An attack of bronchial asthma: causes, relief, alternative methods

An attack of bronchial asthma can occur as a result of the action of external and internal stimuli, contact with which contributes to the acute development of the disease.

Most often, an attack has an allergic nature of development, when the increased sensitivity of the bronchi provokes the development of spasms, preventing the normal passage of oxygen into the pulmonary system. The result of this reaction is a severe cough and the development of choking.

It is important to know that at home an attack of bronchial asthma will not go away on its own. For this, it is imperative to treat the disease using all dosage forms, including inhalation, to prevent choking.

Causes of an attack

The most common causes of an asthmatic attack may be smoking (passive and active), household chemicals and medications can also provoke asthma immediately therapy.

It should be borne in mind that the reasons can be quite different, but they all provoke acute asthmatic symptoms that can occur within a few minutes, therefore timely pre-medical help.

Development mechanism

The mechanism of development of an asthmatic attack is characterized by delayed-type allergic reactions, when as a result the action of external and internal stimuli triggers the inflammatory process of the bronchial system, which provokes an attack choking.

Trigger mechanism for external stimuli (pollen, dust, food, drugs, pain relievers, etc.) directly depends on the severity of asthma and the susceptibility of the immune patient systems. In addition, some viruses and bacteria are an external irritating factor, which, in combination with heredity, can trigger the mechanism of asthma and provoke a new attack.

The triggering mechanism for the course of an attack may depend on the age of the patient. As a rule, in children suffering from bronchial asthma, persistent remission may occur by the age of puberty. If the initial mechanism for the development of asthmatic diseases occurs in adulthood, a bronchial attack can proceed unpredictably. In some patients, asthma can progress with increasing severity, provoking serious complications, such as status asthmaticus. In others, an attack can proceed in waves, alternating with remissions and exacerbations.

Diagnostics

To find out the causes of the disease, the patient is diagnosed with the clinical picture, which is manifested by respiratory failure. Palpation determines the enlargement of the liver (especially during pregnancy), which is explained by the displacement of the liver downward by the enlarged lungs. Diagnostics reveals the expansion of their boundaries, and during auscultation, a long prolonged exhalation and muffled tones of a different nature are heard.

During an attack, the diagnosis of cardiac activity determines an increase in heart rate, which is subsequently confirmed by laboratory test data. Diagnostics involves a blood test. If there is an increased number of eosinophils, then the mechanism of development of bronchial asthma has an allergic nature of development.

Diagnosis of acute respiratory failure is carried out using a peak flow meter, which determines the maximum expiratory flow rate. As a rule, the mechanism of development of an asthmatic attack is characterized by a triad (cough, shortness of breath, wheezing). In this case, the diagnosis is not difficult.

Determine the mechanism and stage of bronchial obstruction, its changes and the possibility of reversibility possible with the help of spirometry with subsequent assessment of the result before and after inhalation with beta-adrenergic agonists.

Symptoms

The mechanism of a bronchial attack is characterized by acute development, which leads to a deterioration in the general condition of the patient. As a rule, shortness of breath, cough, wheezing appear. These symptoms are manifested:

• a sudden attack or a gradual increase in symptoms. Between attacks, negative symptoms are practically absent, only sometimes auscultatory examinations reveal weak wheezing in the respiratory system;
• an attack of bronchial asthma is difficult to confuse with other conditions. With a sudden development, shortness of breath, loud wheezing and a dry, painful cough, accompanied by an attack of suffocation, appear almost instantly;

• The cough that occurs in asthma deserves special attention. It can be dry or wet. If emergency therapy is not provided at the initial stage of asthma development, symptoms progress dramatically, and shortness of breath can turn into asthmatic status;
• the patient feels increased weakness, headaches and cardiac abnormalities (heart rate reaches 140 beats. in 1 minute). Itching, frequent sneezing, and other secondary symptoms may occur;
• with an intractable (prolonged) attack, characteristic symptoms of increasing cyanosis, cough, and threadlike pulse may appear. They may indicate status asthmaticus (the most severe condition of the patient), with the development of which first aid is required in any form (inhalation, oral medications, injections), in order to avoid complications. To reduce suffocation, the patient takes the most comfortable position. This can slightly reduce the symptoms of the disease.

Stages of an attack of bronchial asthma

An asthmatic attack is characterized by three stages:

• Stage I of severity - a prolonged attack that does not respond to treatment with beta mimetics;
• II stage of severity - at this stage there is an auscultatory manifestation of "dumb" areas in the lungs;
• Stage III of severity is the most difficult stage when symptoms are difficult to treat. At the same time, there is a sharp drop in blood pressure and the development of a hypercapnic coma is possible.

Mortality from an asthmatic attack is very rare and, as a rule, its immediate causes depend on the possibility of complications. The most dangerous complications are considered to be acute asphyxia (as a result of blockage of the bronchial passages with sputum) and acute heart failure of moderate severity. In addition, increasing shortness of breath leads to the formation of carbon dioxide. Such consequences are extremely dangerous during pregnancy and in children, therefore, emergency medications are required to relieve the attack.

Seizure development in children

The algorithm for the development of bronchial manifestations in children, as well as in adults, involves the appearance of precursors before the onset of an attack. This condition can last from 2-3 hours to several days. At this time, the child is hyperexcitable, irritable, his sleep is disturbed.

The attack most often appears at night. The reasons for this lie in the increased activity of biological substances that provoke bronchial constriction, precisely at night. A severe nocturnal cough may appear, which is almost impossible to stop. At the peak of the cough, vomiting with viscous mucous sputum, liquid nasal discharge is possible. An increase in body temperature is often noted, as a result of which diagnosis is difficult.

As a rule, at the developmental stage, an attack can be stopped with inhalation of drugs (for better sputum discharge), after which the child becomes lethargic and inhibited. It should be borne in mind that in children under 3 years of age, the typical development of an attack occurs very rarely. As a rule, there is the appearance of a persistent, painful cough that disrupts the child's nighttime sleep.

Development of an attack during pregnancy

Symptomatic manifestations of asthma during pregnancy in predisposed categories of patients are practically no different from the usual ones, and do not depend on the forms of the course.

Initially, pre-asthma appears in the form of chronic development of bronchial diseases or pneumonia in conjunction with bronchospasm, but without an attack of suffocation. At an early stage of development, an attack occurs quite rarely, manifested by a dry cough. Further, the attack becomes more frequent at night, accompanied by a painful cough, rhinitis and a lack of oxygen. The escalation of a seizure during pregnancy can be rapid and unpredictable. In addition to coughing, expiratory shortness of breath joins, and then suffocation may occur.

The most dangerous complication (especially during pregnancy and childhood) is status asthmaticus. It occurs with an increase in the severity of symptoms and a prolonged attack of suffocation with abundant sputum production, which can provoke an increase in blood pressure. During pregnancy, this can negatively affect the placenta, provoking premature delivery. In addition, negative symptoms cause complications in the intrauterine development of the child. To avoid this, a woman during pregnancy should be regularly monitored by a doctor.

Emergency care (relief) of an attack

In case of an acute bronchial attack, it is necessary to do all the necessary measures to provide first aid to the patient before the arrival of the medical team.

• Emergency therapy is aimed at stopping an attack of bronchial asthma by any available methods. To stop the attack, you can do hot wraps (baths) on the limb area, you can apply a mustard plaster on the patient's feet;
• emergency treatment is to ensure maximum oxygen access. To do this, it is necessary to follow the algorithm of behavior: take off clothes that impede free breathing. In order to reduce shortness of breath, the patient is advised to take a comfortable position (standing, resting on a hard surface with his hands). Such actions contribute to the involvement of additional muscles in breathing;
• as a rule, every asthmatic person always has an inhaler with him, but not always during an attack a person is able to adequately assess his strength, so sometimes it is necessary to help him with inhalation in order to relieve an attack choking. If necessary, you can do inhalations instead of the patient, repeating them every 30 minutes.

It is important to remember that first aid only helps relieve symptoms for a short period of time, and completely neutralize them and an attack of cardiac asthma without professional medical assistance, impossible. Only a doctor is able to assess all the symptoms of the disease and decide how to treat the patient in order to prevent various complications of the disease.

Emergency medical assistance

Despite the fact that the first pre-medical therapy was carried out, the algorithm of measures provides that an ambulance must be called without fail. Emergency therapy may use the following drugs to neutralize an acute asthmatic attack.

Adrenalin

Allows you to relieve spasm of the respiratory muscles, and reduce the formation of mucus in the bronchi. Introduced s / c (0.1% - 0.7 ml). The effect occurs within 5-10 minutes after drug administration. If the attack does not stop and the symptoms increase, there is a risk of complication. In this case, the injection can be duplicated. Drugs in this group have side effects (increased heart rate, headache, tremors in extremities), therefore, such drugs can only be administered under the supervision of the attending physician. It should be remembered that Adrenaline cannot be used when the diagnosis is questionable, since, for example, an attack cardiac asthma, post-myocardial infarction and heart failure are contraindications for administration Adrenaline rush.

Ephedrine

This drug is prescribed to relieve an acute attack of coughing. Ephedrine has a shorter duration of action than Epinephrine (20-30 minutes). It is s / c in 1 ml of a 1% solution. Very often, the use of Ephedrine alone is not enough, therefore Adrenaline and Ephedrine are combined with 1% Atropine solution (0.5 ml), which allows you to get a more lasting result.

Euphyllin

This remedy is prescribed if asthma cannot be treated with other remedies. To relieve cough and suffocation, as a rule, emergency intervention is required, therefore, Euphyllin is administered intravenously and very slowly, since sometimes the patient may not adequately respond to this a drug. If an asthma attack of a mixed form does not go away, it is recommended to make a drug mixture that includes Euphyllin and cardiac glycosides.

Pipolfen

Quite often, the causes of the disease are allergic in nature. Therefore, in addition to anti-asthma drugs, antihistamines can be prescribed in order to more effectively relieve asthmatic symptoms. Pipolfen (2.5% and 0.5%) is administered intramuscularly and intravenously (slowly) when the allergic status increases.

No-shpa and Papaverine

Using a combination of these drugs is necessary to relax the muscles. Medicines are used in injections of a 2% solution (1: 1). If the use of antispasmodics did not help to stop acute symptoms, hospitalization of the patient is necessary to avoid complications.

Sometimes, to relieve suffocation, Pantopon is prescribed together with Atropine or Promedol. These funds are used very carefully, in the presence of the attending physician.

Important! You can not use morphine, since this drug is narcotic and can make breathing difficult (up to a complete stop) and increase the cough.

Complications

A long course of the disease, as well as incorrect diagnosis and treatment (especially during pregnancy) can lead to the development of the following complications:

• in the absence of prevention and treatment, status asthmaticus may occur;
• development of pneumosclerosis and emphysema is possible;
• the appearance of respiratory failure and bronchiectasis is often noted;
• an attack of cardiac asthma;
• as a rule, an attack is accompanied by dehydration, and with special severity, hypovolemia, acidosis and hypercapnia are possible.

The most severe is asthmatic status, which is accompanied by a violation of the outflow of bronchial contents. The status develops with a prolonged asthmatic attack, which is not relieved with inhalation and oral medications. Asthmatic status in children is easily determined. At the same time, shortness of breath, cyanosis, panic fear and tachycardia appear.

Status asthmaticus in children is treated by removing bronchospasm and maintaining vital body functions. The sequence of therapy depends on the severity of the condition. Often, pre-hospital emergency therapy, provided correctly, can save the patient's life.

Prevention

1. Prevention is about preventing an acute attack from developing by using inhalation rather than treating it. To do this, it is necessary to give up bad habits and, especially, from smoking, as even tobacco smoke can cause a severe attack, especially in a child.
2. Indoors should be damp cleaned regularly, as allergens (dust, houseplants and animals) have been proven to be the most common causes of asthma. Prevention involves getting rid of indoor flowers (especially geraniums) and limiting contact with animals.
3. Another preventive measure is diet. To protect the child, you should limit the diet of foods that cause an acute allergic attack. In addition, hardening procedures are recommended.

Folk remedies for relieving an attack

In some cases, folk remedies for coughs can be used at home. The following recipes are most often used to relieve cough and choking:

• a proven way to relieve an asthmatic attack is potato inhalation with the simultaneous use of hot lingonberry tea. The procedure is carried out as follows: when suffocation occurs, you should unbutton the tight clothes and, covering your head with a towel, inhale the vapors of potatoes boiled in a saucepan. Hot vapors expand the bronchi, providing maximum assistance to the patient. At the same time, it is recommended to take a hot decoction of lingonberry leaves or berries, using them to relieve bronchospasm;

• with an acute development of an attack, you can swallow several pieces of ice, sniff cotton wool soaked in ammonia, and also take mustard plasters and apply them to the calf area;
• a good expectorant and emollient effect of treatment with folk remedies is observed when the smoke is inhaled while burning the leaves of a dry coltsfoot. Their smoke helps to avoid further complications;
• in case of an acute attack, it is recommended to take a little baking soda to thin the sputum (at the tip of tsp. spoons) or drink 20 ml. sour dry wine;

• you can often find folk recipes with valerian tincture that relieve cough. To do this, you need to dilute 20 drops of the tincture in a glass of water and drink it during an attack.

It is important to note that each stage of the disease requires appropriate therapy. It is prescribed by a doctor, providing drugs for basic and symptomatic therapy. And, of course, the prevention of the development of the disease plays a huge role. It is important to note that folk recipes, as well as medicines, can be used only after prior consultation with a doctor, especially during pregnancy. This will avoid negative consequences.