Asthma -Acute Exacerbation
- Things you should know about Acute exacerbation:
To keep your asthma under control, you need to know what to do when you have a flare-up of symptoms (sometimes this is called an "exacerbation"). First, you need to know the symptoms that tell you your asthma is getting worse (flaring up). Second, you need to know how to treat your asthma when it gets worse. Early treatment of flare-ups works the best and will help get your asthma under control quickly.
- Causes of an acute attack:
Your asthma can flare up for different reasons. If you're allergic to cobwebs, dust mites, pollens or molds, they can make your asthma symptoms get worse. Cold air, exercise, fumes from chemicals or perfume, tobacco or wood smoke, and weather changes can also make asthma symptoms worse. So can common colds. You can help yourself by paying attention to the way these things affect your asthma.
- Symptoms of an asthmatic attack:
Common symptoms are coughing, shortness of breath (feeling breathless), a feeling of tightness in the chest and wheezing. (Wheezing is breathing that makes a hoarse, whistling sound.) It's important to watch yourself every day for symptoms of asthma. You may have only 1 or 2 of these symptoms.
Another clue that your asthma is flaring up is that you have to take extra doses of your quick-relief asthma medicine (with an inhaler). You may use more than 10 puffs in a day, and still feel no better.
- Symptoms which need urgent attention:
Here's a good way to see how bad a flare-up is: Measure your peak expiratory flow (also called "PEF") using a peak flow meter. Your doctor can show you how to use a peak flow meter to keep track of your asthma. First, you find out your "personal best" peak flow. This is the highest reading you can get on the meter over a 2-week period when your asthma is under good control.
Here are some general guidelines you can use to find out how serious an asthma flare-up is:
- During mild flare-ups, you may notice shortness of breath when you walk or exercise, but when you sit still, you feel okay. You can usually breathe well enough to talk in complete sentences. You may hear some wheezing, mostly at the end of exhaling (breathing out). Your peak flow readings will be 80% to 100% of your personal best.
- During moderate flare-ups, you may feel short of breath when you talk or lie down, but if you sit quietly, you feel better. You may talk in a few words rather than using whole sentences because you're short of breath. You may feel anxious or tense. You may be using your neck muscles to help you take deeper breaths. You may hear loud wheezing, especially when you breathe out. Your peak flow readings will be about 50% to less than 80% of your personal best. Inhalers and bronchodilators are most useful at this time.
- During serious flare-ups, breathing will be very difficult and faster than usual. Even when you're sitting still, you'll feel short of breath. You might be able to talk only in a few words at a time because you're so short of breath. You'll feel anxious or tense. Your peak flow readings will be less than 50% of your personal best. If you feel sleepy and confused, and breathing is making you more and more tired, you may be having a life-threatening problem. Serious flare-ups mean you need to be treated right away, preferably in a hospital emergency room. Don't wait to get medical help if you have the symptoms of a serious flare-up!
- Treatment of an acute asthma attack & exacerbation:
The best thing to do first if your asthma symptoms are getting worse is to use your rescue or quick-relief medicine. Ask your doctor if you're not sure what to use for quick-relief medicine. The usual inhaler dose is 2 to 4 puffs every 20 minutes for a total of 3 doses. Salbutamol (Preferably with steroids such as beclamethasone or budesonide) would do. Bronchodilator tablets can be taken for added effect.
You should be able to tell how serious the flare-up is after you use your quick-relief medicine. If you have a peak flow meter, check your PEF again after you use the quick-relief medicine. If your PEF is still very low, your flare-up is serious.
This is a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information, talk to your doctor.
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