An attack of bronchial asthma is an exacerbation of a chronic disease, accompanied by difficulty breathing, dry cough, and in the final stages – complete blockage of inhalation. Patients suffering from allergic reactions get used to the constant danger of an attack and learn to respond in time to the first signs of such a condition. At the same time, a person experiencing an asthmatic attack for the first time may be taken by surprise by severe throat spasms and choking.
Everyone should have basic knowledge of the characteristics of acute asthma and methods of responding to emergency situations. If you suspect that someone close to you (or even yourself) suffers from regular attacks, be sure to read the information below, take steps to eliminate the danger, and then contact us for a full course of treatment.

Periodic attacks of coughing and choking with bronchial asthma are almost inevitable. The septum, which is responsible for allowing new portions of air into the lungs, closes in response to various irritants, and it becomes increasingly difficult to take each new breath. The result is oxygen intake with increasingly shorter breaths, prolonged coughing, turning into the inability to breathe. Doctors note the following reasons for the manifestation of acute conditions:

• Contact with an allergen. Sometimes a reaction occurs to a new source of allergy that the patient has not previously encountered. In other cases, the problem is the difficulty of limiting interaction with a dangerous component. Thus, asthma patients are well aware of the complications that arise in the spring, during the flowering period of most plants.
• Incorrectly selected medications or developed immunity to the prescribed drug. Over the years, the body can develop tolerance to the active substance that stops the allergic reaction. This is one of the common causes of asthma attacks in adults: it is time to change the drug, but it is impossible to recognize this need until breathing problems return.
• Acute respiratory tract diseases. An asthmatic reaction can develop in response to diseases that are not directly related to the bronchi, but increase the load on them or contribute to the aggravation of the internal inflammatory process. Comprehensive treatment is required - otherwise, it will continue to return.
• Physical overload of the body. The condition, characteristic of the manifestations of an attack of bronchial asthma, is typical for people who exercise excessively intensely. The greatest danger lies in running: if you don’t watch your pace and breathing, you may end up with a burning, dry cough and the inability to take a full breath for several minutes. But even during a strength training session with exercise machines, you can bring your body to the point of blocking your breathing. In both cases, you need to stop the exercise and try to relax the airways.
• Panic attacks, stress and other aspects. Heavy mental stress also causes breathing problems. If you or someone in your family is subject to constant stress, it is necessary not only to learn how to solve the problem with sedatives, but also to master proper breathing techniques. They are aimed at both restoring the respiratory rhythm and reducing stress load.

It is not always possible to immediately identify the cause of the complication. If the patient has predominantly nocturnal asthma, then it is most difficult for him to identify the triggering factors and tell the doctor about them. Additional examinations and laboratory tests will help identify the key factors causing the return of suffocation and promptly take action.

How to identify an asthmatic attack in the initial stage?

Knowing the signs of an asthma attack, you can easily identify this condition, even if it begins without visible provocation from the outside. Keep in mind that a person who has not previously suffered from severe bronchial diseases may begin to choke: the first attack has a chance to happen not only in childhood, but also in adulthood.

Symptoms of exacerbation of allergic asthma

As a rule, allergy sufferers are able to independently recognize their condition and cope with it. However, it is still better to know the main warning signs of choking, especially if you suspect an undiagnosed allergy in your own child:

• Intense coughing that continues for a long time. does not go away, the dry throat remains.
• The nose constantly “drips”: mucus leaves, washing away the dangerous allergen from the internal sinuses.
• Constant sore throat that does not disappear with rest (unlike a cold cough).
• The frequency of sneezing increases according to proximity to the allergen; the patient can sneeze up to 20-30 times per minute.
• The pre-attack state may be accompanied by a dull headache.

At this stage, the exacerbation should be stopped by taking anti-allergy drugs or promptly blocking contact with the allergen.

Symptoms of exacerbation of non-allergic asthma

Not all asthma attacks are accompanied by such obvious symptoms. If the condition is not related to an allergic reaction, then the signs will be less specific and therefore more invisible:

• Increased anxiety. The “aura” of anxiety that surrounds a person before an attack of shortness of breath or suffocation during bronchial asthma should be taken seriously: in this way, the body suggests the need for immediate protection from a health threat. In addition, such a condition indicates emotional overstrain - one of the most common factors in exacerbating asthma in people who do not suffer from allergies.
• Sharp weakness, feeling of fatigue. In the initial phase, the body still copes with regulating breathing on its own, but this load does not go unnoticed. The patient wants to leave everything and go into a state of rest - and this desire should be followed, especially if it is accompanied by dizziness.
• Dry cough. As with allergic forms of the disease, one of the most characteristic signs. You should not increase the dosage of anti-cold medications if you have already found them to be ineffective: consult a doctor to select medications that will help gently eliminate bronchial spasm.
• Sleep problems. Despite the general weakness and exhausted state, the patient is unable to sleep - he is disturbed by a painful cough, instantly disturbing his shallow sleep. As a rule, ARVI is not accompanied by such disorders, so their presence is a sure sign of the need for additional consultation with a doctor.

Even one or two warning signs are enough to speak with confidence about the imminence of an attack of bronchial asthma. The time from the initial to acute phase may vary, but in most cases does not exceed 3-5 minutes. If you start acting at this stage, you can completely stop the exacerbation “in the bud.” This is much simpler and more beneficial for the body than drug withdrawal from the later stages of an attack.

How does an asthma attack proceed?

Diagnosis of exacerbation is not difficult. Experts identify the following characteristic signs of an asthma attack:

• Increasing shortness of breath, turning into suffocation. In some cases, the acute phase is limited to this symptom and passes after breathing is restored. Shortness of breath can also block coughing, causing the attack to be prolonged, so this condition should be treated with extreme caution.
• Intense and frequent cough. If you can suppress the urge to cough on your own with a cold, then with asthma it is almost impossible to do this. Coughing occurs in “waves” with short breaks.
• The body is tilted forward, resting on a hard vertical or horizontal surface. This is the forced position of the patient during an acute attack of bronchial asthma, also known as the “forced position.” There is no need to straighten the patient: this position allows you to slightly reduce the load on the respiratory system and restore breathing. At the same time, sneezing, if there was any, intensifies: the body accelerates the elimination of allergens.

Other characteristic, although less noticeable, symptoms of an attack are a sharp increase in the degree of excitability and physical weakness. These signs accompany each other: despite the fact that the body feels exhausted, the psyche reacts excessively to stressful stimuli. This property complicates self-help, which is why asthmatic attacks occurring alone are considered the most dangerous. If you suffer from chronic bronchial diseases and often remain out of contact with your loved ones or your doctor, make sure that those around you are warned about your condition and the signs of an attack, as well as the measures that need to be taken.

The most dangerous stages

A mild asthma attack causes only minor inconvenience, and the patient retains the ability to speak without much difficulty, making it easy to explain the situation or request professional help. At the middle stage, it is no longer possible to speak in full sentences, and one should not count on spontaneous cessation of shortness of breath, but the patient can still formulate a request for help. If a person only “squeezes out” individual short words or says nothing at all between waves of coughing, then he is in one of the most dangerous stages:

• Heavy. It is characterized by a transition to a forced position, refusal to move, pronounced shortness of breath (up to 30 breaths per minute), and an almost complete inability to talk. At the same time, a state of panic develops, decreases (not always), and the heart rate rises sharply (up to 120 beats per minute). The auxiliary muscles unsuccessfully try to compensate for difficulty breathing, and bronchial spasm intensifies over time. Strong drugs in high doses (Dexamethasone, etc.) are immediately prescribed to prevent progression to the next stage.
• . The most dangerous condition that develops as a result of prolonged severe suffocation. An asthma attack completely blocks the functions of the speech apparatus and any physical activity. Consciousness becomes confused, a transition into a coma is possible. Respiratory movements are compensatory and uneven. The pulse drops to 60 beats per minute or less, while the condition remains the same, the costal spaces sink. Treatment at this stage requires promptness and great precision, therefore, after providing first aid measures (intense relaxants, adrenaline to restore heart rate and muscle activity, others depending on the condition), the patient is sent to the intensive care unit.

The danger can be fraught with both habitual “allergenic” and so-called nocturnal asthma. Even a hint of a transition to a severe stage should be enough to call an ambulance, especially if the patient has not previously encountered difficulty breathing. After neutralizing the threat to life and health, preventive treatment is selected.

First aid and prevention measures

If attacks occur to you at least several times a year, make sure in advance that your loved ones are familiar with the basics:

• Immediate use with medication if possible. If not, call an ambulance immediately.
• Elimination of clothing that prevents the free opening of the chest.
• Room ventilation. If possible, open all windows to maximize the flow of fresh air.
• Help in transitioning to the “forced position” that accompanies moderate and severe asthma attacks. This position is a natural reaction of the body, making it easier to restore breathing.
• Communication with the patient. You need to talk to a person suffering from suffocation: remind them of the need for deep and rhythmic breathing, and calm them down. Psychological support in the initial stages leads to the fact that the symptoms of an attack of bronchial asthma are neutralized with minimal participation of medications.
• If the ambulance team is delayed, restore respiratory function by warming up the feet. Hot water is drawn into a small container (for example, a basin), into which the patient’s legs are placed. Warming up helps to open the damper in the bronchi and restore breathing on your own.

If you already know too well how asthma attacks manifest themselves, then you also know that it is better to avoid such a condition if possible. Doctors give the following recommendations:

• Completion of a full medical course of basic therapy. Antiallergic and restorative drugs should be used even after adverse symptoms have passed.
• Timely treatment of diseases of the respiratory system (bronchitis, laryngitis, etc.)
• Eliminating or minimizing unfavorable factors (encounters with allergens, smoking, increased levels of household dust, etc.)
• Maintain moderation in physical activity. Mastering new complex exercises should be supervised by an instructor who can promptly assess breathing problems and correct the range of movements. The best solution would be to master the complex.

A smooth psycho-emotional background is also of considerable importance. People suffering from chronic bronchial diseases should avoid stressful situations, as they can provoke suffocation.

Conclusion

Now you know what an asthma attack is and how to behave if you or someone around you goes into such a state. According to statistics, 5% of people on Earth suffer from bronchial asthma. Are you one of them? How do you cope with attacks, and do your loved ones help you with this? Or maybe you have ever personally provided first aid to a person in such a situation? Share your experience in the comments.

is a chronic non-infectious inflammatory disease of the respiratory tract. An attack of bronchial asthma often develops after warning signs and is characterized by a short, sharp inhalation and a noisy, prolonged exhalation. It is usually accompanied by a cough with viscous sputum and loud wheezing. Diagnostic methods include assessment of spirometry data, peak flowmetry, allergy tests, clinical and immunological blood tests. The treatment uses aerosol beta-agonists, m-anticholinergics, ASIT; in severe forms of the disease, glucocorticosteroids are used.

ICD-10

J45 Asthma

General information

Over the past two decades, the incidence of bronchial asthma (BA) has increased, and today there are about 300 million asthmatics in the world. This is one of the most common chronic diseases, which affects all people, regardless of gender and age. The mortality rate among patients with bronchial asthma is quite high. The fact that in the last twenty years the incidence of bronchial asthma in children has been constantly increasing makes bronchial asthma not just a disease, but a social problem, against which maximum efforts are directed. Despite its complexity, bronchial asthma responds well to treatment, thanks to which stable and long-term remission can be achieved. Constant control over their condition allows patients to completely prevent the onset of asthma attacks, reduce or eliminate the use of drugs to relieve attacks, and also lead an active lifestyle. This helps maintain lung function and completely eliminate the risk of complications.

Reasons

The most dangerous provoking factors for the development of bronchial asthma are exogenous allergens, laboratory tests for which confirm a high level of sensitivity in patients with asthma and in individuals who are at risk. The most common allergens are household allergens - house and book dust, aquarium fish food and animal dander, plant allergens and food allergens, which are also called nutritional allergens. In 20-40% of patients with bronchial asthma, a similar reaction to medications is detected, and in 2% the disease was acquired as a result of working in hazardous industries or, for example, in perfume stores.

Infectious factors are also an important link in the etiopathogenesis of bronchial asthma, since microorganisms and their metabolic products can act as allergens, causing sensitization of the body. In addition, constant contact with infection maintains the inflammatory process of the bronchial tree in the active phase, which increases the body's sensitivity to exogenous allergens. The so-called hapten allergens, that is, allergens of non-protein structure, entering the human body and binding to its proteins also provoke allergic attacks and increase the likelihood of asthma. Factors such as hypothermia, family history and stressful conditions also occupy an important place in the etiology of bronchial asthma.

Pathogenesis

Chronic inflammatory processes in the respiratory organs lead to their hyperactivity, as a result of which, upon contact with allergens or irritants, bronchial obstruction immediately develops, which limits the speed of air flow and causes suffocation. Attacks of suffocation are observed with varying frequency, but even in the remission stage, the inflammatory process in the respiratory tract persists. The disruption of air flow in bronchial asthma is based on the following components: obstruction of the airways due to spasms of the smooth muscles of the bronchi or due to swelling of their mucous membrane; blockage of the bronchi with the secretion of the submucosal glands of the respiratory tract due to their hyperfunction; replacement of bronchial muscle tissue with connective tissue during a long course of the disease, which causes sclerotic changes in the bronchial wall.

The changes in the bronchi are based on sensitization of the body, when during immediate allergic reactions, occurring in the form of anaphylaxis, antibodies are produced, and when the allergen is encountered again, an instant release of histamine occurs, which leads to swelling of the bronchial mucosa and hypersecretion of the glands. Immune complex allergic reactions and delayed sensitivity reactions proceed similarly, but with less severe symptoms. An increased amount of calcium ions in human blood has recently also been considered as a predisposing factor, since excess calcium can provoke spasms, including spasms of the bronchial muscles.

A pathological examination of those who died during an attack of suffocation reveals complete or partial blockage of the bronchi with viscous thick mucus and emphysematous expansion of the lungs due to difficulty in exhaling. Tissue microscopy most often shows a similar picture - a thickened muscle layer, hypertrophied bronchial glands, infiltrative bronchial walls with desquamation of the epithelium.

Classification

Asthma is divided according to etiology, severity, level of control and other parameters. Based on their origin, they distinguish allergic (including occupational BA), non-allergic (including aspirin BA), unspecified, mixed bronchial asthma. Depending on the severity, the following forms of asthma are distinguished:

1. Intermittent(episodic). Symptoms occur less than once a week, exacerbations are rare and short.
2. Persistent(constant flow). Divided into 3 degrees:

• mild - symptoms occur from 1 time per week to 1 time per month
• average - frequency of attacks daily
• severe - symptoms persist almost constantly.

During the course of asthma, there are exacerbations and remission (unstable or stable). If it is possible to control attacks, asthma can be controlled, partially controlled and uncontrolled. A complete diagnosis of a patient with bronchial asthma includes all of the above characteristics. For example, “Bronchial asthma of non-allergic origin, intermittent, controlled, in the stage of stable remission.”

Symptoms of bronchial asthma

An attack of suffocation during bronchial asthma is divided into three periods: the period of precursors, the period of height and the period of reverse development. The period of precursors is most pronounced in patients with an infectious-allergic nature of asthma; it is manifested by vasomotor reactions from the organs of the nasopharynx (copious watery discharge, incessant sneezing). The second period (it can begin suddenly) is characterized by a feeling of tightness in the chest, which does not allow breathing freely. The inhalation becomes sharp and short, and the exhalation, on the contrary, becomes long and noisy. Breathing is accompanied by loud wheezing, a cough appears with viscous, difficult to expectorate sputum, which makes breathing arrhythmic.

During an attack, the patient’s position is forced; usually he tries to take a sitting position with the body tilted forward and find a fulcrum or rest his elbows on his knees. The face becomes puffy, and during exhalation the neck veins swell. Depending on the severity of the attack, you can observe the participation of muscles that help overcome resistance during exhalation. During the period of reverse development, gradual discharge of sputum begins, the amount of wheezing decreases, and the attack of suffocation gradually fades away.

Manifestations in which the presence of bronchial asthma can be suspected.

• high-pitched wheezing when exhaling, especially in children.
• repeated episodes of wheezing, difficulty breathing, chest tightness, and coughing that gets worse at night.
• seasonality of deterioration of health in the respiratory system
• presence of eczema, history of allergic diseases.
• worsening or occurrence of symptoms upon contact with allergens, taking medications, contact with smoke, sudden changes in ambient temperature, acute respiratory infections, physical activity and emotional stress.
• frequent colds that “descend” to the lower respiratory tract.
• improvement after taking antihistamines and antiasthmatic drugs.

Complications

Depending on the severity and intensity of asthma attacks, bronchial asthma can be complicated by pulmonary emphysema and the subsequent addition of secondary cardiopulmonary failure. An overdose of beta-adrenergic stimulants or a rapid reduction in the dosage of glucocorticosteroids, as well as contact with a massive dose of an allergen, can lead to status asthmaticus, when attacks of asthma come one after another and are almost impossible to stop. Status asthmaticus can be fatal.

Diagnostics

The diagnosis is usually made by a pulmonary clinician based on complaints and the presence of characteristic symptoms. All other research methods are aimed at establishing the severity and etiology of the disease. On percussion, the sound is clear and boxy due to hyperairiness of the lungs, the mobility of the lungs is sharply limited, and their boundaries are shifted downward. On auscultation, vesicular breathing is heard over the lungs, weakened with prolonged exhalation and with a large number of dry wheezing rales. Due to the increase in lung volume, the point of absolute dullness of the heart decreases, the heart sounds are muffled with an accent of the second tone above the pulmonary artery. Instrumental studies include:

• Spirometry. Spirography helps to assess the degree of bronchial obstruction, determine the variability and reversibility of obstruction, and also confirm the diagnosis. In asthma, forced exhalation after inhalation of a bronchodilator increases by 12% (200 ml) or more in 1 second. But to obtain more accurate information, spirometry should be performed several times.
• Peak flowmetry. Measuring peak expiratory activity (PEA) allows you to monitor the patient's condition by comparing the indicators with previously obtained ones. An increase in PEF after inhalation of a bronchodilator by 20% or more from PEF before inhalation clearly indicates the presence of bronchial asthma.

Additional diagnostics include allergen tests, ECG, bronchoscopy and chest x-ray. Laboratory blood tests are of great importance in confirming the allergic nature of bronchial asthma, as well as for monitoring the effectiveness of treatment.

• Blood test. Changes in the CBC - eosinophilia and a slight increase in ESR - are determined only during an exacerbation. Assessment of blood gas composition is necessary during an attack to assess the severity of DN. A biochemical blood test is not the main diagnostic method, since the changes are of a general nature and such studies are prescribed to monitor the patient’s condition during an exacerbation.
• General sputum analysis. Microscopy in sputum can reveal a large number of eosinophils, Charcot-Leyden crystals (brilliant transparent crystals formed after the destruction of eosinophils and shaped like rhombuses or octahedrons), Courshman spirals (formed due to small spastic contractions of the bronchi and look like casts of transparent mucus in the form spirals). Neutral leukocytes can be found in patients with infection-dependent bronchial asthma in the stage of active inflammatory process. The release of Creole bodies during an attack was also noted - these are round formations consisting of epithelial cells.
• Immune status study. In bronchial asthma, the number and activity of T-suppressors sharply decreases, and the amount of immunoglobulins in the blood increases. The use of tests to determine the amount of immunoglobulin E is important if allergy tests are not possible.

Treatment of bronchial asthma

Since bronchial asthma is a chronic disease, regardless of the frequency of attacks, the fundamental point in therapy is the exclusion of contact with possible allergens, adherence to elimination diets and rational employment. If the allergen can be identified, then specific hyposensitizing therapy helps reduce the body’s reaction to it.

To relieve asthma attacks, beta-agonists are used in aerosol form to quickly increase the lumen of the bronchi and improve the outflow of sputum. These are fenoterol hydrobromide, salbutamol, orciprenaline. The dose is selected individually in each case. Drugs from the group of m-anticholinergics - aerosols of ipratropium bromide and its combination with fenoterol - are also effective in stopping attacks.

Xanthine derivatives are very popular among patients with bronchial asthma. They are prescribed to prevent asthma attacks in the form of long-acting tablet forms. In the last few years, drugs that inhibit mast cell degranulation have shown positive effects in the treatment of asthma. These are ketotifen, sodium cromoglycate and calcium ion antagonists.

When treating severe forms of asthma, hormonal therapy is included; almost a quarter of patients need glucocorticosteroids; 15-20 mg of Prednisolone is taken in the morning along with antacid drugs that protect the gastric mucosa. In a hospital setting, hormonal medications can be prescribed by injection. The peculiarity of the treatment of bronchial asthma is that it is necessary to use drugs in the minimum effective dose and achieve an even greater reduction in dosage. For better sputum discharge, expectorant and mucolytic drugs are indicated.

Prognosis and prevention

The course of bronchial asthma consists of a series of exacerbations and remissions; with timely detection, a stable and long-term remission can be achieved, but the prognosis depends largely on how attentive the patient is to his health and follows the doctor’s instructions. Prevention of bronchial asthma is of great importance, which consists of sanitizing foci of chronic infection, combating smoking, as well as minimizing contact with allergens. This is especially important for people who are at risk or have a family history.

Table of contents

Bronchial asthma is a respiratory disease of an allergic nature, associated with increased sensitivity of the body to various substances of plant, animal, including microbial, or inorganic origin. An exacerbation of the disease is an attack of bronchial asthma. Symptoms and emergency care for this phenomenon are the topic of this article. What to do if you have an asthma attack and you can’t call a doctor?

An attack of bronchial asthma - symptoms of the phenomenon

An attack is an acute deterioration in the condition of a patient with asthma, manifested by shortness of breath, coughing, wheezing, requiring immediate drug therapy. An exacerbation of the disease is characterized by several sudden attacks or a gradual deterioration of the condition. During the interictal period, complaints usually do not arise; sometimes auscultation reveals small wheezing rales of the respiratory system.

As a rule, an attack of bronchial asthma occurs suddenly at any time of the day, more often at night: the patient wakes up with a feeling of tightness in the chest and acute lack of air. He is unable to push out the air filling his chest, and in order to enhance exhalation, he sits up in bed, resting his hands on it or on the knees of his lowered legs, or jumps up, opens the window and stands, leaning on the table, the back of a chair, thus turning on the act of breathing not only respiratory, but also the auxiliary muscles of the shoulder girdle and chest.

An attack of bronchial asthma is very difficult to confuse with anything; it occurs very quickly and violently. Literally within a few seconds, shortness of breath occurs, clearly audible wheezing in the lungs, and dry coughing attacks appear. A patient with symptoms of an attack feels tightness in the chest and finds it extremely difficult to exhale. They instinctively rest their hands on something in search of support and so that the muscles help the lungs breathe. One of the most suitable positions during an asthma attack is astride a chair facing the back.

An attack of bronchial asthma is characterized by:

cough with a small amount of clear (“glassy”) sputum;

whistling exhalation (short inhalation and long exhalation);

feeling of difficulty in exhaling;

increased breathing (up to 50 per minute and more often);

pain in the lower chest (especially during a prolonged attack);

wheezing in the respiratory system, which can be heard from a distance;

forced position (sitting, holding hands on the table);

There may also be a feeling of fatigue, irritability, anxiety, headache, palpitations (heart rate - 140 beats per minute or more), itching, sore throat, sneezing and other nonspecific symptoms.

Cough is the main attack of bronchial asthma. It may be dry or moist, producing varying amounts of mucous or purulent sputum.

If emergency assistance is not provided in the early stages of the attack, then the symptoms continue to progress: shortness of breath and cough, whistling and wheezing intensify, the voice, complexion, and behavior change.

Stages of an asthma attack and their symptoms

There are three stages of an attack of bronchial asthma, based on the following signs:

Stage I – prolonged attack of bronchial asthma with no effect from beta mimetics,

Stage II of a bronchial asthma attack – the appearance of “silent” zones during auscultation of the lungs,

Stage III of a bronchial asthma attack – hypercapnic coma, drop in blood pressure.

Mortality during an attack of bronchial asthma is a fraction of a percent. The immediate cause of death may be blockage of mucus or phlegm in the bronchi, leading to acute asphyxia; acute failure of the right heart and blood circulation in general; gradually increasing suffocation as a result of lack of oxygen, accumulation of carbon dioxide in the blood, causing overexcitation and decreased sensitivity of the respiratory center.

The development of these complications of an attack of bronchial asthma, the symptoms of which may include increasing cyanosis, the appearance of shallow breathing, weakening of breathing and a decrease in the amount of dry wheezing during auscultation, the appearance of a thread-like pulse, swelling of the neck veins, swelling and severe pain in the liver, is especially likely with prolonged (so-called intractable) attack, and even more so in an asthmatic state.

Diagnostic symptoms of an asthma attack

The clinical picture of an attack of bronchial asthma is very characteristic. The patient's face during an asthma attack is cyanotic, the veins are swollen. Already from a distance, whistling wheezing can be heard against the background of noisy, difficult exhalation. During an attack of bronchial asthma, the chest seems to freeze in the position of maximum inspiration, with raised ribs, an increased anteroposterior diameter, and bulging intercostal spaces.

When percussing the lungs during an attack of bronchial asthma, a box sound is determined, their boundaries are expanded, auscultation reveals a sharp prolongation of exhalation and extremely abundant varied (wheezing, rough and musical) wheezing. Listening to the heart is difficult due to emphysema and an abundance of wheezing. The pulse is of normal frequency or accelerated, full, usually relaxed, rhythmic. Blood pressure can be low or high. The apparent enlargement of the liver, sometimes revealed by palpation, can be explained (in the absence of congestion) by its being pushed down by the inflated right lung. Often patients are irritated, fear death, and groan; during severe attacks, the patient cannot utter several words in a row due to the need to take a breath. A short-term increase in temperature may occur. If the attack is accompanied by a cough, a small amount of viscous, mucous, glassy sputum is difficult to clear. Examination of blood and sputum during an attack of bronchial asthma reveals eosinophilia.

The course of attacks of bronchial asthma, even in the same patient, can be different: from “erased” (dry cough, wheezing with a relatively mild feeling of suffocation for the patient) and short-term (an attack lasts 10-15 minutes, after which it goes away on its own or after use dosed inhalations of beta-mimetics) to very severe and prolonged, turning into an asthmatic state.

The asthmatic condition lasts from several hours to many days. The attack does not stop, or the “light intervals”, when breathing becomes somewhat easier, are very short, and one attack follows another. The patient does not sleep, greets the new day sitting, exhausted, and without hope. Breathing remains noisy and whistling all the time, there is no sputum, and even if it is released, it does not bring relief. Beta-agonists, which previously quickly stopped the attack, do not work or provide a very short-term and insignificant improvement. Tachycardia (usually up to 150 beats per minute while maintaining the correct rhythm), red-bluish complexion, and skin covered with drops of sweat are noted.

Often during an attack of bronchial asthma there is an increase in blood pressure, which creates additional stress on the heart. The discrepancy between the obvious deterioration of the patient’s condition and auscultatory data is characteristic: when listening, a decrease or complete disappearance of wheezing is noted due to blockage of the small and medium bronchi with mucus plugs (“silent lungs”). Gradually, the patient weakens, breathing becomes shallow, less frequent, the feeling of suffocation becomes less painful, blood pressure decreases, and heart failure increases. There is a risk of developing a coma and respiratory arrest. Loss of consciousness may be preceded by the patient's agitation, stuporous state, and convulsions.

Clinical criteria for an asthmatic condition are, therefore, a rapid increase in bronchial obstruction, increasing respiratory failure and lack of effect from beta-mimetics.

The clinical picture of bronchial asthma with a characteristic triad of symptoms (breathing difficulties, cough, wheezing) usually does not create diagnostic difficulties.

Differential diagnosis of bronchial asthma

Differential diagnosis is carried out primarily with cardiac asthma. It is very important not to forget that the signs of bronchial asthma - wheezing against the background of noisy, difficult exhalation - can be a consequence of swelling and spasm of the bronchi that occurs against the background of acute coronary insufficiency, hypertensive crisis, etc., i.e. in cases where one can think about the occurrence of left ventricular failure and cardiac asthma, accompanied by spasm of the bronchi and swelling of their mucous membrane.

In chronic lung diseases, for example, chronic bronchitis, emphysema, pneumosclerosis and cor pulmonale, periods of sharp increase in shortness of breath often occur; they can be distinguished from an attack of bronchial asthma by the absence of clear signs of the latter (sudden onset, vigorous participation of auxiliary muscles in the expiratory phase, whistling, “musical” wheezing against the background of sharply difficult exhalation). In these cases, there is no eosinophilia in the blood and sputum.

Sometimes it may be necessary to differentiate an attack of bronchial asthma and the so-called stenotic shortness of breath, which occurs when there is scar narrowing of the larynx or bronchi, narrowing of their lumen due to compression from the outside by a tumor, aneurysm, or entry of a foreign body into the trachea or bronchi: such shortness of breath is inspiratory in nature (prolonged noisy inhalation, accompanied by retraction of the intercostal spaces, suprasternal and supraclavicular fossae), there is no acute emphysema and other characteristic symptoms of bronchial asthma. Finally, attacks of suffocation in nervous patients (“hysterical shortness of breath”) occur without orthopnea (patients can lie down), frequent shallow breathing is not accompanied by wheezing and sharply prolonged exhalation, the general condition of the patients remains satisfactory.

Bronchial asthma attack - emergency care

If there is shortness of breath, a patient with a disease of the respiratory system should be placed in a semi-sitting position, open a window or window, and free the chest from tight clothing and heavy blankets. If possible, use an oxygen cushion.

Cough and difficulty breathing, as well as chest pain, are relieved by applying cupping or mustard plasters, the use of which should be alternated.

For thick, difficult to expectorate sputum, you can recommend drinking warm alkaline mineral water or hot milk with soda (0.5 teaspoon of soda per glass of milk) or honey.

If there is abundant liquid sputum, a patient with bronchial asthma or other respiratory disease should be given less fluid, and also put in a position for 20–30 minutes, 2–3 times a day, in which a cough occurs and accumulated sputum is removed. Minor hemoptysis usually does not require any - emergency measures, but you need to inform your doctor about it.

In case of excessive hemoptysis or sudden pulmonary hemorrhage, you should immediately call an ambulance. To prevent the patient from suffocating and the spilled blood from entering the neighboring bronchi and areas of the lungs, before the doctor arrives, the patient must be laid on his stomach, the foot end of the bed raised by 40–60 cm, while the patient’s legs should be tied to the back headboard of the bed so that he does not slid down, you need to hold your head up.

With a significant increase in temperature, the patient may experience severe headache, anxiety, and even delirium. In this case, you should put an ice pack on your head and use cold compresses. In case of sudden chills, the patient should be covered and covered with heating pads. With a rapid decrease in temperature and increased sweating, it is necessary to change bed linen more often and give the patient strong, hot tea.

In children suffering from asthma, you can try to calm the attack by patting them on the back and reassuring them that everything is fine and that everything will pass soon - the main thing is not to panic.

How to provide emergency assistance to yourself during an attack of bronchial asthma?

If you or someone else is having an asthma attack, the first thing you need to do is try to calm down and normalize your breathing, trying to exhale as much air as possible from your lungs.

You need to provide yourself with a flow of fresh air.

After this, during an attack of bronchial asthma, immediately use a metered dose inhaler (it should always be at hand) with one of the bronchodilators, such as Salbutamol, Terbutaline. These medications help to quickly relieve an attack of suffocation by acting on the smooth muscles of the bronchi. Take two inhalations, wait, if the condition does not improve, repeat after 10 minutes. Increasing the dose may cause side effects due to overdose.

Also, intravenous aminophylline, an effective bronchodilator, is used to quickly relieve an attack of suffocation.

Emergency treatment for bronchial asthma can also be achieved with home remedies. Dilute baking soda in hot water (2-3 small spoons per glass) and add a couple of drops of iodine. Breathe over this solution and then take a few sips. If this method does not immediately help, then you should not continue. If there is no improvement, call an ambulance.

Emergency medication during an attack

During an attack of bronchial asthma, it is very important to take the medicine recommended by your doctor in a timely manner. When using inhaled medications, 1-2 inhalations are usually sufficient. Longer use of medication for bronchial asthma can be dangerous. If there is no effect, you should call a doctor.

If the attack does not occur for the first time and the patient is already receiving drug therapy against bronchial asthma, immediately take the drug (usually in the form of inhalations) in the dosage prescribed by the doctor to relieve the attack. After the condition improves, you can repeat taking the drug after 20 minutes. If such symptoms occur for the first time or the attack is severe, you must urgently go to the hospital or call an ambulance.

For mild attacks of bronchial asthma, drugs are prescribed in the form of tablets and inhalations of adrenergic agonists, such as Ephedrine, Euspiran, Alupent, Theophedrine and others. In the absence of such drugs, administer 0.5–1.0 ml of 5% ephedrine subcutaneously or 1 ml of 1% Diphenhydramine solution.

In case of a severe asthma attack, the drugs are administered parenterally. Adrenomimetic drugs are also indicated: Adrenaline – 0.2–0.5 ml of 0.1% solution subcutaneously with an interval of 40–50 minutes; Alupent – ​​1-2 ml of 0.05% solution subcutaneously or intramuscularly. Usually you cannot do without antihistamines intravenously or intramuscularly, such as Demidrol or Suprastin.

In addition, during emergency care during an asthma attack, humidified oxygen is inhaled, and for severe attacks, 50–100 mg of hydrocortisone is administered intravenously. The scope of emergency care for asthmatic patients outside an outpatient setting depends on the stage of asthma.

The pathogenesis of an attack of bronchial asthma determines the paramount importance of the use of emergency therapy to relieve bronchospasm. Graduality and consistency of this therapy are necessary. Often, patients themselves know which of the drugs, in what dose and with which method of administration help them and which do not, which makes the doctor’s task easier. In any case, while inhalation agents are effective, injections should not be resorted to.

Therapy during an attack of bronchial asthma begins with dosed inhalations of short-acting beta-agonists. The speed of action, relatively simple method of use and a small number of side effects make inhaled beta-agonists the drug of choice for relieving an attack of bronchial asthma. In emergency care of a patient with an attack of bronchial asthma, preference is given to selective beta-2-adrenergic agonists (the use of Berotek, Salbutamol is optimal, the use of non-selective drugs such as Ipradol and Astmopent is undesirable). The inhalation route of administration also increases the selectivity of the action of drugs on the bronchi, allowing for maximum therapeutic effect with a minimum of side effects. Tremor is the most common complication of metered dose aerosol therapy; agitation and tachycardia are rare. Rinsing the mouth after inhalation can further reduce the systemic effects of beta-agonists.

Emergency treatment for an asthma attack using an inhaler

In order for the patient to be able to independently stop mild attacks of bronchial asthma, he must be taught the correct technique for using the inhaler. Inhalation is best done while sitting or standing, tilting your head back slightly so that the upper respiratory tract straightens and the drug reaches the bronchi. After vigorous shaking, the inhaler should be turned upside down. The patient exhales deeply, clasps the mouthpiece tightly with his lips and, at the very beginning of the inhalation, presses the canister, after which he continues to inhale as deeply as possible. At the height of inhalation, you need to hold your breath for a few seconds (so that the medicine settles on the wall of the bronchus), then calmly exhale.

The patient should carry an inhaler with him at all times (similar to nitroglycerin for angina pectoris); Just a feeling of confidence and a reduction in fear of a possible attack of suffocation can significantly reduce the frequency of asthma attacks. In most cases, 1-2 doses of the drug are enough to stop an attack; the effect is observed after 5-15 minutes and lasts about 6 hours. If the first 2 breaths of the aerosol are ineffective, it is possible to inhale 1-2 doses of the drug again every 20 minutes until the condition improves or until side effects appear effects (usually no more than 3 times within an hour). It should be emphasized that short-acting beta-agonists are the drug of choice for the relief, but not for the prevention, of attacks of bronchial asthma - their frequent use can worsen the course of asthma.

What to do if you have an attack of bronchial asthma as a result of an anaphylactic reaction

If an asthmatic condition develops as part of an anaphylactic reaction (severe bronchospasm and asphyxia upon contact with an allergen), adrenaline becomes the drug of choice. Subcutaneous injection of a 0.1% solution of Adrenaline often stops an attack within a few minutes after the injection. At the same time, the use of adrenaline is fraught with the development of serious side effects, especially in elderly patients with atherosclerosis of the brain and heart vessels and organic myocardial damage, arterial hypertension, parkinsonism, hyperthyroidism, so only small doses should be administered with careful monitoring of the state of the cardiovascular system. Therapy begins with 0.2-0.3 ml of a 0.1% solution; if necessary, the injection is repeated after 15-20 minutes (up to three times). With repeated injections, it is important to change the injection site of the drug, since adrenaline causes local vascular contraction, which slows down its absorption.

It should be borne in mind that sometimes intradermal (lemon peel method) administration of Adrenaline as an emergency measure gives an effect in cases where the same dose of the drug administered subcutaneously did not bring relief. The possibility of a paradoxical increase in bronchospasm instead of the expected bronchodilator effect with frequent repeated administration of adrenaline limits its use in cases of prolonged intractable attack of bronchial asthma and asthmatic condition.

As an alternative to adrenergic agonists in case of their intolerance, especially in elderly patients, anticholinergic blockers - Ipratropium bromide (Atrovent) and Troventol - can be used in the form of metered aerosols. Their disadvantages are the later development of the therapeutic effect compared to beta-agonists and significantly lower bronchodilator activity; The advantage is the absence of side effects from the cardiovascular system. In addition, anticholinergic blockers and beta-agonists can be used in parallel; potentiation of the bronchodilator effect in this case is not accompanied by an increased risk of side effects. The combined drug Berodual contains 0.05 mg of Fenoterol and 0.02 mg of Ipratropium bromide in one dose.

The onset of action of the drug is 30 seconds, duration is 6 hours. In terms of effectiveness, Berodual is not inferior to Berotek, but in comparison with it contains a 4 times smaller dose of Fenoterol.

In case of a severe attack of bronchial asthma (when the edematous and obstructive mechanisms of obstruction prevail over the bronchospastic component), with the development of status asthmaticus, as well as in the absence of inhalation agents or the impossibility of their use (for example, the patient cannot be trained in the inhalation technique), the standard “ambulance” emergency medicine Eufillin remains a help. Typically, 10 ml of a 2.4% solution of the drug is diluted in 10-20 ml of isotonic sodium chloride solution and administered intravenously over 5 minutes.

During the administration of Eufillin, the patient's horizontal position is preferable. Rapid administration of the drug may be accompanied by side effects (palpitations, pain in the heart area, nausea, headache, dizziness, a sharp drop in blood pressure, convulsions), especially likely in elderly patients with severe atherosclerosis.

If there is an increased risk of side effects, Eufillin is administered intravenously - 10-20 ml of a 2.4% solution of the drug is diluted in 100-200 ml of isotonic sodium chloride solution; infusion rate – 30-50 drops per 1 minute. The average daily dose of aminophylline is 0.9 g, the maximum is 1.5-2 g. If the patient has previously received therapy with long-acting theophylline preparations (Retafil, Teopek, Theotard, etc.), the dose of aminophylline administered intravenously should be halved. The question of the advisability of using aminophylline after adequate therapy with inhaled beta-agonists (3 inhalations over 60 minutes) remains quite controversial; According to many researchers, the risk of developing side effects from such a combination of drugs exceeds the potential benefits of administering Eufillin.

What to do if an attack of bronchial asthma does not go away

In cases where the attack is prolonged, turns into an asthmatic state, and the above-described therapy is ineffective within 1 hour, further use of adrenergic agonists is contraindicated due to the possibility of paradoxical effects - “rebound” syndrome (increased bronchospasm due to functional blockade of beta-adrenergic receptors by metabolic products of adrenergic agonists) and “locking” syndrome (impaired drainage function of the lungs due to dilation of the vessels of the submucosal layer of the bronchi).

In such a situation, hormone therapy is necessary; The traditional regimen for relieving an attack of bronchial asthma is Prednisolone 90-120 mg intravenously in a stream or drip in 200 ml of isotonic sodium chloride solution or other corticosteroids (Hydrocortisone, Betamethasone) in an equivalent dose. Corticosteroids prevent or inhibit the activation and migration of inflammatory cells, reduce swelling of the bronchial wall, mucus production and increased vascular permeability, and increase the sensitivity of beta receptors of bronchial smooth muscle.

After the introduction of glucocorticoids, repeated use of aminophylline and beta-agonists can again become effective. The administration of corticosteroids is repeated, if necessary, every 4 hours; when treating status asthmaticus, there is no limit on the maximum dose for glucocorticosteroids. If there is no effect within 24 hours, oral hormones are added to the treatment of an attack of bronchial asthma at the rate of 30-45 mg of prednisolone in 1-2 doses (2/3 of the dose should be taken in the morning). After relief of status asthmaticus, the dose of corticosteroids can be reduced daily by 25%, the total duration of the course of hormone therapy is usually 3-7 days. If necessary, the patient is transferred to hormonal inhalers.

In order to combat hypoxemia, as well as to eliminate the patient's anxiety, oxygen therapy is performed. Humidified oxygen is supplied through nasal cannulas or through a mask at a rate of 2-6 l/min.

The issue of hospitalization is decided taking into account the general course of the disease and the patient’s condition during interictal periods. In case of an intractable attack and an asthmatic condition, the patient must be hospitalized immediately, since only in a hospital can the full scope of emergency care be applied, including, in especially severe cases, forced ventilation (transfer to mechanical breathing). The method of transportation (patient position, accompaniment) depends on the patient’s condition.

Causes and prevention of bronchial asthma attacks

An attack can be provoked by:

emotional stress;

tobacco smoke;

fur and epidermis of domestic animals;

respiratory diseases;

other allergens (plant pollen, food, specific odors, etc.).

Pathogenesis of the development of bronchial asthma attacks

In order to know how to properly stop an attack of bronchial asthma, you need to thoroughly study the information about this disease. Bronchial asthma is a chronic inflammatory disease of the airways, characterized by attacks of suffocation due to their obstruction. The pathogenesis of bronchial asthma is based on the complex interaction of inflammatory cells (eosinophils, mast cells), mediators and cells and tissues of the bronchi, caused by changes in the reactivity of the bronchi - primary (congenital or acquired under the influence of chemical, physical, mechanical factors and infection) or secondary (as a result of changes in the reactivity of the immune, endocrine and nervous systems). Today we will talk about what to do during an attack of bronchial asthma

In many patients, it is possible to identify heredity burdened by allergic diseases (atopy), a history of infectious or allergic pathology, and the presence of infectious-inflammatory processes during examination of the patient (i.e., the infectious-allergic nature of the disease is revealed). In cases where the allergic nature of the disease is not associated with an infectious process, aromatic compounds play a special role. Among this group of allergens are the odors of cosmetics, flowers, pollen, etc.

Often an attack of bronchial asthma is provoked by house dust (the main allergic component is house mites) and epidermal allergens (dander and animal hair). Cold, nervous stress, physical activity, and infection can also cause attacks of bronchial asthma. In patients with the “aspirin triad” (bronchial asthma, aspirin intolerance, nasal polyps), any non-steroidal anti-inflammatory drug (aspirin, analgin, indomethacin, voltaren, etc.) can cause a severe attack of suffocation.

An attack of suffocation in bronchial asthma is based on airway obstruction. The disruption of their patency is caused by spasm of the smooth muscles of the bronchi, edema and swelling of the bronchial mucosa, blockage of the small bronchi with secretions, which leads to impaired pulmonary ventilation and oxygen starvation. The immediate cause of an attack can be either direct exposure to allergens (contact with animals, inhalation of dust, exacerbation of the infectious process), or the influence of nonspecific factors - meteorological (cooling is a common cause), mental, etc.

Sometimes an attack is preceded by a bad mood, weakness, itching in the nose or along the front surface of the neck, congestion, soreness along the trachea, dry cough, sneezing, copious discharge of watery secretion from the nose, and a feeling of chest immobility. Sometimes an attack is provoked by emotional stress (crying, laughing, etc.).

How to prevent an attack of bronchial asthma?

To prevent attacks of bronchial asthma, the most important role is played by correct, systematic, ongoing treatment of the disease. The first-line drugs are inhaled forms of Cromolyn and Nedocromil sodium, beta-agonists and corticosteroids. Cromolyn sodium (Intal) and Nedocromil sodium (Tyled) suppress the activation of mast cells and the release of mediators from them. The drugs are used in the form of a dosed aerosol, 2 breaths 4 times a day.

Among inhaled beta-agonists during an attack of bronchial asthma, preference is given to long-acting drugs. Inhaled corticosteroids (Beclomethasone, Triamcinolone) are prescribed 2 puffs 4 times a day 5-10 minutes after the injection of beta-adrenergic agonists. After using inhaled corticosteroids, mouth rinse is necessary (prevention of oral candidiasis). Chronic oral corticosteroids are a “desperate therapy” and should only be used when frequent severe asthma attacks continue despite maximal therapy.

Long-term administration of hormones in tablets leads to osteoporosis, arterial hypertension, diabetes, cataracts, obesity and other complications. Long-acting theophylline preparations (Retafil, Teopek, etc.) are second-line drugs for the treatment and prevention of attacks of bronchial asthma.

These drugs are indicated in children and adults with severe manifestations of encephalopathy (when it is impossible to teach the patient how to use an inhaler), with severe shortness of breath (when it is impossible to take a deep breath), with severe exacerbation of the disease (when it is necessary to maintain a constant concentration of the drug in the blood).

At home, a patient with bronchial asthma needs particularly strict hygienic conditions. It is necessary to remove everything from his room that can cause allergies: pillows and feather beds made of feathers and down, flowers, cologne, perfume, eliminate kitchen odors, stop smoking. The room where the patient is located must be well ventilated, cleaned only with wet methods, and bed linen must be changed frequently. Breathing exercises are of great importance in the prevention of bronchial asthma attacks.

Monitoring a patient with bronchial asthma or other respiratory disease includes measuring temperature and determining respiratory rate and pulse, collecting and monitoring the nature of sputum, and in the presence of edema, measuring the amount of fluid drunk and urine excreted (daily diuresis).

Patients prone to attacks of bronchial asthma and other respiratory diseases must observe a hygienic regime. Sleep should be sufficient, nutrition varied and nutritious. Hygienic exercises, including breathing, are necessary. The simplest breathing exercises are to lengthen and intensify your inhalation. It is important to stop smoking, as it contributes to the development and aggravates the course of chronic lung diseases.

Bronchial asthma is a disease characterized by periodic exacerbations or attacks. An attack of bronchial asthma is a condition when the symptoms of the disease appear suddenly or intensify so much that the patient experiences severe lack of air, even to the point of suffocation.

What is asthma?

Bronchial asthma is a disease in which chronic, that is, constant, inflammation forms in the mucous membrane of the patient’s bronchi. The patient's airways become hyperreactive, that is, their reaction to any external irritation is significantly enhanced. Due to the latter, the patient periodically experiences episodes of wheezing, shortness of breath, coughing or chest tightness, especially at night or early in the morning. These symptoms should be attributed to common but variable airway obstruction. This means that the bronchi narrow in different sections to varying degrees, which is why symptoms of the disease arise. Symptoms characteristic of exacerbation of bronchial asthma may disappear spontaneously or after the use of medications.

There are a number of congenital and circumstantial characteristics that predispose a patient to the development of bronchial asthma. These include the following:

Atopy.
Atopy is the increased production of immunoglobulin E in response to contact with an allergen in the patient’s body. Immunoglobulin E triggers and actively participates in allergic reactions. Atopy is an important predisposing factor to the development of allergic or atopic asthma. Genetic predisposition to atopy or asthma itself.
The fact is that if one of the parents or both has been diagnosed with bronchial asthma, then the likelihood of their child getting sick is very high. A predisposition to atopy can also be inherited. Genetic predisposition to airway hyperresponsiveness.

How does an attack develop?

Pathogenesis is the main mechanism for the development of a disease or pathological process. The underlying pathogenesis of asthma is inflammation. It, in turn, begins in response to the influence of so-called triggers or specific irritants on the mucous membrane of the respiratory tract.

The most studied triggers are:

Household allergens and occupational sensitizing agents.
They are also called external allergens - these are dust, pieces of skin from pet hair, those volatile mixtures and substances that an asthmatic can inhale while working at work.
Infections.
In this case, viruses are of primary importance. For example, the influenza virus. Medicines.
The most common triggers for asthma are non-hormonal anti-inflammatory drugs, such as aspirin. Drugs such as non-selective beta blockers can also cause asthma symptoms. For example, propranolol. Aeropollutants.
This is the name for substances that, when inhaled, irritate the human respiratory tract. For example, household chemicals or odorous substances.

When triggers affect the lining of the respiratory tract, it becomes filled with blood. Specific cells accumulate in its microvessels, causing an inflammatory reaction.

The main ones among the latter should be considered the so-called mast cells. The granules of the mast cell contain mediator substances, such as histamine, leukotrienes, which act on the wall of the bronchi and cause the muscle cells in it to contract. This is the mechanism for the development of bronchospasm itself, that is, narrowing of the airway lumen.

In addition to mast cells, the inflammation mechanism is also carried out by other cells: white blood cells, macrophage cells and lymphocytes, which are called T-helpers.

Inflammation, in turn, further enhances the hyperreactivity of the bronchial mucosa. Thus, one mechanism for the development of an attack complements another mechanism: the vicious circle closes.

In addition, the pathogenesis of asthma can and usually does include an allergic component. In this case, in response to contact with the allergen, the level of immunoglobulin E in the patient’s blood sharply increases. Immunoglobulin E comes into contact with the mast cell and the antigenic, that is, foreign to the patient’s body, part of the allergen: a violent allergic inflammatory reaction begins.

The diagram shows granules with mediators in the mast cell, immunoglobulins E, which simultaneously come into contact with it and with an allergen site that is foreign to the patient’s body

An attack of the disease in its allergic form can develop very quickly.

Asthma symptoms are the final link that completes the pathogenesis of the disease. The mechanism for the development of wheezing is as follows: the small, terminal sections of the respiratory tract narrow to varying degrees and the air passing through them gives a characteristic whistling sound. The mechanism for the development of expiratory shortness of breath, that is, difficulty exhaling, is as follows: due to a lack of air, the force with which the patient tries to inhale increases, which leads to early closure of the respiratory sacs; their walls seem to touch, preventing the air stream from passing freely. The mechanism of cough development is as follows: the penetration of irritating substances into the respiratory tract and their effect on the bronchial mucosa leads to a protective reaction of pushing out these particles - a cough appears.

How to recognize an attack?

An attack of suffocation in bronchial asthma is a classic manifestation of the disease. Diagnosis of this attack, as a rule, does not cause difficulties. Usually the attack is preceded by symptoms of the disease, which manifest themselves quite mildly. The patient may have a cough, slight chest discomfort, and a general feeling that something is wrong. Also, a few days before an attack, an asthmatic may experience individual symptoms and signs indicating an imminent attack. These signs may include nasal congestion, frequent sneezing, and itchy eyes and nose. The patient may also become restless, irritable, depressed or scared: sudden changes in mood should also be noted.

The picture shows the difference between a healthy person and an asthmatic during an attack: a grayish tint of the skin, a barrel-shaped chest, frozen when inhaling, the lungs are full of air, additional breathing muscles are connected

When an exacerbation of the disease actually occurs, the patient experiences severe attacks of dry cough, which are difficult to interrupt.

His position is usually such that he rests his hands on the edge of a chair or bed: the patient uses this maneuver so that additional muscles begin to participate in breathing. The patient becomes agitated and has a frightened expression on his face. Speech is significantly difficult: a person can usually pronounce only individual words. The patient's condition is also characterized by pale skin. Sometimes the latter has a grayish tint. The wings of the nose swell, the chest seems to become frozen when inhaling, this position determines pathogenesis: the exhalation mechanism is disrupted.

Diagnosis by physical examination is as follows. If you percussion the chest, that is, tapping it, the sound over the entire surface will be similar to the sound of knocking on an empty box. That's what they call it - boxed. If you listen to the lungs, wheezing is usually clearly audible both during inhalation and during exhalation.

After the attack stops, more detailed diagnostics can be carried out. In a conversation with the patient, you can determine whether he inhaled, for example, allergens before the symptoms of the disease significantly intensified or arose. As a rule, an attack can only go away after treatment is applied to it. When the attack is over, the symptoms of the disease become milder. Coughing attacks are transformed into productive ones and pass with the release of very thick, viscous, transparent sputum, called “vitreous.”

The state of suffocation can last up to several hours or even last a whole day.

Night attacks usually occupy the attention of doctors. These happen between 2 and 6 am. They are called paroxysms of respiratory discomfort. If the night symptoms of the disease bother the patient, then there is a high probability that his treatment is insufficient or inadequate.

What to do during an attack?

If an attack does occur, you can immediately apply specific treatment. Such treatment should consist of expanding the narrowed bronchi. For this purpose, short-acting drugs that cause relaxation of muscle cells in the wall of the bronchi, such as salbutamol or fenoterol, are usually used.

This treatment will quickly reduce the symptoms of the disease. The mechanism of action of these drugs is to stimulate receptors sensitive to the mediator norepinephrine. This causes relaxation of the smooth muscle cells in the wall of the airways.

In addition, sometimes treatment may be based on theophylline preparations. However, they are less effective. It is also important that their mechanism of action is such that serious cardiac conduction disturbances can be caused.

If drug treatment during an attack of bronchial asthma is unavailable for some reason, the patient can still be helped. Non-drug treatment should primarily focus on reassuring the patient. We need to teach him to breathe correctly. Explain that you need to form your lips into a tube and slowly blow through them, as if through a straw, while exhaling.

In this case, the pathological mechanism of rapid collapse of the walls of the respiratory sacs and small bronchi will be interrupted. This will allow you to exhale more completely, followed by a slower, more complete inhalation. Symptoms of the disease will immediately begin to decrease.

It is also necessary to carry out such basic measures as opening the window, unbuttoning the patient’s shirt so that he has greater access to fresh air. Treatment may also include stimulation of the chest through massage. You can also immerse the patient's feet in hot water. This will also help relieve symptoms of the disease.

Periodic short-term, 6-8 second, breath holdings by the patient will have a positive effect on the course of the attack. This promotes the accumulation of carbon dioxide in the patient’s blood and dilation of the bronchi. The mechanism is as follows: due to the increase in carbon dioxide, the patient’s body switches to inhalation.

How is the disease complicated?

Exacerbation of bronchial asthma can lead to serious complications. The most common complications that arise are:

Respiratory failure.
Occurs due to lack of oxygen. Since during an attack the efficiency of inhalation is greatly reduced, oxygen does not reach the patient’s organs and tissues in the required quantity. Spontaneous pneumothorax.
Due to severe coughing and overfilling of the lung tissue with air, ruptures may occur. In this case, air accumulates between the lung and its membrane. This is called pneumothorax. This complication should be feared, as it is life-threatening.

The air compresses the lung

It must be diagnosed immediately. Signs: severe chest pain, accelerated increase in shortness of breath. Treatment is surgical.

Asthmatic status.
This is the name for prolonged severe suffocation, which cannot be stopped until intensive treatment is carried out. Atelectasis.
Collapse of areas of lung tissue when the bronchi ventilating them are blocked by dense casts of sputum. There is a decrease in lung tissue involved in ventilation. In this regard, the increase in hypoxia, that is, lack of oxygen, and the onset of respiratory failure, respectively, accelerate.

The above complications are acute, that is, they usually occur during an attack. There are also chronic complications of asthma that require attention. Chronic complications are those that arise over time and develop gradually.

Chronic complications:

emphysema or expansion of the air sacs in the lungs, pneumosclerosis, that is, the replacement of part of the lung tissue with connective, non-respiratory tissue.

The figure shows the difference between the alveoli or respiratory sacs in a healthy lung and in emphysema

All this leads to disruption of gas exchange, and therefore the patient eventually develops signs of respiratory failure.

Status asthmaticus

Status asthmaticus requires closer attention, since it is this complication that can result in death. Status asthmaticus is a very prolonged attack of suffocation. Its diagnosis is simple: if the patient becomes resistant to treatment, then most likely he has already developed status asthmaticus.

Status asthmaticus often develops quite slowly, however, with allergic asthma, status asthmaticus can develop very quickly. Therefore, it is impossible to delay treating the patient during an attack.

When status asthmaticus has just begun, the patient develops resistance to short-acting adrenergic agonists, for example, salbutamol. In response to them, the expansion of the airways no longer occurs. Later, when status asthmaticus passes into the so-called “silent lung” stage, the patient experiences a rapid increase in respiratory failure, and gas exchange in the lungs is greatly impaired. In the third stage, advanced status asthmaticus without intensive care measures can result in coma and death.

Preventive measures

To prevent asthma attacks from happening as often as possible, they can be prevented. First of all, for effective prevention it is necessary to try to exclude from the patient’s life all kinds of allergens to which he reacts. These can be household allergens, such as dust, animal hair, household chemicals, or avoid exposure to work, for example, if industrial pollutants also cause or intensify the symptoms of the disease, that is, they have a great influence on its pathogenesis.

To prevent bronchial asthma, you can also use various breathing exercises, as well as general strengthening physical exercises from a course of physical therapy.

It is important to remember that during the prevention of exacerbation of the disease, its complications are also prevented. After all, the most dangerous, like status asthmaticus, acute complications of the disease usually occur during an attack of bronchial asthma.

In order for asthma treatment to be partially replaced by conventional non-drug prevention of attacks, timely diagnosis of the disease is important. In order for such a diagnosis to be carried out, it is necessary to contact a medical institution if alarming signs and symptoms similar to those of bronchial asthma occur.

Video: Project “Tablet”, topic of discussion: “Bronchial asthma”

No one knows for sure what causes asthma. What is known for sure is that asthma is a chronic inflammatory disease of the airways. The causes of asthma symptoms may vary from person to person. One thing remains unchanged: when the airways come into contact with factors that provoke asthma, they become inflamed, narrowed and filled with mucus.

During an asthmatic attack, spasm of smooth muscles, inflammation and swelling of the mucous membrane of the airways and intense secretion of mucus leads to a narrowing of the airways. This increases the sensitivity of the bronchi and leads to difficulty breathing, causing shortness of breath, coughing, or a wheezing sound during breathing. A cough can be caused by irritation in the bronchi and the body’s desire to get rid of accumulated mucus.

So why do some people have asthma and others don't? Nobody knows for sure. It is known that allergies play a large role in the occurrence of the disease in many people, but not in all. Along with allergies, one of the factors is a hereditary predisposition to asthma (the genetic component in the development of the disease is large).

If you are prone to asthma, it is important to understand what may trigger it. By understanding what are the starting factors (triggers) of your disease, you can largely control it by avoiding contact with these factors and thus reducing the frequency of attacks. For example, if you find that allergens cause asthmatic attacks, then you have allergic asthma, and you will have to “hide” from the allergens.

Here are the most common triggers for asthma.

Allergy

Foods and food additives that trigger asthma

Although food allergens rarely cause asthma, they can trigger a severe, life-threatening condition. The most common foods associated with allergic reactions include:

• Cow's milk
• Peanut
• Wheat
• Shrimp and other crustaceans
• Salad and fresh fruit

Canned food can also cause asthma. Sulfite additives such as sodium bisulfite, potassium bisulfite, sodium pyrosulfite, potassium pyrosulfite and sodium sulfite are often used in canned foods and may be a cause of asthma in people prone to the disease.

Exercise asthma

Intense can cause the airways to narrow by up to 80% in people with asthma. For some people, exercise may be the main cause of asthma symptoms. With exercise asthma, the following symptoms appear: chest tightness, cough, difficulty breathing in the first 5-8 minutes of aerobic exercise. Usually these symptoms disappear after 20-30 minutes of exercise, but in more than half of the cases a second attack occurs after 6-10 hours.

Asthma and heartburn

Asthma and heartburn often go hand in hand. Recent studies have shown that approximately 89% of asthma sufferers also suffer from heartburn, known as gastroesophageal reflux. Gastroesophageal reflux most often occurs at night when a person is in a lying position. Normally, the valve between the esophagus and stomach prevents acid from flowing back into the esophagus from the stomach. With gastroesophageal reflux, valve function is impaired. There is a reverse release of acid from the stomach into the esophagus; if the acid enters the pharynx or respiratory tract, this leads to an asthmatic attack.

Reflux is one of the most common causes of asthma in adulthood, without a previous allergic history or susceptibility to bronchitis, hereditary predisposition, difficult-to-control asthma or cough while lying down.

Smoking and asthma

Smokers are more likely to develop asthma. If you smoke if you have asthma, it can worsen symptoms such as coughing or difficulty breathing. Women who smoke during pregnancy increase the risk of wheezing in their children. Children whose mothers smoked during pregnancy have worse lung function tests than those whose mothers did not smoke. The only way out for a smoker with asthma is to quit smoking.

Sinusitis and other upper respiratory tract infections

Just as inflammation of the lining of the airways causes asthma, sinusitis causes inflammation of the lining of the sinuses. This inflammation of the mucous membrane leads to increased secretion of mucus. When the sinuses are inflamed, the airways respond in a similar way to people with asthma. Proper treatment of sinusitis is necessary, including to relieve asthma symptoms.

For more details see Sinusitis and asthma

Infections and asthma

Colds, flu, bronchitis and sinusitis can trigger an asthma attack. These respiratory infections of viral or bacterial etiology are a common cause of asthma, especially in children under 10 years of age. Increased sensitivity of the airways and a tendency to narrow may continue for two months after recovery from the infection. It is estimated that 20 to 70% of asthma patients are prone to concomitant sinusitis. On the other hand, 15 to 56% of people with allergic rhinitis (hay fever) or sinusitis are likely to develop asthma.

Medicines and asthma

Many people with asthma are hypersensitive to aspirin and possibly also to other anti-inflammatory drugs, such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), ketoprofen (Orudis) and beta blockers (used for heart disease). , high blood pressure and glaucoma). If you know you are sensitive to these drugs, make sure your doctor records this information in your chart. We also recommend that you always consult your pharmacist about the possible effects of the drug.

Other causes of asthma

Irritants. Many irritants, including tobacco smoke, fire smoke, wood burning, strong perfume, cleaning products, etc., can trigger an asthma attack. In addition, an attack can be caused by air pollution, including air from the work area (in production), dust or fumes.

Weather. Cold air, changes in temperature and humidity can also trigger asthma.

Strong emotions. Stress and asthma are always close together. Anxiety, crying, screaming, stress, irritation or strong laughter can trigger an asthma attack.

How do these factors provoke an attack?

In people with asthma, the airways are always inflamed and very sensitive, so they easily react to various external factors. Contact with these factors causes asthma symptoms to appear, the mucus blocks the airways and as a result the symptoms worsen. An asthma attack can occur immediately after exposure to triggers or several days or weeks later.

There are many such factors. The reaction to them is individual for each person and can vary from attack to attack. Certain factors may only cause inflammation in some people, but may be harmless for others. Some people may have several causes of asthma, while others cannot identify any. Identifying and avoiding exposure to asthma triggers, whenever possible, is an important step in controlling asthma. Always remember that the best way to do this is to treat with anti-asthma drugs on time.

How to understand which factors cause asthma?

Assess what factors are present when asthmatic symptoms appear. This will be the first step in establishing the cause. Although the reasons are varied, you may not respond to all of them. Some react to only one factor, others to several at once.

Many factors can be determined by taking your medical history or performing an allergy skin test or

An attack of bronchial asthma in sick children and adults develops with increased sensitivity of the bronchi to various allergens, and some patients know what exactly they are allergic to. Upon contact with allergens, bronchospasm occurs, which prevents the normal passage of air into the pulmonary system. Bronchial spasm in bronchial asthma is manifested by difficulty in exiting, severe coughing and the development of an attack of suffocation.

An asthma attack will not go away on its own at home. The disease must be treated using all possible dosage forms, including inhalations, in order to prevent suffocation.

Today we will look at an attack of bronchial asthma, its symptoms, emergency care in case of an attack of suffocation, how and how to relieve an attack (its relief) in a child and an adult at home.

Reasons for the development of an attack of suffocation. Why is the patient suffocating?

The most common causes of development may be smoking (passive and active); asthma can also be triggered by household chemicals and medications that require immediate treatment.

It must 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, so timely first aid is important.

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

The triggering mechanism of external irritants (pollen, dust, foods, medications, painkillers, etc.) directly depends on the severity of asthma and the susceptibility of the patient’s immune system. In addition, some viruses and bacteria are external irritating factors, which, in combination with heredity, can trigger the mechanism of asthma and provoke a new attack.

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

Signs of bronchial asthma

To find out the causes of the disease, the patient is diagnosed with a clinical picture that manifests itself as respiratory failure. Palpation determines the enlargement of the liver (especially during pregnancy), which is explained by the displacement of the liver downwards by the enlarged lungs. Diagnostics reveals an expansion of their boundaries, and upon auscultation, a long, prolonged exhalation and dull 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. Diagnosis involves a blood test. If an increased number of eosinophils is observed, then the mechanism of development of bronchial asthma is of an allergic nature.

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, diagnosis is not difficult.

It is possible to determine the mechanism and stage of bronchial obstruction, its changes and the possibility of reversibility using spirometry with subsequent assessment of the result before and after inhalation with beta-agonists.

Symptoms of an asthma attack

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, and wheezing appear. These symptoms appear:

1. a sudden attack or a gradual increase in symptoms. Between attacks, there are practically no negative symptoms, only sometimes auscultatory examinations reveal mild wheezing in the respiratory system;
2. An attack of bronchial asthma is quite difficult to confuse with other conditions. With a sudden development, shortness of breath, loud wheezing and a dry, painful cough appear almost instantly, accompanied by an attack of suffocation;
3. The cough that occurs with asthma deserves special attention. It can be dry and wet. If emergency treatment is not provided at the initial stage of asthma development, symptoms progress sharply, and shortness of breath may develop into asthmatic status;
4. the patient feels increased weakness, headaches and cardiac dysfunction (heart rate reaches 140 beats per minute). Itchy skin, frequent sneezing and other secondary symptoms may occur;
5. with an intractable (protracted) attack, characteristic symptoms of increasing cyanosis, cough, and thready pulse may appear. They may indicate status asthmaticus (the most severe condition of the patient), the development of which requires first aid in any form (inhalations, oral medications, injections) to avoid complications. To reduce suffocation, the patient takes the most comfortable position. This allows you to slightly reduce the symptoms of the disease.

Stages of an asthma attack

An asthma attack is characterized by three stages:

1. Stage I severity - a protracted attack that cannot be treated with beta mimetics;
2. Stage II of severity - at this stage there is an auscultatory manifestation of “silent” areas in the lungs;
3. Stage III severity is the most complex degree, when symptoms are difficult to treat. In this case, there is a sharp drop in blood pressure and the development of hypercapnic coma is possible.

Mortality from an asthma 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 tract with sputum) and moderate acute heart failure. In addition, increasing shortness of breath leads to the formation of carbon dioxide. Such consequences are extremely dangerous during pregnancy and in children, so 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, assumes 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, and has disturbed sleep.

The attack most often occurs at night. The reasons for this are the increased activity of biological substances that provoke constriction of the bronchi, specifically at night. A severe night cough may occur that is almost impossible to stop. At the peak of the cough, vomiting with viscous mucous sputum and runny nasal discharge may occur. An increase in body temperature is often noted, making diagnosis difficult.

As a rule, at the developmental stage, an attack can be stopped with the help of inhaled medications (for better sputum discharge), after which the child becomes lethargic and lethargic. It must be taken into account 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 night 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 combination with bronchospasm, but without an attack of suffocation. At an early stage of development, an attack occurs quite rarely, manifesting itself as a dry cough.

Further, the attack becomes more frequent at night, and is accompanied by a painful cough, rhinitis and lack of oxygen. The progression of an attack during pregnancy can be rapid and unpredictable. In addition to coughing, expiratory shortness of breath occurs, and then suffocation may occur.

The most dangerous complication (especially during pregnancy and childhood) is status asthmaticus. It occurs with increasing severity of symptoms and a prolonged attack of suffocation with copious sputum production, which can provoke an increase in blood pressure.

During pregnancy, this can negatively affect the placenta, causing premature delivery. In addition, negative symptoms cause complications in the intrauterine development of the child. To avoid this, a woman should be regularly monitored by a doctor during pregnancy.

Emergency assistance – relief of – attack

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

1. Emergency therapy is aimed at stopping an attack of bronchial asthma using any available methods. To stop the attack, you can apply hot wraps (baths) to the extremities, you can apply mustard plaster to the patient’s feet;
2. Emergency therapy is to ensure maximum oxygen availability. To do this, you must follow the algorithm of behavior: remove clothes that interfere with free breathing. In order to reduce shortness of breath, the patient is recommended to take a comfortable position (standing, leaning on a hard surface with his hands). Such actions promote the involvement of additional muscles in breathing;
3. As a rule, every asthmatic always has an inhaler with him, but during an attack a person is not always able to adequately assess his strength, so sometimes it is necessary to help him with inhalation in order to relieve an attack of suffocation. If necessary, you can do inhalations together with the patient, repeating them every 30 minutes.

It is important to remember that first aid only helps to relieve symptoms for a short period of time, and it is impossible to completely neutralize them and an attack of cardiac asthma without professional medical help.

Only a doctor is able to assess all the symptoms of the disease and make a decision on how to treat the patient in order to prevent various complications of the disease.

Emergency medical care

Despite the fact that the first pre-medical therapy was carried out, the algorithm of measures stipulates that an ambulance must be called. Emergency treatment 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. Injected subcutaneously (0.1% - 0.7 ml). The effect occurs within 5-10 minutes after administration of the drug. If the attack does not stop and the symptoms increase, there is a risk of complications. In this case, the injection can be duplicated. Drugs in this group have side effects (increased heart rate, headache, tremors in the limbs), so such drugs can only be administered under the supervision of a physician. It should be remembered that Adrenaline cannot be used when the diagnosis is questionable, since, for example, an attack of cardiac asthma, post-infarction condition and heart failure are contraindications for the administration of Adrenaline.

Ephedrine. This drug is prescribed to relieve an acute attack of cough. Ephedrine has a shorter period of action compared to Adrenaline (20-30 minutes). 1 ml of 1% solution is administered subcutaneously. Very often, the use of Ephedrine alone is not enough, so Adrenaline and Ephedrine are combined with a 1% solution of Atropine (0.5 ml), which allows for a more lasting result.

Eufillin. This remedy is prescribed if asthma cannot be eliminated by other means. To relieve coughing and choking, as a rule, emergency intervention is required, so Eufillin is administered intravenously and very slowly, since sometimes the patient may react inadequately to this drug. If a mixed form of asthma attack does not go away, it is recommended to take a medicinal mixture that includes Euphyllin and cardiac glycosides.

Pipolfen. Quite often, the causes of the disease are allergic in nature. Therefore, in addition to anti-asthmatic 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 medications is necessary to relax the muscles. Medicines are used in injections of a 2% solution (1:1). If the use of antispasmodics does not help relieve acute symptoms, hospitalization of the patient is necessary to avoid complications.

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

Important! Morphine should not be used, as this drug is a narcotic and can make breathing difficult (even to a complete stop) and increase coughing.

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:

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

The most severe is status asthmaticus, which is accompanied by impaired outflow of bronchial contents. The status develops with a prolonged asthmatic attack, which is not relieved by inhalation and oral medications. Asthmatic status in children is determined quite easily. In this case, shortness of breath, cyanosis, panic and tachycardia appear.

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

Prevention

Prevention consists of preventing the development of an acute attack, using primarily inhalations, rather than treating it. To do this, you need to give up bad habits and, especially, smoking, as even tobacco smoke can cause a severe attack, especially in a child.

It is necessary to regularly carry out wet cleaning of premises, since it has been proven that allergens (dust, indoor plants and animals) are the most common causes of asthma. Prevention involves getting rid of indoor flowers (especially geraniums) and limiting contact with animals.

Another preventative measure is diet. To protect the child, you should limit your diet to foods that cause an acute allergic attack. In addition, it is recommended to carry out hardening procedures.

Folk remedies for relieving an attack

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

1. A proven way to relieve an asthmatic attack is potato inhalation while drinking hot lingonberry tea. The procedure is carried out as follows: if suffocation occurs, you should unbutton tight clothing and, covering your head with a towel, inhale the vapors of potatoes boiling in a pan. Hot vapors dilate 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;
2. during the 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;
3. a good expectorant and softening effect of treatment with folk remedies is observed when inhaling smoke while burning the leaves of dry coltsfoot. Their smoke helps avoid further complications;
4. during an acute attack, to thin the sputum, it is recommended to take a little baking soda (on the tip of a teaspoon) 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 tincture in a glass of water and drink during an attack.

It is important to note that each stage of the disease requires appropriate therapy. It is prescribed by a doctor, providing basic and symptomatic therapy. And, of course, preventing the development of the disease plays a huge role.

It is important to note that folk recipes, as well as medicines, can only be used after prior consultation with a doctor, especially during pregnancy. This will avoid negative consequences.

Video: First aid for a choking attack

Health-saving channel, video content:

1. The disease is bronchial asthma.
2. Causes of bronchial asthma.
3. Symptoms of bronchial asthma.
4. An attack of suffocation in bronchial asthma.
5. First aid for bronchial asthma.

Presenter: Irina Lisitsyna. Practicing doctor of the 1st category: Anna Maslennikova

Information for reference. It is necessary to consult a specialist.

Asthmatic status: what to do, how to stop an attack

On the video channel "kostyaisaru".

Status asthmaticus is the most terrible complication of bronchial asthma, which has three stages of development.

My contact details:

1. Skype: ya_konstantin.

Publication source: http://allergiyanet.ru/zabolevaniya/astma/pristup-bronchialnoj-astmy.html