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Tuesday, March 9, 2010

Asthma

"Asthma doesn't seem to bother me any more unless I'm around cigars or dogs. The thing that would bother me most would be a dog smoking a cigar."-Steve Allen While researching first aid stations for a Cub Scout activity, I realized that I know very little about Asthma and how to respond. After looking at a dozen medical websites I still know very little about what to do. The sites describe Asthma, its symptoms, its triggers, its medical treatment, but very little about instructions for Asthma attacks. The usual language is “See your doctor for an Asthma Action Plan.” Very little advice for Scout Leaders with an Asthmatic hiker.
So what have I learned? During the asthma attack, the lining of the airways and lungs become swollen or inflamed and thicker mucus -- more than normal -- is produced. This causes coughing, wheezing, and chest tightness as breathing becomes more difficult and less effective. Symptoms include:
· Severe wheezing when breathing both in and out
· Coughing that won't stop
· Chest pain or pressure
· Tightened neck and chest muscles, called retractions
· Difficulty talking
· Very rapid breathing
[DANGER signs, call 911]
· Extreme difficulty breathing
· Rapid pulse
· Pale, sweaty face
· Blue lips or fingernails
· Anxiety or panic over inability to breathe
· Severe drowsiness or confusion
With mild asthma attacks the airways open up within a few minutes to a few hours after treatment. Severe asthma attacks are less common but last longer and require immediate medical help. If a mild attack is not treated and becomes severe, the lungs may tighten so much that there is not enough air movement to produce wheezing. This is called a "silent chest,"; it is a dangerous sign and requires immediate medical attention before the victim dies from lack of air. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.
Asthma attacks can be triggered by cold-air, too much exercise, stress, pet dander, dust, mold, pollen, and tobacco & wood smoke. Asthma cannot be cured but you can keep the body health and strong, avoid the asthma triggers, and follow a two pronged medical regimen.
1. Long Term Medications to reduce the likelihood of attacks. These include corticosteroids, bronchodilators, Leukotriene inhibitors, and others.
2. Emergency Medications used during an attack.
a. Short-acting bronchodilators (inhalers)
b. Corticosteroids injected directly into a vein during a severe attacks

Asthma suffers can monitor their state of health with a breathing apparatus that measures “Peak Flow” of how much air they can take in. There is a Green Zone of 80-100% flow, a Yellow caution zone of 50-80% and a Red danger zone of 50% Peak Flow capacity.
Bottom Line
What can I do to help during an Asthma attack?
- If feasible, move them out of a trigger area (away from smoke, cold air, pet dander)
- Sit the person comfortably upright – do NOT have them lie down.
- Stay calm and soothe the victim. This may help him or her relax and breathe more easily.
- Have the victim use their inhaler as instructed by their doctor
- Coach the person to breathe steadily with pursed lips (puckered or "fish" lips), especially on the exhale. Breathe with the person, helping them focus on you.
- If the victim has no inhaler or no history of Asthma before, call 911.
- If the inhaler is not helping, call 911
- If the victim passes out, begin rescue breaths and, if necessary, CPR.

- Asthma attacks are NOT “cured” by drinking large amounts of liquids
- Non-prescription medicines such as antihistamines or cold remedies apparently have no effect in controlling asthma.
Asthma Resources
http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.pdf
http://www.webmd.com/asthma/
https://health.google.com/health/ref/Asthma
http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_Treatments.html
http://www.mayoclinic.com/health/asthma/DS00021/DSECTION=when-to-seek-medical-advice
http://www.cdc.gov/asthma/faqs.htm
First Aid
http://www.nationalasthma.org.au/content/view/281/572/
http://www.firstaidtopics.com/asthma-attack/
http://www.ehow.com/how_7912_treat-asthma-attacks.html