Module 6

Asthma

1 in 9 people suffer from asthma

7 people in Australia die each week.. - In 1989 – 964 deaths in Australia

2013 – 389 2014 – 4192015 - 4212016 - 455 deaths

Compromising 312 females and 144 males

Who has Asthma ?

When sensitive airways are exposed to a trigger the airway narrows, making it hard to breathe.

The inside lining of the airways becomes red and swollen and extra mucous may be produced.

The muscle around the airways tightens.

What is Asthma ?

Pathology of Asthma

Breathing RatesNormal breathing rates for Adults, Children and Infants

Newborn 40-60 breaths per minuteInfants (1-12 mths) 25-40 breaths per minute

Children (1-5 yrs) 25-30 breaths per minuteChildren _6-12 yrs) 16-25 breaths per minuteAdults 16-20 breaths per minute

1. Infections (colds, viruses)2. Allergens (pollens, moulds, animals)3. Food allergies4. Exercise5. Smoke (cigarette, wood)6. Strong odours (perfumes, deodorants)7. Air pollution8. Weather9. Strong emotions (anxiety, crying)10. Certain medications11. Occupational12. Gastro-Oesophageal Reflux GORD

12 Common Asthma Triggers

Mild asthma attack• Coughing• Some shortness of breath• Wheezing• Still capable of speaking full

sentences between breaths

Symptoms can be mild, moderate or severe.

Moderate asthma attack

• Persistent cough• Tightness in chest• Moderate to loud wheeze• Noticeable difficulty breathing• Only able to speak in short

phrases between breaths

• Severe wheezing (both on breathing in and out)• Coughing that won’t stop• Severe difficulty breathing• Inability to catch breath• Inability to fully exhale• Chest pain or pressure• Tightened chest and neck muscles• Difficulty speaking more than single words• Feeling of anxiety or panic• May have blue lips or fingertips

Severe Asthma Attack

Reliever (no script required)Short acting, relaxes the muscles around the airways. Works within minutes, lasts for about 2-4hrs.

Preventer (prescribed)Reduces the inflammation and helps to dry up mucous. Should be taken every day and can take a few weeks to be effective.Will not provide relief in an asthma emergency

Asthma Medication

Symptom Controller (prescribed)Relaxes the airway muscles for up to 12 hours. Needs to be taken twice a day. Only used when people using preventer medications still have symptoms. Slow acting.

Combination Medication (prescribed)Contains both a preventer and a symptom controller. Doesn’t come in an inhaler/puffer.

Asthma Medication

• Inhaler/puffer/Reliever • Turbohaler• Accuhaler

Types of Dispensers

The spacer allows time for the casualty to inhale sufficiently down the trachea,

not into the oesophagus

• Reduce triggers• Train staff in Asthma Management• Improve communication• Manage risk• Review strategies every 12 months

Prevention is better than treatment.

• All asthmatics should carry an Action Plan.

• Action Plans should be signed off by a doctor.• Action Plans should be updated after an attack, or at

least : Adults- 12 monthsChildren- 6-12 months

•

Asthma Action Plans

• Sit the casualty upright

• Be calm and reassuring, don’t leave the casualty

• Ensure to shake the inhaler well and check expiry date

• If no spacer - Give 4 puffs with 4 breaths from casualty (1x1, 1x1, 1x1 , 1x1)

•Wait 4 minutes

• If spacer is available – Give 1 puff at a time with 4 breaths after each puff

(1x4, 1x4, 1x4 , 1x4)

• If no improvement after the 4 minutes give another 4 puffs and call 000.

• Continue administering 4 puffs every 4 minutes until help arrives.

•During an Asthma Attach please seek help from Emergency Services 000, a Doctor, Registered Nurse or Qualified First Aider

What can we do...

After the arrival of an ambulance it is vital to they receive a proper handover. Information they require:• Introduce the casualty

• The history including time the symptoms started• Time/s you administered Asthma Reliever

Always be calm and reassured of what is happening

Medical Handover

Thunderstorm Asthma...What is it?• In November 2016, 10 people died as a result of the Melbourne storm.•Caused by a mix of pollen and weather conditions that can cause sever asthma symptoms.

Who’s affected?Anyone can be affected, even if no history of Asthma.Thunderstorm Asthma is just normal Asthma and should be treated the same way.

Thunderstorm Asthma...

Management/Treatment•Be aware of forecast thunderstorms in the pollen season particularly on days with a HIGH or EXTREME pollen count.•Use Vic Emergency App for high pollen count and notifications of Thunderstorm Asthma

•Where possible, stay indoors with doors and windows closed until the storm front has passed. •Follow Asthma Action Plan if you have one. •If at any point you are concerned your asthma is rapidly worsening, call 000 and say you are having an asthma attack.