Asthma Attack

An asthma attack is an episode of shortness of breath that requires treatment or medical intervention to restore normal breathing. At the time of the attack, the muscles around the bronchial tubes in the lungs are contracting and closing off the air passage that allows the movement of oxygen into and out of the lungs. The initial onset of an asthma attack allows an adequate amount of oxygen into the lungs but prevents carbon dioxide from leaving the lungs. In a prolonged attack, carbon dioxide builds up in the lungs and eventually the amount of oxygen decreases.

diagram of an asthma attackUnder-diagnosis and misdiagnosis of asthma in today’s U.S. adult population remains at an alarmingly high level. This applies particularly to elderly sufferers, where adult asthma symptoms are often mistaken as the symptoms of other diseases associated with cardiac (heart), pulmonary (lung) and bronchial conditions.

Warning Signs of an Asthma Attack

For some individuals the only symptom of asthma may be a persistent cough easily mistaken for a cold symptom. But a persistent dry cough may be the first warning sign that the bronchial tubes are reacting to allergens or other factors.

Wheezing: Wheezing is another common symptom of asthma. This whistling sound is created as the bronchial tube constricts. If the larger bronchial tubes at the top part of the lung constrict, the wheezing can be heard without a stethoscope. Audible wheezing can also be heard in later stages of an asthma attack. Many asthmatics will have wheezing that can only be heard with a stethoscope. Wheezes can occur in any or all of the bronchial tubes.

Production of Sputum: Inflammation of the mucous membranes in the bronchial tubes leads to the production of mucus or sputum. Sputum production is the body’s natural way of ridding itself of the offending allergen. Unfortunately, sputum production can add insult to injury during an asthma attack. The already wheezing bronchial tubes can become clogged with mucus and make it even harder to breathe.

Advanced Stages of an Asthma Attack

As the attack progresses other symptoms of asthma are set in motion. The respiratory rate increases and the heart beats more rapidly to meet the greater demands for oxygen throughout the body. Wheezing becomes tight and airflow limited. The asthmatic will use neck muscles and the muscles between the ribcage to assist their breathing. If left untreated the asthmatic eventually becomes exhausted and can stop breathing altogether.

Warning! This development is dangerous. Immediate medical intervention is necessary.

What to Do For Someone Having an Asthma Attack

The best and first way to respond to someone having an asthma attack is to remain calm. Anyone who has difficulty breathing already has an increased level of anxiety. They need to know that they will be able to breathe normally again. Here are some simple steps that you can take while you are waiting for treatment.

  • Encourage the asthmatic to find a comfortable position. The most common position is sitting upright at the edge of a bed or couch with a table to lean on.
  • Assure the asthmatic that they will be fine. Tell them to think only of their breathing. Sometimes, breathing with them in a rhythmic fashion allows them to focus better.
  • Employ a technique known as pursed lip breathing. Patients with lung disease as well as runners use this breathing technique. Encourage the asthmatic to inhale as normal but to actively “blow” out the air through pursed lips on exhalation. The most common cause of shortness of breath is the inability to blow off carbon dioxide through the wheezing bronchial tube. By blowing the air out, the bronchial tubes are stretched and able to expel carbon dioxide.

When Is Asthma Not Just Asthma?

For some people, allergens like foods, chemicals or medications can cause a serious condition known as anaphylactic shock. Anaphylactic shock is a massive allergic response that affects the whole body. When a large number of the body’s mast cells release histamine and other substances into the blood stream, the respiratory tract can be severely compromised. Blood flow to major organs is also compromised. Anaphylactic shock is a medical emergency and requires prompt treatment.

Symptoms of anaphylactic shock include:

  • severe asthmatic wheezing
  • rapid heartbeat and shortness of breath
  • flushes
  • swelling of the throat
  • hives
  • vomiting and nausea
  • chest tightness
  • cramps
  • drop in blood pressure.

IMPORTANT!

Anyone suffering from anaphylactic shock is seriously ill and needs IMMEDIATE medical treatment. The condition is life threatening and may lead to cardiac arrest.

Treatment for Anaphylactic Shock: Treatment usually consists of intravenous epinephrine (adrenalin). In certain cases, antihistamines and steroids are also administered. Aminophylline (a respiratory stimulant and bronchodilator) is used occasionally in situations where the patient fails to respond to epinephrine. Anyone at risk of anaphylactic shock should carry a pre-loaded adrenaline syringe (often referred to by the brand names Ana-Guard® or Epipen®).

Resources

American Lung Association. (2002, March). Asthma attacks.

Foundation for Better Health Care. (nd). Asthma.

Gislason, S.J. (nd). Anaphylaxis and asthma.