Treatment when asthma attacks recur

My husband has bronchial asthma, uses inhaler to stabilize, sometimes has acute attacks when the seasons change. How to recognize asthma attacks, how to handle them? Ngoc Minh (25 years old, Ha Nam)

Reply

Bronchial asthma is a chronic inflammation of the bronchial mucosa, with many easily observed symptoms such as poor adaptation to cold weather, persistent cough, especially at night, susceptibility to allergies, shortness of breath, wheezing, always feeling tired when exercising, and chest tightness. Acute bronchial asthma is manifested by increased shortness of breath, cough, chest tightness, and reduced lung ventilation function.

Signs of an acute asthma attack are usually itchy nose, itchy throat, sneezing, coughing, watery eyes, runny nose, itchy or red eyes, and drowsiness. If your husband has the above symptoms, you should observe and quickly identify the source of irritation (pollen, animal hair, allergic foods, etc.) and isolate the patient from this agent. At the same time, the patient needs to keep the body warm, avoid air conditioning, humidifying fans, and lie with half of the body elevated (on the bed) to make breathing easier. Do not rub or stroke the patient's chest because it can easily affect the airways, making the asthma attack worse.

In mild to moderate asthma, the patient shows signs of speaking in phrases, preferring to sit rather than lie down, not being mentally agitated, increased breathing rate, not using accessory respiratory muscles, heart rate around 100-120 beats per minute, SpO2 90-95%. At this time, the patient needs to use the inhaler twice at a time, spray up to three times, each time 20 minutes apart if the acute symptoms do not decrease.

When the patient speaks each word, sits hunched forward, is mentally agitated, has a breathing rate of more than 30 per minute, has accessory respiratory muscles contracted, has a heart rate of more than 120 beats per minute, and has an SpO2 of less than 90%, the condition is severe. The patient needs to be given an inhaler to relieve the attack immediately and taken to the nearest hospital for medical intervention.

With a severe asthma attack, the patient feels sleepy, the body turns purple, and cannot speak. At this time, the family needs to call an ambulance immediately. While waiting for the ambulance, they need to immediately spray two puffs of acute asthma relief medication.

Asthma attacks can progress rapidly and become dangerous. Therefore, the best way is to adhere to treatment and have regular check-ups to proactively prevent asthma attacks from recurring. Patients should quit smoking and avoid passive exposure to cigarette smoke, and practice gentle breathing. Build a diet rich in fresh vegetables and fruits, and avoid foods that can cause allergies. Patients should control their emotions, limit loud laughter, crying, anger, or uncontrolled fear.

In addition, to improve respiratory resistance, your husband should get a flu vaccine once a year, a pneumococcal vaccine, and a whooping cough vaccine (if not already vaccinated).

MSc. Dr. Le Thi Hong Tham
Respiratory Department, Tam Anh General Hospital Hanoi

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