Asthma

Factors to consider in the evaluation of asthma patients include the patient's appearance and ability to speak, increased recent inhaler use, recent use of steroids, and a history of previous asthma attacks requiring intubation or hospital admission. Very acutely ill asthmatics may not move enough air to wheeze and may have relatively normal PC02 as they tire. Hypoxia generally precedes the development of hypercapnia.

The diagnosis of asthma must be made cautiously in older patients, since their wheezing may be caused by cardiac disease.

Causes

Asthma is most cause to a combination of environmental and genetic factors. You're more likely to develop asthma if it runs in your family and if you're sensitive to environmental allergens. Early, frequent infections and chronic exposure to secondhand smoke or certain allergens may increase your chances of developing asthma.

The following are common things that trigger asthma symptoms:

• Allergens, such as pollen, animal dander or mold
• Smoke and eat tobbacco
• Air pollutants and irritants
• Some common infections, including the common cold
• Physical exertion, including exercise
• Strong emotions and stress
• Cold air or cold enviornment
• Changes in the weather. 
• Fumes given off by cleaning products and solvents in the home including floor cleaners, room fresheners and polish.
• Foods such as nuts and shellfish, or food additives such as tartrazine

If you have an asthma attack your immune system overreacts to a trigger causing the airways to become swollen and inflamed. The muscles in the airways also tighten causing your air passages to get narrower.

Sometimes you may have another asthma attack 6 to 10 hours after breathing in an allergen. This is known as a late reaction.

Symptoms

• Dyspnea
• Wheezing
• Cough
• Chest tightness
• Inability to sleep

Signs

• Expiratory wheezing
• Hyperinflation
• Rhonchi
• Prolonged expiration
• Pulsus paradoxus 10 to 25 mm Hg

Reliable markers of severe illness include the following:

• Abnormal vital signs (RR >25, pulse >110, bradycardia, hypotension)
• Diaphoresis
• Accessory muscle use
• "Silent" chest
• Feeble respiratory effort, broken sentences, or exhaustion
• Cyanosis, confusion, coma (life-threatening signs)

Treatment

Several types of medications available for treating asthma. Most people use a combination of long-term control medications and quick relief medications. Your doctor can help you decide which option is best for you based on your age and the severity of your symptoms. In general, the main types of asthma medications are:

• Long-term-control medications. These medications are used regularly to control chronic symptoms and prevent asthma attacks.
• Quick-relief medications. You use these as needed for rapid, short-term relief of symptoms during an asthma attack.
• Medications for allergy-induced asthma. These decrease your body's sensitivity to a particular allergen and prevent your immune system from reacting to allergens.

Listed below are some ways to change the environment in order to lessen the chance of an asthma attack:

• Clean the house at least once a week and wear a mask while doing it
• Avoid pets with fur or feathers
• Encase the mattress, pillows and box springs in dust-proof covers
• Use the air conditioner
• Keep the humidity in the house low