Asthmatic status is a complication that occurs with a severe attack of bronchial asthma. This attack can last for several hours or even days. This condition is characterized by blockage of the middle and small bronchi, as well as the development of acute respiratory failure. Those drugs that the patient takes at home, in this case are ineffective. Therapy is possible only in a hospital setting, so if someone in the family has asthma, you need to know how to provide emergency care for asthmatic status.
Causes of the development of the disease
The same factors that cause the appearance of mild asthma attacks can trigger asthmatic status. These include the following:
- Contact with allergens, including medications.
- Stressful situations.
- Gastroesophageal reflex, which is a reflux of gastric juice directly into the esophagus, which then passes into the upper respiratory tract.
- Viral bronchopulmonary infections.
- Inhalation of air "poisons" called pollutants. Such "poisons" include exhaust gases, dust, industrial emissions.
Quite often, the patient's condition begins to deteriorate due to improperly conducted therapy, for example, during uncontrolled administration of bronchodilators, sedatives, as well as during the abrupt cancellation of glucocorticoids.
Symptoms of asthmatic status
Before embarking on an emergency with asthmatic status, you should familiarize yourself with the symptoms of this ailment. As a rule, in the clinical picture there are three main stages that should be considered in more detail.
Moderately heavy
At this stage, the patient is in clear consciousness. The patient may experience mild shortness of breath, dry cough, tachycardia, blueness of the mucous membranes and lips. In parallel with this, sweating intensifies. In some cases, blood pressure rises slightly. Breathing may be accompanied by dry wheezing. In order to alleviate the condition, the patient is forced to lean forward with the shoulder girdle. Attacks are not stopped by conventional bronchodilators.
Heavy
In severe cases, mental disorders are observed. At the same time, it is worth paying attention to the fact that periods of irritability in the patient are replaced by complete apathy. In some cases, even hallucinations occur. Blood pressure drops, tachycardia intensifies. Quite often, the heart rate reaches 140 beats per minute. Breathing becomes wheezing and noisy, neck veins swell.
Extremely heavy
At this stage, the patient loses consciousness. At the same time, breathing becomes rare, superficial, without pronounced wheezing. The pulse is palpable. Salivation and excessive sweating may begin. Due to severe perspiration, the human body is dehydrated, blood thickens.
Depending on the main cause of the attack, symptoms of asthmatic status can increase smoothly or develop rapidly. If the patient is not given emergency care with asthmatic status, then the course of this ailment will be complicated by DIC or pneumothorax.
First aid
As mentioned earlier, most often an asthmatic attack is observed in those people who suffer from bronchial asthma, often suffer from various forms of bronchitis. Before starting emergency care for asthmatic status, it should be recognized. To do this, you should pay attention to some symptoms:
- Wheezing and frequent breathing.
- Suffocation.
- Long expiration of air.
- Cyanosis of the skin.
- Dyspnea.
- Dry cough, which in some cases may be with sputum.
Sometimes there is a cough with a discharge of a small amount of sputum. The provision of emergency care with asthmatic status should be timely, immediately during the manifestation of deterioration, when the symptoms only begin to increase. The consequences of this condition may be as follows:
- Coma.
- Pneumonia.
- Subcutaneous emphysema, followed by suffocation, as well as oxygen starvation.
Emergency care for asthmatic status should be carried out according to the algorithm, which will be described below. This is of vital importance, since untimely or incorrect first aid can cause the death of the patient. That is why diagnostics and emergency care with asthmatic status are so important. Let's take a closer look at what you need to do.
Asthma Emergency Algorithm: Actions That Can Help
The sequence of relief during asthmatic status is as follows:
- If the patient has persistent asthma attacks for a long time, and the symptoms are increasing, then first of all you need to call an ambulance.
- After that, the emergency care algorithm for asthmatic status implies providing the patient with rest and access to fresh air. To do this, you can open the window and part if the attack occurred in a crowd.
- If clothing interferes with the patient, then it must be removed or unfastened.
- If the attack was triggered by allergens, then they should be eliminated, for example, remove flowers, animal, food, which caused an exacerbation.
- The emergency care algorithm for asthmatic status suggests that the patient should be helped to take a comfortable posture, as well as to be given an inhaler.
Thanks to such actions, it is possible to significantly alleviate the condition of the patient before medical workers capable of providing professional assistance arrive. This is a serious situation, so it is so necessary to know the features of emergency care for asthmatic status. In the clinic, other help will be provided to the patient.
Medical emergency
To provide emergency care, you should have special knowledge to perform manipulations, therefore only people with medical education can be entrusted with saving lives. Let's look at the clinical recommendations for emergency care for asthmatic status:
- Place the patient in a comfortable position, raise his head and shoulders. In a clinic or ambulance, this can be done using special beds or equipment.
- Next, a nasal-type mask or catheter is put on the patient, through which moistened oxygen is supplied.
- The specialist should conduct a survey of relatives of the patient in order to clarify information about the treatment before the attack, as well as learn about the dosage of the drugs.
- The patient is inhaled through a mask or using special aerosol products, such as Berotek or Salbutamol.
- In order to administer andrenomimetics, for example Terbutaline or Brikanil, injections must be given intravenously or intramuscularly.
- If the patient exhibits hectic behavior, he should be given sedatives, such as Diazepam. In the case of children, sodium oxybutyrate is injected into the vein to calm the vein.
If the patient worsens, disappears or there is no reaction to the actions taken, then specialists should conduct lung ventilation.
Pulmonary ventilation
This procedure is required in the following cases:
- Loss of consciousness.
- A sharp decrease in blood pressure.
- The patient fell into a dysfunctional state.
- During weak respiratory activity.
- With existing cyanosis of a generalized type.
The actions of specialists must be timely and accurate. Thanks to this, it will be possible to avoid possible complications, as well as death. Therefore, emergency care for asthmatic status must be carried out according to the stages described above.
Hospital treatment
When emergency medical care will be carried out with asthmatic status, the patient will be transferred to hospital conditions. Further treatment is carried out in several directions:
- Infusion therapy. It is carried out by introducing into the human body a solution of sodium chloride, Ringer's solution and Reopoliglukin. Medications such as Prednisone and Heparin are also used. They are able to normalize the viscosity and composition of the blood. When blood circulation is restored and normalized, beta-type stimulants are used. During an attack of asthmatic status, which was triggered by an allergy, the patient is given an antihistamine, for example, "Zodak" or "Tavegil".
- Oxygen therapy. Oxygen treatment is used for any severity of this condition. For this, the concentration of moistened oxygen is selected for the patient, usually this indicator is 30-40%.
- Adrenoreceptor stimulation. It can lead to relaxation of the bronchi, as well as to their expansion. During this, liquefaction of sputum or its discharge is also observed. Thanks to this, the general condition of the patient is significantly improved.
If the patient fell into a coma of a hypoxic nature, then measures should be taken to resuscitate the patient. All actions must occur correctly and quickly so that the patient can be saved. For this, glycoside preparations for the heart are used. Doctors use antihistamines with caution in case of respiratory failure, since they are able to dry the mucous membrane on the bronchi. A fatal outcome can also occur due to excessive use of drugs or due to improper assessment of the patient's condition.
Features of prevention
To never experience an asthmatic attack, you should adhere to a number of simple rules. Preventive measures are as follows:
- It is necessary to take anti-asthma drugs on a regular basis .
- Contact with various allergens should be avoided.
- It is necessary to very carefully use antibacterial and antihypertensive drugs, and also use them only after consulting with your doctor.
- It is important to avoid psychological overstrain and frequent stress.
- Serious physical overload is strictly prohibited.
Another important rule is that you must always carry an inhaler with you, thanks to which you can quickly get rid of an attack. But we must remember that the use of an inhaler is allowed no more than 8 times a day. Frequent use can cause the development of resistant asthmatic status.
Conclusion
In conclusion, it is worth noting that the provision of emergency care during asthmatic status can save a patient's life, and also help to avoid possible serious consequences. This attack is characterized by pronounced symptoms, which are quite difficult not to determine. If a person knows these signs, then it will be possible to provide first aid to the patient in a timely manner. However, it is worth paying attention to the fact that even after this it is necessary to call specialists who will conduct a professional relief of the attack.