What is Asthma?

It is estimated that at least 2 million Australians have asthma. Up to 16% of children are estimated to have asthma in Australia. The majority of people with asthma do not have an action plan and many do not carry their reliever medication with them. People with asthma have very sensitive airways. An asthma attack is caused by spasms or narrowing of the bronchioles (air passages) in the lungs.  

During an episode, air passages become narrowed by muscle spasms, swelling of mucous membranes and increased mucous production. Although the exact cause of asthma is still unknown, exposure to certain toxins, such as smoking during pregnancy is linked with the condition. 

Main Factors that can Cause Airways to Narrow 

Muscle Spasm: 

• The layer of muscle surrounding each bronchiole constricts or tightens, causing the air passage to become narrower 

Inflammation: 

• The lining of each passage, being very sensitive, becomes inflamed and swollen 

Excess Mucus: 

• More than usual amounts of mucus are produced in each bronchiole that contributing to the narrowing of the airways 

The above may cause coughing (varied), wheezy breathing (not always), tiredness, difficulty speaking, chest tightness, and shortness of breath or rapid breathing. The casualty may become very distressed because of difficulty in breathing. 

Every person’s asthma is different, and not everyone will have the same triggers. 

Triggers can include: 

• Viral respiratory infections  
• Exposure to known allergens, eg: dust mites, pollens, animal dander, moulds  
• Exposure to chemicals or other occupational sensitisers  
• Exposure to irritants, eg: cigarette smoke, bush fires, perfume  
• Reflux 
• Drugs, eg: aspirin, ibuprofen and beta-blockers  
• Foods, eg: nuts, seafood  
• Food additives – sulphite preservatives, colourings, metabisulphite, monosodium glutamate (msg)  
• Changes in the weather, exposure to cool air  
• Exercise 
• Emotion
  

How to Assess Asthma Attacks?

Mild Asthma attack: 

• Cough  
• Soft wheeze  
• Minor difficulty breathing  
• No difficulty speaking in a sentence 

Moderate Asthma Attack: 

• Persistent cough  
• Loud wheeze  
• Tightness in the chest  
• Obvious difficulty breathing  
• Able to speak in short sentences only 

Asthma Medication (Bronchodilators) 

Relievers: 

• Used to relieve symptoms: relaxes tight muscles around the airways  
• Common names: Airomir, Asmol, Bricanyl, Epaq, Ventolin, Atrovent  
• They mainly come in two forms of delivery devices: 
  o Puffer colour: Blue – Grey (refer to image) 
  o Inhaler – Turbuhaler device – white blue – Bricanyl 

Treatment: Using a Puffer (4 x 4 x 4): 

1. Sit the person upright, reassure them and attempt to keep them calm
2. Do not leave the person alone 
3. Without delay shake a blue reliever puffer and give 4 separate puffs 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  
4. Wait 4 minutes.  
5. If there is no improvement repeat step 3  
6. If there is still no improvement after another 4 minutes, or you are concerned at any time, call an ambulance immediately (Dial 000), and repeat steps 3 and 4 until the ambulance arrives or the casualty is breathing normally 

Note: When ringing 000, respiratory physicians and some ambulance services recommend to state “severe asthma attack” (if appropriate) straight up so there is no unnecessary delay in dispatching an ambulance – personal and all other details can be collected later. 

Conclusion

Asthma is a chronic lung disease that inflames and narrows the airways. For people with asthma, this can cause wheezing, coughing, chest tightness, and shortness of breath. If you have asthma, it’s important to understand how to assess an asthma attack so you can get relief as soon as possible. We hope this article has helped give you a better understanding of what to do if your asthma symptoms worsen. Be sure to talk to your doctor about the best way to manage your asthma and always carry your rescue inhaler with you in case of an emergency.

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