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Asthma shortterm treatments
Created by Amy Fan.
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Why give people with asthma oxygen if the problem is not getting the oxygen into the lungs? Why not give them something other than the inhaler medicine that aids in getting rid of CO2?
My reasoning towards not giving people with asthma oxygen is that it is hard to get the CO2 out of the lungs when you have asthma, not getting O2 in. The more O2 you give them without something to aid in getting rid of CO2 the higher the CO2 levels in the lungs. If it gets high enough the CO2 will go back into the oxygenated blood and cause a disorder known as hypercapnia. Hypercapnia means higher than normal levels of CO2 in the blood.
In the same way giving O2 to people with asthma can potentially cause hyperoxia which is a disorder from too much oxygen.(16 votes)
We give people with asthma oxygen because as oxygen binds to hemoglobin it increases the hemoglobin's affinity to oxygen. Also, an increase in the alveolar partial pressure of oxygen has the ability to displace more CO2 across the alveolar-capillary membrane. As the pH decreases, as is present in hypercapnia, the hemoglobin's affinity for O2 rises. In short, the best way to offload CO2 in the blood is to increase O2 in the lungs. For more information on this research the O2 disassociation curve.(2 votes)
Why should patients with asthma avoid NSAIDs?(7 votes)
NSAIDs inhibit enzymes called cyclooxygenases, which are a key step in the pathway that converts arachidonic acid into prostaglandins. This leaves an excess of arachidonic acid, which is then diverted into a pathway that makes it into leukotrienes. Leukotrienes can cause asthma attacks in many people with asthma, so it's considered safest for people with asthma to avoid use of NSAIDs.(14 votes)
well if a baby has a asthma attack (if they can.) do they get the same treatments at a adult would?(6 votes)- Baby as in infant? We do give albuterol but in my experience, it was told to me that doctors do not diagnosis babies under 2 with asthma. It is usually upper respiratory infection or called something else. I do not know if that has something to do with their floppy airway or not?(2 votes)
- how many people died from asthma?(5 votes)
It's more easily treatable nowadays, however experts say that their has been a dramatic rise in asthma cases in recent years. So you're more likely to be diagnosed with asthma, but more likely to successfully treat it.(2 votes)
At1:52, why does magnesium sulfate open up the muscles in your lungs?(4 votes)
Magnesium has an inhibitory action on smooth muscle contraction, on histamine release from mast cells and on acetylcholine release from cholinergic nerve terminals. Magnesium also relaxes bronchial smooth muscle by modulating calcium ion transport at the cellular level.(2 votes)
- Does anyone know the statistics behind what percentage of patients have such severe asthma to require second or top tier treatment?(3 votes)
- Well, it isn't really dependent upon how severe the asthma itself is (since the severity can change at any point in time), but more so on how severe the asthma attack is. I do know that generally those who are hospitalized due to an asthma attack will receive an IV (so the percentage would be pretty high since that is the main hospital treatment for an asthma attack). As for intubation, that would mean that the asthma attack is a life or death situation that must be handled as if the person will die. This percentage is not as high (about 4,00 people die from asthma yearly), but it is still higher than it should be. Hope this helps!(1 vote)
I thought asthma is a type of obstructive disease. The patient will have trouble getting CO2 out of their lungs and she did say getting O2 into the lungs is not a problem. Why then, would they give O2 on the way to the hospital? I'm so confused(2 votes)
will asthma ever kill people in the hospital other than annoy them(1 vote)- If their asthma attack is severe enough and they can't get to their inhaler in time, then yes.(4 votes)
I have asthma is that Bad?(1 vote)- It doesn't have to be. If you stay fit (swim?) and recognise symptoms quickly, acting on them immediately, then it really doesn't need to be. :)(2 votes)
- How can you become inflicted with asthma? In other words, how do you get it?(1 vote)
- Genetics is a big one. But your environment and people who are around you can also give a big impact. I would suggest watching the first KA video on Asthma "What is asthma?"(2 votes)
1:52Video transcript
- Even under the best of circumstances, people who have asthma are
always at risk for a bad attack. So, here we talk about
short-term treatments. So, I'm going to write asthma attack, and this level of symptoms will usually land this
person in the hospital. So, this is what we would
do in the short-term to get them out of that. Hopefully, when the symptoms first started they would have tried the things
that usually work for them. They should have tried
their rescue inhaler with usually it's a beta-2 agonist. Beta-2 inhaler didn't work. They could try a nebulizer. Nebulizer. Or they could try
something with a steroid. Usually, if they're having
a really severe attack, the things they usually do for themselves won't be helpful. Hopefully, in route to the hospital they would have been given some oxygen. Since their lungs are really
struggling to get air in, they need some help staying oxygenated. So, oxygen should be given freely to people who have asthma attacks. Okay, so now we're at the hospital, and so far, nothing
has helped this person. We basically can take
some of the same drugs that you would use at home and upgrade them to the big guns, by making them IV or intravenous. I'm sure you've all had this before. When you got to the
hospital, they put a needle with a catheter behind it into your arm, could be your leg, depending
on what's most convenient, and the drug gets infused
directly into the bloodstream. So, the closer a medicine
gets to our blood during the delivery, the more pure it is. So, inhaled or ingested
or a pill or something, it takes a while to get there, but directly into our blood,
it's going to be fast. So, we can do some of the same things. So, beta-2 or we can do IV steroids. This is really the big guns. We can also do magnesium sulfate, which is just a chemical
that also opens up the smooth muscles in
our lungs, force it open, and help the patient breathe better. Something else we can give is epinephrine or I'm just going to write epi. You've probably heard of people who have bad allergy reactions and carry an EpiPen. This is sort of the same thing. So, epinephrine in our
body is usually produced by the adrenal glands, and
epinephrine starts the whole fight or flight emergency response, and it has effects all over the body. So, it can get our eyes to open up, so we can see better during the attack. It can make our heart beat faster, pump more blood to the muscles, and in the lungs, it opens up the airways. So, this person is going
to get heart palpitations and just feel really panicked,
but that's the side effect, because the epinephrine
may save their life by opening up their lungs. Epinephrine can be given as an injection, and we usually only give
a little bit at a time. So, epinephrine here. At this level, instead of
giving them just steady oxygen, a few liters through their nose, we might upgrade to masks. They can either be called CPAP or BiPAP. The difference between these two is how continuous the pressure is. The main thing to remember
with these is that they both push oxygen into the lungs, just with greater force than you would get with a nasal cannula or
just tubes in the nose. So, this CPAP or BiPAP covers their face and forcefully pushes oxygen in to help them oxygenate better. At this point, if none of this
have worked for this patient, then we've got to think about intubation. Now, intubation is kind
of a big procedure. We're going to put a breathing
tube down their throat and hook it up to a machine that mechanically
breathes for this patient, and, of course, that's very uncomfortable, so we have to knock them
out with some drugs. I'm going to draw a breathing tube here. So, this can be a big
procedure for some people, because they have to be under anesthesia, and intubation itself
is hard on the lungs, but as a last resort, it's
necessary to save people's lives. It can be a hard call of
when it's time to intubate. If you intubate too late, they might have permanent
damage from lack of oxygen, or too early, it can hurt the lungs and put them through
something unnecessary. So, at these levels
there's a question mark of when to go to this step,
but when it's necessary and this person is just not
responding to treatment, it's definitely necessary
for a bad asthma attack. But hopefully, our asthma
patient knows the things that trigger them and avoid them. So, I would say this every time, avoid smoking, either
secondhand or firsthand. Avoid NSAIDs. This is your ibuprofen, your
aspirin, a lot of painkillers. This can trigger in a lot of
people, especially adults. Avoid things like allergens, and basically just avoid the triggers. The key is to know yourself
and know what triggers you and stay away from those things. And for our patient here, if
they've gotten to this level, definitely if they've
gotten to intubation, they'll probably need to stay
in the hospital for a while, to make sure they don't
have another attack and to make sure that they
recover from this one.