily through the airways. These medicines relieve your symptoms when they happen and are used for intermittent and chronic asthma.
    • Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways. They make it easier for air to enter and exit your lungs. Your healthcare provider may prescribe them to take every day to control or prevent your symptoms of chronic asthma.
    • Biologic therapies for asthma: These are used for severe asthma when symptoms persist despite proper inhaler therapy.

    You can take asthma medicines in several different ways. You may breathe in the medicines using a metered-dose inhaler, nebulizer or another type of asthma inhaler. Your healthcare provider may prescribe oral medications that you swallow.

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    What To Expect After Leaving The Hospital

    After symptoms improve, an individual receives discharge instructions. These include when and how to take asthma medications and spot signs of a flare-up.

    After leaving the hospital, a person should follow up with their doctor. They may suggest the following changes:

    • new medications

    Several strategies to help prevent flare-ups include the following:

    • Taking an asthma education class: Asthma education classes teach participants about:
    • the causes of asthma
    • ways to reduce flare-ups
    • how to develop an asthma action plan
  • Avoiding triggers: Asthma triggers cause a flare-up of symptoms. Triggers are different for everyone, but keeping a log of symptoms may help identify triggers. After determining triggers, doctors can suggest ways to avoid them as much as possible.
  • Using a long-acting bronchodilator: This inhaled medication keeps the airways open longer than a fast-acting inhaler. Steroids also help prevent inflammation and flare-ups.
  • Using a peak flow meter: A peak flow meter measures the air a person can blow out in one breath. When a person is symptom-free, measuring peak flow helps determine their personal best. Airways may narrow even before more obvious symptoms develop. A decrease in peak flow by 2030% may mean the start of an asthma attack.
  • A person should consult a doctor to discuss any of the above strategies.

    American Heart Association , people with persistent asthma may have a 1.5 times greater risk of developing atrial fibrillation an abnormal heart rhythm.

    What Are The Symptoms Of An Asthma Attack

    Asthma Exacerbation Case Study 1 – Treatment (Asthma Flare / Attack)

    The most common symptoms include:

    Mild to Severe

    • Disrupted sleep due to asthma symptoms & breathing difficulty
    • Daytime symptoms 2 or more times per week
    • Inability to exercise normally without breathing issues
    • Getting a cold/flu

    If you experience any of the above symptoms, book an urgent appointment with your healthcare provider. An asthma attack could be on its way. The timely help can prevent dangerous consequences.


    • Excessive cough, wheeze and chest tightness
    • Difficulty speaking due to asthma
    • Experiencing shortness of breath at rest
    • Lips or nail beds turning blue
    • Reliever medication isnt helping

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    Reducing The Burden Of Asthma

    Asthma cannot be cured, but good management with inhaled medications can control the disease and enable people with asthma to enjoy a normal, active life.

    There are two main types of inhaler:

    • bronchodilators , that open the air passages and relieve symptoms and
    • steroids , that reduce inflammation in the air passages. This improves asthma symptoms and reduces the risk of severe asthma attacks and death.

    People with asthma may need to use their inhaler every day. Their treatment will depend on the frequency of symptoms and the different types of inhalers available.

    It can be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. Using a spacer device makes it easier to use an aerosol inhaler and helps the medicine to reach the lungs more effectively. A spacer is a plastic container with a mouthpiece or mask at one end and a hole for the inhaler in the other. A homemade spacer, made from a 500ml plastic bottle, can be as effective as a commercially manufactured inhaler.

    Access to inhalers is a problem in many countries. In 2021, bronchodilators were available in public primary health care facilities in half of low- and low-middle income countries, and steroid inhalers available in one third.


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