Asthma is a respiratory disease that affects many people daily. It is commonly developed in childhood and can present as very mild to extremely life-threatening. Asthma can be brought on by many factors including, environmental and physical. People living with this disease find it difficult to do certain activities, typically exercising for a prolonged amount of time. To effectively manage asthma, it is important to know what causes it and what medications to give at what times. We will briefly examine the epidemiology of asthma and then proceed to go more in-depth into the pathophysiology and what is included in a paramedic effectively managing a patient suffering from such a condition.
Asthma is one of the few diseases more commonly found in women than men, 9.8% of women suffer from asthma while it is less prominent in men at 6.1%. WHO (world health organization) makes notes that asthma affected 262 million people in 2019 and caused a death toll of 455,000. Asthma having such a prominent rate in society is why it needs to be studied and monitored since such a mild disease can suddenly turn into something very serious.
Asthmatics do not typically show any signs and symptoms until triggered by physical and/or environmental factors. The manifestations that indicate asthma includes a cough, which can begin mild and then can develop to become chronic, other additional symptoms are shortness of breath, wheezing during expiration, and chest pain. When evaluating a patient’s vitals, their respiratory rate will be above 20 breaths a minute, pulse rate above 100 beats per minute, a patient’s SP02 will be below 92% and blood pressure can also spike, showing hypertension.
To further understand asthma symptoms and how to treat them, it is important to learn about the pathophysiology of the disease. Asthma happens in the lungs, specifically the bronchi and bronchioles. The bronchi and/or bronchioles are inflamed in asthma patients and are narrower than in a person who is not suffering from this illness. The smooth muscles of these airways are narrowed during an attack and then begin to secrete mucus, it then becomes difficult for oxygen to travel due to the obstructing airway, which in turn results in the patient’s symptoms.
When patients are suffering from an asthma attack, it is important to act quickly as it may quickly become a more life-threatening event. When first taking notice of the patient, it is important to note how serious the scene currently is, if the patient’s signs and symptoms are only mild and moderate, not as much medication may need to be administrated and revaluation of the patient should be done post every drug. Every patient no matter whether symptoms are mild to life-threatening should receive oxygen. Once oxygen therapy has begun, one of the first medications to consider is salbutamol. Salbutamol is a medication known as a bronchodilator; bronchodilators work by relaxing the muscles in the airways to assist in oxygen passing through. If the patient’s symptoms don’t begin to subside, the next medication to consider is ipratropium bromide. Ipratropium bromide is another bronchodilator agent that works by relaxing the muscles around the airway. The next step in drug administration is hydrocortisone. Hydrocortisone is a steroid, in use for asthma attacks, it assists in reducing inflammation and the production of mucus, therefore, resulting in the airways becoming less inflamed and blocked to let air pass through. If the signs and symptoms still have not begun to subside and no relief is visible, then adrenaline and magnesium sulfate are the next courses of action. Therefore, with effective management and continuous revaluation of patients experiencing asthma, the paramedic can greatly improve patient outcomes, improving the overall quality of life and preventing complications.
In conclusion, asthma is an extremely problematic disease to manage, and understanding chronic respiratory conditions will be crucial for better patient care. For paramedics that respond to asthmatic emergencies, knowledge of pathophysiology will assist in deciding how to treat patients presenting with this disease. Only through further study into the disease, medications, treatments, and experience with patients who are having symptoms of asthma, will a paramedic be able to fully be best prepared for such an emergency and improve the quality of life and overall outcome for patients.
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