Asthmatic status is a complication that occurs during a severe attack of bronchial asthma. This attack can last for several hours or even days. This condition is characterized by blockage of medium and small bronchi, as well as the development of acute respiratory failure. Those drugs that the patient takes at home are ineffective in this case. Therapy is possible only in a hospital, so if someone in the family has bronchial asthma, you need to know how to provide emergency care for status asthmaticus.
Reasons for the development of the disease
The same factors that cause mild asthma attacks can provoke status asthmaticus. These include the following:
- Exposure to allergens, including drugs.
- Stressful situations.
- Gastroesophageal reflex, which is the reflux of gastric juice directly into the esophagus, which then passes into the upper respiratory tract.
- Viral bronchopulmonary infections.
- Inhalation of air "poisons", which are called pollutants. Such "poisons" include exhaust gases, dust, industrial emissions.
Quite often, the patient's condition begins to deteriorate due to improper therapy, for example, during uncontrolled use of bronchodilators, sedatives, and also during abrupt withdrawal of glucocorticoids.
Symptoms of status asthmaticus
Before you start emergency care for status asthmaticus, you should familiarize yourself with the symptoms of this disease. As a rule, there are three main stages in the clinical picture, which should be considered in more detail.
Moderate-severe
At this stage, the patient is lucid. The patient may experience moderate shortness of breath, dry cough, tachycardia, blue mucous membranes and lips. In parallel with this, sweating increases. In some cases, the 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 the severe stage, mental disorders are observed. At the same time, it is worth paying attention to the fact that the periods of irritability in the patient are replacedcomplete apathy. In some cases, even hallucinations occur. Blood pressure drops, tachycardia increases. Quite often, the number of heartbeats 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 threadlike. Salivation and heavy sweating may begin. Due to strong sweating, the human body is dehydrated, the blood thickens.
Depending on the main cause of the attack, the symptoms of status asthmaticus may increase gradually or develop rapidly. If the patient is not provided with emergency care for status asthmaticus, then the course of this disease will be complicated by DIC or pneumothorax.
First aid
As mentioned earlier, most often an asthmatic attack occurs in those people who suffer from bronchial asthma, often suffer from bronchitis of various forms. Status asthmaticus must be recognized before emergency treatment can be started. To do this, you should pay attention to some symptoms:
- Wheezing and rapid breathing.
- Suffocation.
- Exhale for a long time.
- Cyanosis of the skin.
- Shortness of breath.
- Dry cough, which in some cases may be accompanied by phlegm.
Sometimes there is a cough with a small amount of sputum. Providing emergency care for asthmastatus should be timely, immediately at the time of manifestation of deterioration, when symptoms are just beginning to increase. The consequences of this condition may be as follows:
- Coma.
- Pneumonia.
- Subcutaneous emphysema followed by suffocation and oxygen starvation.
Emergency care for status asthmaticus 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 provoke the death of the patient. That is why the diagnosis and emergency care for status asthmaticus is so important. Let's take a closer look at what to do.
Status Asthma Emergency Algorithm: Actions That Can Help
The sequence of care during status asthmaticus is as follows:
- If a patient has asthma attacks for a long time, and symptoms are increasing, then first of all you need to call an ambulance.
- After that, the status asthmaticus emergency care algorithm involves ensuring that the patient rests and has access to fresh air. To do this, you can open the window and part if the attack occurred in the crowd.
- If clothes interfere with the patient, then they must be removed or unbuttoned.
- If the attack was provoked by allergens, then they should be eliminated, for example, remove the flowers, animal, food that causedexacerbation.
- The status asthmaticus emergency algorithm suggests that the patient should be helped into a comfortable position, as well as allowed to use an inhaler.
Through such actions, it is possible to significantly alleviate the patient's condition before medical workers arrive who can provide professional assistance. This is a serious situation, so it is so necessary to know the features of emergency care for status asthmaticus. The clinic will provide other care to the patient.
Medical Emergency
To provide emergency care, you should have special knowledge to perform manipulations, so only people with medical education can be entrusted with saving lives. Let's take a look at the clinical emergency response guidelines for status asthmaticus:
- Place the patient in a comfortable position, raise the head and shoulders. In a clinic or ambulance setting, this can be done with special beds or equipment.
- Next, the patient is put on a mask or nasal type catheter through which humidified oxygen is supplied.
- The specialist should conduct a survey of the patient's relatives in order to clarify information about the treatment performed before the onset of an attack, as well as find out about the dosage of the drugs.
- The patient is inhaled through a mask or using special aerosol products, such as Berotek or Salbutamol.
- To administer andrenomimetics, for example,Terbutaline or Bricanil, injections must be given intravenously or intramuscularly.
- If there is a restless behavior of the patient, he should take sedatives, for example, "Diazepam". In the case of children, sodium oxybutyrate is injected into a vein to calm them down.
If the patient's condition worsens, disappears or there is no reaction to the actions taken, then specialists should ventilate the lungs.
Ventilation of the lung system
This procedure is required in the following cases:
- Loss of consciousness.
- Dramatic drop in blood pressure.
- The patient fell into a somnolent state.
- During poor breathing.
- 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 that were described above.
Inpatient treatment
When urgent medical care is provided for status asthmaticus, the patient is transferred to a hospital. Further treatment is carried out in several directions:
- Infusion therapy. It is carried out by introducing sodium chloride solution, Ringer's solution and Reopoliglyukin into the human body. Also used are medicationsfunds like "Prednisolone" and "Heparin". 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 provoked 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. To do this, the patient selects the concentration of humidified oxygen, usually this figure is 30 - 40%.
- Adrenoreceptor stimulation. It can lead to relaxation of the bronchi, as well as to their straightening. During this, sputum liquefaction or its discharge is also observed. This greatly improves the general condition of the patient.
If the patient fell into a hypoxic coma, 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 respiratory failure, as they can dry out the mucous membrane on the bronchi. Death can also occur due to excessive use of medications or due to an incorrect assessment of the patient's condition.
Peculiarities of prevention
To never experience an asthma attack, you should follow a number of simple rules. Preventive measures are as follows:
- You need to take your asthma medication regularly.
- You should avoid contact with various allergens.
- It is necessary to use antibacterial and antihypertensive drugs very carefully, and also use them only after consulting your doctor.
- It is important to avoid psychological overstrain and frequent stress.
- Severe physical overload is strictly prohibited.
Another important rule is to 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 the inhaler is allowed no more than 8 times a day. Frequent use may cause the development of resistant asthmatic status.
Conclusion
In conclusion, it is worth noting that the provision of emergency care during status asthmaticus can save the patient's life, and also help to avoid possible serious consequences. This attack is characterized by pronounced symptoms, which are quite difficult not to identify. 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, specialists should be called who will professionally stop the attack.
