When To Seek Emergency Medical Care
Anyone experiencing any of the following emergency warning signs of flu sickness, including people with asthma, should seek medical attention right away.
People experiencing these warning signs should obtain medical care right away.
These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.
Sinusitis And Other Upper Respiratory Infections
Much like asthma causes inflammation in the lining of your airways, sinusitis causes inflammation in the mucus membranes that line your sinuses. This makes the membranes put out more mucus. If you have asthma and your sinuses get inflamed, your airways may too. Prompt treatment of a sinus infection can relieve asthma symptoms.
Discharge And Follow Up
Decisions around discharge depend on severity and response to therapy administered.
Discharge home may be considered if the patient is clinically stable on 3-hourly salbutamol, clinical signs are within normal limits for age, early follow up plans have been arranged and education has been delivered to parents including an asthma action plan and safety-netting.3
The parents must be comfortable with the discharge plan and feel confident to action this at home.
Admission will be required to the ward for stretching of salbutamol if the patient does not meet the above criteria.
Transfer to tertiary care or PICU in cases of severe or life-threatening, requiring IV infusions or respiratory support .
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The Innate Immune Response
Clearance of viral pathogens begins with interferon secretion, and the underproduction of these factors has been postulated to lead to viral-induced exacerbations. There are three types of interferons, based on the receptors they bind: type I , type II , and type III . HRV infection induced epithelial expression of mRNA for both type I and type III IFNs, and it has been suggested that impaired epithelial production of IFN- and IFN- in asthmatic subjects may contribute to viral exacerbations of asthma . Contoli et al. showed significant inverse correlations between ex vivo production of IFN- and severity of symptoms, bronchoalveolar lavage viral load and airway inflammation, and a strong positive correlation with reductions in lung function during in vivo infection. Genome-wide association studies showed that single nucleotide polymorphisms involve in various diseases. Interferon- polymorphisms may effect on the incidence of HRV infection .
Message et al. reported virus load in asthmatic subjects as being related to increased lower airway inflammation, and in turn increased lower airway inflammation being related to increased symptoms, reductions in lung function, and increases in bronchial hyperreactivity. These data suggest a causal role for HRV infection in the pathogenesis of asthma exacerbations.
How Long Does Asthmatic Bronchitis Last
The duration of the disease usually depends on the patients overall health and age. In patients with acute bronchitis symptoms may last less than 10 days. In patients with severe asthmaticbronchitis, the symptoms are recurrent and usually last between 30 days to even 2 years with flares and remissions. The flares depend on the patients lung function and immune response. In extreme cases, it may affect the quality of life and may also cause death. The symptoms may include:
- Breathlessness or short breath while talking, laughing or running
- Sleep apnea or trouble while sleeping caused by breathlessness
- Excess mucus
Triggering factors may include:
- Exposure to substances, such as pollen, dust, mold, animal fur, sand, and bacteria, which triggers allergic reactions. People who suffer from allergies, such as hay fever, neurodermatitis, or cradle cap, have an increased risk of bronchial asthma.
- Viral infection like cold and flu or pneumonia
- Air pollution, smoke, fumes from vehicles, etc.
- Weather, especially extreme changes in temperature
- Food additives
- Smoke or pollution
- Frequent respiratory tract infections also can lead to the development of bronchial asthma
- Risk factors may also include low birth weight and excess weight in childhood
It is recommended that a person sees a doctor immediately if they experience:
- Symptoms that do not clear up in 3 weeks
- Fever of 100.4° F or higher
- Recurrent episodes
- Bluish skin or nails
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Surprising Signs Of Adult
This post is available in: Spanish
That persistent cough that keeps you up at night may stem from more than just a tickle in the back of your throat. It could be adult-onset asthma.
Many people experience a jolt of disbelief when they are diagnosed with asthma later in life, especially if they have never experienced symptoms before. Asthma? That condition that causes kids to wheeze?
It turns out adult-onset asthma is far more common than many people realize. Asthma is often considered a disease of children, so adults may be surprised when they are diagnosed with asthma, says pulmonologist Javier Pérez-Fernández, M.D., the critical care director at Baptist Hospital of Miami.
The number of people with asthma grows every year. Currently, more than 26 million Americans have asthma, according to the U.S. Centers for Disease Control and Prevention. Of those cases, more than 20 million are among adults, with the greatest number of cases among ages 35 and 65.
Asthma is a chronic inflammation of the lung airways that can lead to coughing, chest tightness, shortness of breath or wheezing. Among adults who develop asthma later in life, the symptoms may initially be more subtle than in children, which can cause patients to overlook or ignore the condition. But its important to treat symptoms as soon as possible so they dont become severe, said Dr. Pérez-Fernández, who also serves as director of pulmonology for West Kendall Baptist Hospital.
What Are Common Asthma Attack Triggers
An asthma attack happens when someone comes in contact with substances that irritate them. Healthcare providers call these substances triggers. Knowing what triggers your asthma makes it easier to avoid asthma attacks.
For some people, a trigger can bring on an attack right away. Sometimes, an attack may start hours or days later.
Triggers can be different for each person. But some common triggers include:
- Air pollution: Many things outside can cause an asthma attack. Air pollution includes factory emissions, car exhaust, wildfire smoke and more.
- Dust mites: You cant see these bugs, but they are in many homes. If you have a dust mite allergy, they can cause an asthma attack.
- Exercise: For some people, exercising can cause an attack.
- Mold: Damp places can spawn mold. It can cause problems for people with asthma. You dont even have to be allergic to mold to have an attack.
- Pests: Cockroaches, mice and other household pests can cause asthma attacks.
- Pets: Your pets can cause asthma attacks. If youre allergic to pet dander , breathing in the dander can irritate your airways.
- Tobacco smoke: If you or someone in your home smokes, you have a higher risk of developing asthma. The best solution is to quit smoking.
- Strong chemicals or smells.
With asthma, you may not have all of these symptoms. You may have different signs at different times. And symptoms can change between asthma attacks.
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Medications For Allergic Asthma
Try nasal allergy medications that donât make you sleepy, saline rinses, and nasal sprays . If these donât work, use nasal steroid sprays and stronger antihistamines. If none of this helps, it may be time to talk to a doctor about allergy shots.
There are many good asthma treatments, but most require a prescription. These medications include inhaled steroids, which fight inflammation, and bronchodilators, which open up your airways. If traditional treatments donât help your allergic asthma, Xolair, an injectable medication that reduces IgE levels, may help. Also, the long-acting anticholinergic medication called tiotropium bromide may be used in addition to your regular maintenance medications to help with symptom control. This medication can be used by anyone ages 6 years and older.
SOURCES:American Academy of Asthma, Allergy, and Immunology: “What to expect at the doctor’s office,” “How to help your allergies and asthma,” “Allergic asthma information,” “Is your asthma allergic?” American Medical Association, Essential Guide to Asthma, 1998. National Heart, Lung and Blood Institute: “Asthma: How is Asthma Diagnosed?” “How is asthma treated?”Boehringer Ingelheim: “US FDA Expands Approval of Tiotropium RespimatÂ® for Maintenance Treatment of Asthma in Children.”FDA. Prescribing Information: Spiriva Respimat.
Laughter Found To Be A Trigger Of Asthma Attacks
More than half of people with asthma have symptoms that are triggered by laughter, researchers have found.
Laughter is one more trigger in a long list of triggers for asthma, said study author Dr. Stuart Garay of the New York University Medical Center in New York.
However, among people with symptoms brought on by laughter, nearly half said they could laugh attack-free when their asthma was under better control. To Garay, this suggests that people who get asthma symptoms from laughing should consider tweaking their medicine to improve control of their condition. Laughter-induced asthma may be a sign that you need some adjustment in your medication, he said.
Garay and colleagues asked 235 people with asthma if laughter affected their asthma. They found that 56% of people developed symptoms after laughing, most commonly cough and chest tightness.
However, 47% of people with asthma brought on by laughter said that when their asthma was under good control, they could laugh all they want, and have no symptoms. When their asthmas not controlled, its easier to bring out these symptoms, Garay said.
He emphasized that no one should try to live without laughter to avoid an asthma attack.
The researchers presented their findings last week at the American Thoracic Society International Conference in San Diego.
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Treating Allergies And Sinusitis
Patients with asthma and chronic allergic rhinitis may need daily medications. Patients with severe seasonal allergies may need to start taking medications a few weeks before the pollen season, and to continue them until the season is over.
Immunotherapy may help reduce asthma symptoms, and the use of asthma medications, in patients with known allergies. They may also help prevent the development of asthma in children with allergies. Immunotherapy poses some risk for severe allergic reactions, especially for children with poorly controlled asthma, so it is important that the doctor carefully evaluates the child’s asthma condition.
The latest guidelines indicate that immunotherapy injections for treatment of allergies are safe for young children.
Researchers are studying an oral form of immunotherapy that uses a sublingual tablet. Some, but not all, sublingual tablets are approved for children older than 10 years. Recent studies indicate that sublingual therapy may be helpful for asthma. However, questions still remain including dosage and duration of treatment. Sublingual therapy has recently been FDA-approved for allergic rhinitis. At this time, sublingual immunotherapy is not approved or recommended for asthma treatment in the United States.
The Difference Between Poorly Controlled Asthma And Asthma Exacerbations
The most commonly used definition of an asthma exacerbation requires not an event of a particular character but the management of it, whether that be hospitalisation, emergency room presentation or a course of oral corticosteroids . Such an exacerbation can be an extension of the pattern of disease in ongoing poor control or an independent event. It is clear that some patients have excellent current control of asthma with minimal or no symptoms, and yet have sudden and severe exacerbations. Viral infections have been implicated in such events. At the other extreme, some patients have unrecognised or ineffectively managed asthma, and have extreme variability in symptoms and lung function. In these cases, exacerbations may be recorded not necessarily for the deepest fluctuations in lung function or for specific patterns of asthma worsening, but for those occasions where medical advice was sought and treatment given.
One particularly challenging aspect of asthma exacerbations is the differentiation between inadequate treatment regimens leading to episodic symptomatic asthma and catastrophic failures in asthma control in response to various stimuli, i.e. an exacerbation.
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Risk Factors Of Asthma
Although it cant be said for sure what causes asthma in some people and not in others, however, there can be some triggers. One of the reasons for asthma can be being exposed to elements such as:
- Airborne allergens such as pollen or dust mites
- Respiratory infections such as common cold
- Chilly air
Additionally, youll be at a greater risk for asthma if:
- Youre overweight
- You have a family history of asthma
- You get exposed to passive smoking
- You have any form of allergy
- You are exposed to fumes and other types of pollutants
- You are exposed to harmful substances at work such as chemicals
Now that youre aware of the causes of bronchial asthma, lets look at the asthma symptoms and treatment.
What Helps Asthma When You Are Sick
There are no treatments specifically for viral-induced asthma symptoms, but there are a number of treatments that can alleviate cough, chest tightness, and wheezing. The best way to manage asthma is prevention and long-term control that stops attacks before they happen.
First, develop an asthma action plan with your healthcare provider before you get sick. This is a very specific document that is based on your numbers when you breath into a peak flow meter and symptoms. There are three zones: green, yellow, and red.
Each zone should have corresponding medications that are recommended to help control your asthma. Frequently being in the yellow or red zone is a sign of severe asthma, Dr. Poinsett says.
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Other Preventive Actions For People With Asthma
In addition to getting a flu vaccine, people with asthma should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, and washing hands often.
Specific Health Actions for People with Asthma
- Take asthma medication exactly as your doctor or other medical professional tells you to do. Know how to use your asthma inhaler if your doctor of other medical professional tells you to use one.
- Plan ahead to maintain sufficient supplies of your regular medications for chronic medical conditions .
- Know and avoid the asthma triggers that can cause you to have an asthma attack.
- Follow an updated, written Asthma Action Plan developed with your health care provider.
- Follow this Asthma Action Plan for daily treatment to control asthma long-term and to handle worsening asthma, or attacks.
- If your child has asthma, make sure that their up-to-date written Asthma Action Plan is on file at school and/or at the daycare center. Be sure that the plan and medication are easy to get to when needed.
Why Does Viral Wheeze Happen
The viral infection may cause a narrowing of the small airways or an increase in mucus production in your child’s lungs. Viral wheeze is more common in children under the age of 3 years as their airways are smaller.
The wheeze may return each time your child has a cold and can occasionally last for some weeks.
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Attachment To Airway Epithelial Cells
When RT-PCR is used to either supplement or replace conventional culture techniques, viruses have been found in approximately one half to three quarters of adults experiencing an acute wheezing episode , and the majority of viruses identified were HRVs . However, the evidence is weak, and mechanisms are poorly understood. Initially, HRV-A and -B attach to airway epithelial cells via ICAM-1 or LDLR . The receptor or receptors for the recently identified group HRV-C have yet to be clarified. HRV-infected BECs secrete a wide range of cytokines and chemokines such as IL-1, IL-6, CCL5/RANTES , CXCL8/IL-8, GM-CSF, and CXCL10/interferon-inducible protein 10 , which induce neutrophilic, lymphocytic, and eosinophilic inflammation together with airway hyperresponsiveness and airway remodeling .
How Do You Monitor Asthma Symptoms
Monitoring your asthma symptoms is an essential piece of managing the disease. Your healthcare provider may have you use a peak flow meter. This device measures how fast you can blow air out of your lungs. It can help your provider make adjustments to your medication. It also tells you if your symptoms are getting worse.
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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:
- 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.
- 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.
- Biologic therapies for asthma when symptoms persist despite being on 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 other inhaler. Your healthcare provider may prescribe oral medications that you swallow.