MANAGEMENT OF AN ACUTE ATTACK
To be well prepared to tackle an emergency is half the battle won. It is wise to be aware of the triggers, danger signals and the medications to be taken and have a plan to deal with the situation.
- Remove or reduce exposure to the trigger, if present and recognized.
- Remain calm– asthma often worsens on panic.
- Sit down comfortably and upright or a position that is comfortable to you.
- Take Reliever medication as an inhaler–Give 2-4 puffs in children and 6-8 puffs in adults of the reliever medication.
- Wait for 5-10 minutes and if no relief is there repeat the dose.
- If still no relief is there call the doctor and an ambulance.
- While waiting for the ambulance keep repeating the dose of the reliever medication.
- If using a spacer to take the reliever release 1 puff and breath 4 times.
Spacers work ideally in an emergency but if not available at hand can be designed from plastic bottles or paper cups. This is done by making a hole at the bottom of the cup/bottle and placing the inhaler’s mouth in it, the mouth of the cup/bottle is to be placed on the patient’s mouth and the medication can be taken without exertion by the patient.
How to manage Asthma
Different patients of asthma need different medications i.e. the treatment needs to be individualized depending on the severity of the disease. One should always consult a qualified physician to get the right medicine or combination of medicines and to learn how to take them properly. A very mild attack may require only some inhaled bronchodilator (reliever) therapy whereas a severe attack mm1erits hospitalization/nebulization and long term anti inflammatory (preventer) therapy.
Goals of management
The goals of management are to
- Minimal or no chronic symptoms day or night.
- Minimal or no acute attacks .
- No limitations of activities; no school or work missed.
- PEF >= 80% of personal best.
- Minimal use of short acting B 2 agonist inhalers (less than once a day).
- Minimal side effects from medications.