ABRAHAM: Asthma's severity shouldn't be underestimated
Opinions Column: Code Wellness
It was 9:45 p.m. on a busy Friday. My beeper goes off indicating a new admission to the unit. An ER patient will be arriving within 15 minutes. While I quickly scramble to get the chart ready, alert the staff, update the assignment and answer the phone, which appears to never stop ringing, I start thinking about the incoming patient. What’s the diagnosis? How old is he or she? What’s his or her story? Within minutes, the patient arrives — a 24-year-old male. Diagnosis: severe asthma attack, on a ventilator. Status: critical.
Nights like these are always the hardest, especially when you have patients who are so young, yet are knocking on death’s door. Shortly after, I was able to learn that this young man was an intelligent individual who had a severe asthma attack while hanging out with his friends. He was quickly rushed to the hospital, intubated and placed on a ventilator. Unfortunately this remarkable individual did not make it. While it pains me to even envision the anguish that his loved ones are experiencing, I have come to realize that cases such as this one are far too common in the United States and around the world.
The Centers for Disease Control and Prevention estimate that “about 25 million people have asthma, and the numbers are increasing every year.” Moreover, "1 in 2 people or approximately 12 million individuals with asthma had an asthma attack in 2008." So what is asthma? Asthma is a non-curable, chronic condition that causes inflammation of your airways. Oftentimes asthma suffers may have difficulty breathing and shortness of breath, because the muscles surrounding their airways tighten. In addition to breathing difficulties, asthmatics may also experience symptoms such as “coughing, wheezing, shortness of breath and/or chest tightness.” The American Academy of Allergy, Asthma & Immunology (AAAAI) explains that asthma symptoms may be worse during exercise, weather/seasonal changes or during times of high stress. The AAAAI also states that allergic asthma symptoms can be triggered by allergies or exposure to certain allergens such as “dust mites, pet dander, pollen or mold.” Furthermore, occupational asthma can be trigger symptoms when “inhaling fumes, gases, dust or other potentially harmful substances while on the job."
While asthma does not have a cure, symptoms can be controlled. Controlling your symptoms requires taking medications as prescribed, having an asthma action plan (especially for children) and learning to avoid or effectively deal with (if you cannot avoid) the triggers that cause and worsen your symptoms. Most importantly, you should always carry your quick-relief rescue inhaler everywhere you go. Not having emergency medications or not knowing what to do in an asthma attack is detrimental and in some cases fatal.
Do not underestimate the seriousness of asthma in any population. Remember the severity of asthma can rapidly escalate, hence it is important to be aware of the signs and symptoms of an asthma attack. Some signs and symptoms, as mentioned on WebMD, include rapid breathing, severe wheezing upon inhalation and exhalation, chest tightness and pressure, coughing, trouble talking, retractions of the chest and neck muscles, blue lips or fingernails (cyanosis) and/or feeling anxious or panicky. It is so important to call 911 and seek immediate medical attention if you or anyone you know has these symptoms. Remember that without prompt medical treatment, one can lose consciousness and die.
Clinicians recommend that asthmatics receive the annual flu vaccine since asthmatics are at risk for developing respiratory infections. Creating an asthma action plan may be helpful to improve the day-to-day management of asthma. An asthma action plan is a set of written instructions that “can be based on peak flow rate or asthma symptoms." The plan consists of three different levels (called zones) and interventions that you (or an assigned caregiver) would take in each zone. For example, the green zone indicates that you are doing well and are effectively managing your symptoms. The yellow zone indicates that your symptoms are getting worse. The red zone indicates further worsening of the symptoms and requires immediate medical attention. The American Lung Association states that an asthma action plan should include, medications to take based on your signs, symptoms or peak flow measurements, symptoms or peak flow measurements (if used) that indicate the need for urgent medical attention, and telephone numbers for an emergency contact, healthcare provider, and local hospital.
Asthma does not have to control you. You can control your asthma. Properly adhering to treatment regimens, maintaining a healthy lifestyle, knowing your triggers, having easy access to your rescue inhaler and creating an asthma action plan can make a difference.
Cilgy Abraham is a Rutgers School of Nursing senior. Her column, "Code Wellness," runs on alternate Mondays.
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