Managing an Acute Asthma Attack

Asthma attacks will be less frightening and dangerous if you follow the "Asthma Action Plan" worked out with your doctor or asthma educator. Having a complete understanding of your medication is also important so that you can use the appropriate medication in the right quantity.

Keep a card in your wallet and by your telephone at home with your doctor's name and his telephone number. Also keep the ambulance or emergency number on the card.

Early Intervention

Early treatment demands fast detection of a worsening condition - ideally before a full-blown attack of symptoms takes place. Early detection is accomplished by recognising key symptoms that you have come to identify as heralding the onset of attacks.

What You Should Do in an Asthma Emergency:

Once you determine that you are in the early stages of an attack, begin treatment according to a predetermined "Asthma Action Plan". Your Asthma Action Plan should include:

1. Removing or reducing the exposure of any trigger that is contributing to the attack, if possible.
2. Beginning a predetermined medication routine already approved by your doctor. This most often will be an increase in asthma medications you are already taking.
3. Informing your doctor or seeking emergency care, whenever your asthma worsens to a certain degree of severity, according to criteria already agreed to.

These steps you should take when dealing with an Acute asthma attack:

Measuring Improvement:

When taking asthma medications, it is important that you start seeing an improvement quickly. Improvement can be measured in two ways:

1. How you feel: symptoms are less - breathing gets easier; chest tightness, cough and wheezing get better; you are able to undertake more and more physical activity without bringing on symptoms.
2. The Peak flow increases

• Remain Calm: asthma worsens with panic.
• Sit near open windows may make you feel less panicky.
• Try to slow your breathing as much as you can. Not only will this help you relax but also to conserve your strength.
• Sit in a position that you find comfortable. Do not lie down on your back.

Knowing when to seek emergency help can be a problem. If symptoms persist despite using reliever medication, urgent attention is needed. Twenty-five percent of deaths from acute asthma happen within one hour of the onset of the attack.

Take inhaled reliever medication. If you do not have your own, use someone else's. This is quite acceptable in an emergency. Wait five to ten minutes and if necessary take the reliever again. If the situation improves there is less urgency, so carefully monitor the situation to ensure that it doesn't unexpectedly begin again.

If the reliever does not help, take the situation very seriously. This is the most important sign of uncontrolled asthma. It means you can no longer handle the situation on your own and you need medical help. Call an ambulance.

While waiting for the ambulance to arrive, continue to give yourself treatment although the reliever may not seem to be working. The suggested dosage is 6-8 puffs every 5 minutes, but ideally, you should have discussed this dose with your doctor. At this stage, it may become difficult to actually inhale medication. A spacer can be used, simply breathing in and out as well as you can, putting one puff into the spacer at a time and shake the canister between each puff.

Makeshift spacers can be made out of a paper cup or plastic bottle. Make a hole at the bottom and push the aerosol mouthpiece through it. Aluminum foil fashioned into a cup or a plastic bottle can also be used. Place the cup over your mouth, and puff the inhaler. The asthmatic can then breathe normally and take the medication without further exertion.

Asthma Emergency Step by Step

1. Sit the person comfortably upright. Be calm and reassuring
2. Give 2 - 4 puffs of a blue Reliever inhaler (puffer) - Ventolin, Bricanyl, Respolin, etc.

* Use the person's own inhaler if possible. If not, borrow one from someone or use the First Aid kit inhaler
* Relievers are best given through a spacer, if available. Use 1 puff at a time and ask the person to take 4 breaths from the spacer after each puff

3. Wait 5 - 10 minutes. If there is no improvement, give 4 puffs.
4. If little or no improvement, CALL AN AMBULANCE IMMEDIATELY and state that  an asthma attack is occurring. Keep giving 4 puffs every 5 minutes until the ambulance arrives

* Children: 4 puffs each time is a safe dose.
* Adults: up to 6-8 puffs every 5 minutes may be given for a severe attack while waiting for the ambulance.