Health

Asthma: Signs that may appear during an asthma attack

During an asthma attack, the typical signs are audible and extensive wheezing in both lungs, which is characterized by a relatively high pitch, similar to a wire-like tremor, and prolonged expiratory sounds. If the condition is more critical, “silent lungs” will appear. , That is, the wheeze will weaken or even disappear completely. Asthma is mainly divided into allergic asthma, exercise asthma, cough asthma, occupational asthma, aspirin asthma and so on. In addition to the typical physical signs that can indicate an asthma attack during an attack, it can also be judged by the main symptoms, which can be manifested as shortness of breath, shortness of breath, wheezing, coughing, dyspnea, chest tightness, etc. In addition, the clinical manifestations of different types of asthma usually have certain differences. It is recommended that patients seek medical treatment in time for targeted treatment. The symptoms can usually be relieved or relieved by themselves after treatment.

1. Allergic asthma: usually accompanied by symptoms of local allergies or general allergies, which can be manifested as sneezing, runny nose, sputum, fever, etc.;

2. Exercise-induced asthma: This type of asthma can show obvious dry rales and wheeze after lung examination, and can also show no symptoms after exercise, or have atypical symptoms, such as fatigue, headache, abdominal pain, and muscles. Cramps and discomfort during exercise, etc.;

3. Cough asthma: also known as cough variant asthma, the clinical manifestations are usually irritating chronic cough, no wheezing symptoms, usually onset or aggravated at night or early morning;

4. Occupational asthma: after exposure to amines, isocyanates, phthalic anhydride and other asthma-causing substances in occupational species, the clinical symptoms are mainly itchy, tearing and other symptoms in addition to typical asthma;

5. Aspirin asthma: refers to asthma that occurs after taking aspirin. Patients with sinusitis, nasal polyps and other diseases usually have a higher incidence after taking aspirin, which can be manifested as hyperhidrosis, irritability, cyanosis of the lips, and conjunctival hyperemia And so on, some patients may also have severe symptoms such as urticaria and shock.

What are the signs of an asthma attack

The typical symptoms of an asthma attack are episodic, dyspnea accompanied by wheezing, and may be accompanied by shortness of breath, chest tightness or cough. The symptoms can be onset within a few minutes and last for several hours to several days. The asthma relieved after drug treatment or relieved spontaneously. Attacks or exacerbations at night and in the early morning are important clinical features of asthma. Some patients, especially teenagers, have asthma symptoms that appear during exercise, which is called exercise asthma.
Clinically, there is atypical asthma without wheezing symptoms. Patients can present with episodic cough, chest tightness or other symptoms. Atypical asthma with cough as the only symptom is called cough variant asthma, and atypical asthma with chest tightness as the only symptom Some people call it chest tightness variant asthma. The specific clinical manifestations and severity of asthma are variable at different times.

How to deal with an asthma attack?

As the weather turns cooler in autumn, the number of children visiting the pediatric clinic for “coughing, wheezing or asthma” has increased significantly. Some parents of children with confirmed asthma also have this experience, that is, every season, especially in the spring and autumn, when the temperature changes suddenly, children with asthma are very prone to attack.

  So, why does asthma appear seasonally?
  To answer this question, we must first understand the pathogenesis of asthma. The so-called asthma is the abbreviation of bronchial asthma. It is a recurrent disease, with paroxysmal coughing, wheezing, and wheezing in the throat. Older children and adults report chest tightness and shortness of breath. In severe cases, they cannot lie on their back. As a feature. Modern medical research has proved that bronchial asthma is a chronic inflammatory allergic disease with increased airway reactivity. The patient is sensitive to certain factors outside or in the body, causing bronchospasm to produce asthma symptoms. Clinical practice shows that external environmental factors have a significant impact on asthma attacks, especially in autumn, asthma attacks are more likely to occur.
  In autumn, the temperature changes drastically in hot and cold weather, and children with asthma are prone to dysfunction of airway and contraction, which can cause bronchial smooth muscles to spasm after being stimulated and cause asthma. In addition, colds are easy to catch in autumn, and colds are also one of the predisposing factors for asthma.
  In autumn, plants such as flowers, trees, etc. gradually wither and are blown up by the autumn wind, causing many tiny particles such as pollen and plant leaf dust to float in the air. After inhalation, asthma patients with allergic physique can easily induce allergies and cause asthma attacks.
  Mites and other microorganisms that are invisible to the naked eye can easily induce bronchial asthma. At about 25 degrees Celsius, they are suitable for growth and reproduction, and are blown into the air by the autumn wind. Asthma patients naturally cause asthma when inhaled.
  Once you understand the characteristics of bronchial asthma that are prone to seasonal attacks, then in autumn, children with asthma should pay attention to protection. One is to keep warm and prevent colds. The second is to strengthen exercise, enhance physical fitness, and enhance disease resistance. 3. When necessary, inject or take immunomodulators to enhance immunity. Fourth, it is best for children with asthma to wear a mask when going out in autumn to prevent inhalation of dust, mites and other allergies. Fifth, children with asthma should receive systematic and standardized treatment in time to prevent asthma attacks. The last point is the most important control measure. Avoid blindly treating infectious diseases.


  How to deal with an asthma attack
  Acute asthma attack is a critical condition of common respiratory diseases in children and must be treated immediately. When a mild asthma attack occurs, children usually have no obvious symptoms of respiratory obstruction, except for signs of itchy nose and eyes, sneezing, and coughing, or slight wheezing. At this time, the child should be instructed to rest and eliminate the internal and external factors that cause the continuous increase in respiratory tract reactivity, such as avoiding inhaling various irritating gases, keeping warm and preventing colds, avoiding fear, and choosing quick-acting β-agonist atomization inhalation, such as Salbutamol aerosol (Vantolin), and some anti-asthmatic drugs such as salbutamol, boliconyl, metrophane, etc. can also be taken orally.
  Children with moderate asthma attacks show choking, wheezing, mild expiratory dyspnea, unable to lie down, sleep effects, and activities are also affected. During a moderate attack of asthma, rest should be emphasized, the cause should be actively searched, anti-asthmatic drugs should be used in combination, and quick-acting β-agonist aerosol inhalation and oral aminophylline and mechuanqing should be selected.
  When a severe asthma attack occurs, the child has obvious difficulty breathing and both lungs are full of wheezing, and he cannot lie down and breathe upright. Some also showed irritability, sweating, pale complexion, and cyanotic lips. At this time, the condition was already in a critical state and must be sent to the hospital for emergency treatment immediately.
  Family treatment
  during an asthma attack  As asthma attacks are often sudden, in many cases, parents of children have to deal with it first to relieve the condition. Therefore, it is best for each parent of a child to master some commonly used medication methods and prevention principles for asthma, which is conducive to early control of asthma. When an asthma attack occurs at home, parents should do the following:
  1. Quickly get the child out of the allergen. Once out of the allergic environment, even if no medication is given, the condition can be relieved.
  2. Parents should comfort children to relieve psychological pressure. During an asthma attack, children often have a sense of fear, irritability, and these mental stimulating factors can also make the attack and symptoms worse.
  3. Give salbutamol aerosol inhalation in time (try to effectively inhale through the mist storage tank) to quickly relieve bronchospasm and relieve asthma. At the same time, aminophylline can be given 4-6mg/kg? times, 3 times a day orally, or dexamethasone 2.5-5mg/time, intramuscular injection.
  4. If there is cyanosis around the lips, it means that you have hypoxia, you can connect the spare oxygen bag at home to the nasal cannula to inhale oxygen, and adjust the oxygen concentration to 25%-40%.
  5. When the asthma attack is severe or persistent, it must be sent to the hospital for treatment as soon as possible.
  Therefore, aerosols, oxygen bags, etc., such as Shuchuanling or Chulaning, should be necessary for the family to prevent asthma attacks.
  In summary, the key to the treatment of asthma is the long-term and regular use of preventive drugs to control its onset.

Whether to use antibiotics during an asthma attack

Asthma is a chronic inflammatory disease of the airways. This inflammation is an allergic inflammation (or allergic inflammation) rather than infectious inflammation. Treating allergic inflammation with antibiotics is ineffective.

  It is currently believed that glucocorticoids are effective drugs to control allergic inflammation. For allergic airway inflammation, we try to use inhaled hormones to control the chronic allergic airway inflammation of asthma. Although infection is an important cause of asthma (especially in children), the common infectious agent is a virus or mycoplasma, not a bacteria. Whether it is a viral infection or a mycoplasma infection, the use of antibiotics is not necessary. Of course, if it is clear that the infection is mycoplasma, macrolide antibiotics, such as azithromycin or erythromycin, should be taken reasonably under the guidance of a doctor. Otherwise, there is no need to take antibiotics.

  Many studies have confirmed that the use of antibiotics in the neonatal and infancy period can lead to changes in the intestinal flora and increase the risk of asthma.

  According to a report in the journal Thoracic Surgery in June 2007, the results of the study showed that infants under 1 year of age who were given antibiotics due to non-inspiratory tract infections significantly increased their chances of developing asthma. The highest-risk patients are those who have used multiple courses of antibiotics and children who have used broad-spectrum antibiotics. The study included a total of 14,000 children born between 1995 and 2003, and it has been tracked until after 7 years of age. Studies have found that children who have taken 1 to 2 courses of antibiotics have a 21% increase in asthma risk; children who have taken 3 to 4 courses of antibiotics have a 30% increase in asthma risk; and those who have taken more than 4 courses have a risk of asthma. An increase of 46%. Moreover, children who use antibiotics to treat non-inhalation tract infections (such as urinary tract infections) have an 86% higher chance of developing asthma compared with children who are treated for inhalation tract infections. We have now found evidence that the use of antibiotics within 1 year of age is closely related to the occurrence of asthma. Broad-spectrum antibiotics can kill a variety of bacteria, including beneficial bacteria and harmful bacteria. Beneficial bacteria play an important role in the development of the immune system of infants within one year of age. If broad-spectrum antibiotics are used at this time, they will kill too many beneficial bacteria. Bacteria, it may cause asthma.

  In addition, more and more epidemiological investigations have confirmed that certain infectious diseases in early childhood may reduce the risk of allergic diseases and asthma in the future.

  For example, in a survey of Japanese elementary school students, children who have received tuberculosis vaccine injections or who have had tuberculosis, have a strong tuberculin skin test, have a reduced incidence of allergic diseases and asthma. With the improvement of the social environment and hygiene in Western countries, the chances of early contact with microbial antigens in infants and young children are reduced, which may also contribute to the continuous increase in the incidence of allergic diseases in children. At the beginning of the 20th century, some people put forward the “hygiene theory” of the onset of asthma, that is, newborns or infants who live in a clean environment and have the opportunity to contact allergens (such as dust mites, animal skins, etc.) are prone to allergic diseases in the future. And asthma; on the contrary, the chance of suffering from allergic diseases and asthma is significantly reduced, and even if asthma occurs, its symptoms are also mild.

  Asthma is closely related to Th1/Th2 cell dysfunction. T lymphocytes are important immune cells in the human body. Among them, helper T cells (Th) are divided into Th1 cells and Th2 cells. The enhanced activity of Th1 cells has the effect of anti-inflammatory or allergic reactions caused by microorganisms, while Th2 cells produce a large number of cytokines related to allergic diseases, accelerating the occurrence and development of allergic diseases. Asthma patients often dominate Th2 cell function. The occurrence and development of Th1 cells and Th2 cells in the human body are different in the fetal period, infancy and young adults. During the fetal period, the activity of Th2 cells dominates. Afterwards, the immune system of the newborn is continuously improved and exposed to pathogenic microorganisms, thereby activating Th1 cells and inhibiting the activity of Th2 cells, so that Th1/Th2 tends to balance. If babies live in a clean environment at an early stage, lack of stimulation such as endotoxins, pathogenic bacteria, etc., so that the dominant position of Th2 cells cannot be changed, allergic diseases such as asthma are prone to occur.

  In addition, the normal flora of the gastrointestinal tract can produce organic acids such as acetic acid and lactic acid in the intestine, creating an acidic environment in the intestine. It can be directly used as an energy source for intestinal epidermal mucosal cells, making cell metabolism smoother and maintaining the integrity of intestinal mucosa. This is not only beneficial to maintaining intestinal health, but also to reduce intestinal mucosal absorption of food antigens into the blood. More importantly, the growth and reproduction of normal flora is an important factor in regulating the balance of Th1/Th2 cell function. If infants and young children use a large amount of antibiotics to kill these normal bacteria or inhibit their growth, it may increase the child’s wheezing. chance. Therefore, excessive use or abuse of antibiotics is detrimental to the immune system of children.

  In summary, we can get the following conclusions:

  1. Infants need to be cautious when applying antibiotics, and strictly grasp the indications, viral infections and other diseases caused by non-bacterial infections, and antibiotics should not be used.

  2. Choose the sensitive type of antibiotics and adhere to the course of treatment and adequate application.

  3. When taking antibiotics for a long time, the normal intestinal flora should be prevented from imbalance.

How to relieve an asthma attack

The general relief of asthma in an acute attack is to choose comprehensive treatment measures according to the condition. For general symptoms of wheezing and shortness of breath, glucocorticoids can be selected, such as dexamethasone, methylprednisolone, prednisone and budesonide It can be administered by oral, intravenous drip, or atomization inhalation. In addition, bronchial dilation drugs can be used in combination, including salbutamol, terbutaline, ipratropium bromide, etc., administered by aerosol inhalation, which generally relieves symptoms. If sputum expectoration occurs, the sputum is relatively thick, and there may be sputum clots that block the airway and aggravate the symptoms of dyspnea. Venous channels should be opened, and intravenous infusion of energy mixture and dextrose normal saline will dilute the sputum and promote the discharge of sputum. If there is a decline in lung function, appropriate oxygen can be used to prevent respiratory failure, and appropriate antibiotics can be given to prevent infection, especially if yellow sputum occurs, antibiotics should be given, and penicillin, amoxicillin and other drugs should be selected.

What position to take during an asthma attack

When asthma is acute or severe, the patient usually chooses to sit in a sitting or semi-recumbent position. The reason for choosing this position is mainly from the physiological perspective of the human body. The details are as follows:
1. Semi-recumbent or In the sitting position, the blood flow back to the right heart of a person will be significantly reduced, and the right heart function is relatively poor during an asthma attack. If the blood back flow is too much at this time, it is easy to aggravate the function of the heart and affect breathing.
2. In the sitting or semi-recumbent position, the diaphragm moves down relatively, so that the volume of the thoracic cavity is relatively enlarged, which helps the patient to take deep breaths or increase his own air volume, which is helpful for alleviating asthmatic breathing difficulties and hypoxia Symptoms also have great benefits.
Therefore, there is a very scientific basis when choosing the position of asthma patients. According to the different conditions of the patients, doctors will also provide different treatment plans.

How to avoid asthma attacks

The manifestations of asthma
  1. Sudden onset of wheezing is the main feature of childhood asthma. The wheezing symptoms of childhood asthma vary greatly according to the severity of asthma. Children may have high-pitched wheezing and “sizzling” when exhaling. “The sound is similar to the sound of pulling a wind box.
  2. Increased breathing frequency and difficulty in breathing. Infants and young children can breathe with mouth open and flap their noses.
  3. Many children may have a cough.
  4. Severe attacks can be manifested as irritability, cyanosis, pale complexion, and cold sweats. On physical examination, there was a three-concave sign, an increased heart rate, and wheezing in both lungs. Further exacerbation may cause heart failure, such as jugular venous swelling, edema, middle lung, small blisters sound, and liver enlargement.
  The main measures to avoid an acute attack of asthma are as follows:
  1. Try to avoid contact with allergens, wind-borne pollen, mold spores, mites, etc.;
  2. Strengthen the physical fitness and encourage children to participate in activities such as radio exercises, walking, swimming, etc. Do not exercise suddenly;
  3. Pay attention to increase (morning and evening) and reduce (noon) clothing in time;
  4. Children with a history of asthma can take montelukast orally to prevent attacks before entering September. Once there is an asthma attack (such as flow [ Nasal discharge, sneezing, coughing), you should see a doctor in time, and appropriately increase the dose of inhaled corticosteroids for about 1 week.