My husband has asthma and uses an inhaler to stabilize his condition, but he occasionally experiences acute exacerbations during seasonal changes. How can we recognize an asthma attack and how should we manage it? (Ngoc Minh, 25 years old, Ha Nam )
Reply
Asthma is a chronic inflammatory disease of the bronchial mucosa, with many easily observable symptoms such as poor adaptation to cold weather, persistent cough, especially at night, increased susceptibility to allergies, shortness of breath, wheezing, constant fatigue during physical activity, and chest tightness. Acute asthma attacks manifest as increased shortness of breath, coughing, chest tightness, and decreased lung ventilation function.
Symptoms of an asthma attack often include itchy nose, itchy throat, sneezing, coughing, watery eyes, runny nose, itchy or red eyes, and drowsiness. If your husband exhibits these symptoms, observe and quickly identify the source of irritation (pollen, animal dander, allergenic foods, etc.) and isolate him from it. At the same time, he should be kept warm, avoid air conditioning or humidifying fans, and be placed on a raised platform (in bed) to facilitate breathing. Do not massage or rub his chest as this can easily affect the airways and worsen the asthma attack.
In mild to moderate asthma, patients exhibit symptoms such as speaking in short bursts, preferring to sit rather than lie down, being less agitated, having an increased respiratory rate, not using accessory respiratory muscles, a heart rate of approximately 100-120 beats per minute, and an SpO2 of 90-95%. At this stage, patients should use their inhaler twice a day, up to three times, with 20-minute intervals between each inhalation if acute asthma symptoms do not subside.
When a patient speaks in single words, hunches forward, is agitated, has a respiratory rate exceeding 30 breaths per minute, exhibits accessory respiratory muscle contraction, has a heart rate exceeding 120 beats per minute, and an SpO2 below 90%, the condition is considered severe. The patient needs immediate rescue inhaler administration and should be taken to the nearest hospital for medical intervention.
During a severe asthma attack, the patient feels drowsy, their body turns blue, and they are unable to speak. At this time, the family needs to call an ambulance immediately, and while waiting for the ambulance, they should immediately use two puffs of their asthma relief inhaler.
Asthma attacks can be rapid and dangerous. Therefore, the best approach is to adhere to treatment and attend regular check-ups to proactively prevent recurrent acute asthma attacks. Patients should quit smoking and avoid passive exposure to secondhand smoke, and practice gentle breathing exercises. They should adopt a diet rich in fresh fruits and vegetables and avoid foods that may cause allergies. Patients should manage their emotions, limiting loud laughter, crying, anger, or uncontrollable fear.
Additionally, to boost his respiratory immunity, your husband should get a flu vaccine once a year, as well as a pneumococcal vaccine and a pertussis vaccine (if he hasn't already).
MSc. Dr. Le Thi Hong Tham
Department of Respiratory Medicine, Tam Anh General Hospital , Hanoi
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