Asthma
Asthma is a common condition that affects approximately two million Australians. It is estimated that up to one in four children, one in seven adolescents and one in 10 adults will experience symptoms of asthma at some time.
What is asthma?
In people with asthma, the airways in the lungs are twitchy or sensitive. When exposed to certain trigger factors (something that makes a person’s asthma worse), the airways tighten, the lining of the airways becomes red and swollen and mucus is formed, causing the air passage to become narrower.
What are the main symptoms?
Asthma symptoms may vary from person to person. Possible symptoms include:
* Coughing
* Wheezing - a high pitched whistling or sighing sound on breathing
* Shortness of breath
* Tightness in the chest.
A person with asthma may have one or more of these symptoms. The symptoms are often worse early in the morning and on waking.
What can trigger symptoms?
Different people with asthma may have different asthma triggers (trigger factors) which may make their asthma worse.
Common triggers include:
* Colds and flu
* Exercise (this can be managed)
* Inhaled allergens (e.g. house dust mites, pollens, moulds, animal hair)
* Cigarette smoke
* Cold air or temperature/weather changes
* Certain medications (ask a doctor or pharmacist)
* Chemicals, irritants and strong smells
* Some foods and food preservatives, flavourings and colourings
* Some occupations (e.g. exposure to chemical, dust and gases)
* Emotion, stress, anxiety.
If you are worried about these triggers, speak to your pharmacist or doctor about how to manage them.
Asthma medications
People with asthma can lead normal, active lives if their asthma is well controlled. This can be done by avoiding exposure to trigger factors and with the use of asthma medications. Asthma medications mostly come in the form of inhalations. There are four types of asthma medications which help decrease the development of asthma symptoms.
They include:
Preventers - used to prevent the redness, swelling and mucus production (inflammation) in the airways. These need to be taken even when there are no symptoms. Colour coded in ‘autumn colours’.
Relievers - used to relieve the symptoms of asthma by widening the airways. Colour coded blue.
Symptom controllers - used for people who still get asthma symptoms even when they take their preventer medication as prescribed. Symptom controllers should not be used for first-aid during an asthma attack.
Combination medications - a combination of preventers and symptom controller medications.
Recognising a severe attack
An asthma attack can develop in anything from a few minutes to a few days. Signs of a severe asthma attack include: shortness of breath, severe chest tightness, being unable to speak more than one or two words per breath, distress, little or no improvement after using reliever medication, ’sucking in’ of the throat and ribs, blue colour around the lips.
If a person with asthma has any of these signs, call an ambulance (Dial 000) straight away and state that the person is having an asthma attack. Follow the four-step first aid for asthma plan:
l. Sit the person upright and reassure them.
2. Give four puffs of blue reliever/inhaler (Airomir, Asmol, EPAQ, Ventolin). Use one puff at a time and ask the person to take four breaths from the spacer after each puff of medication. Use a person’s own reliever/inhaler if possible. If not, use the first aid reliever/inhaler or borrow one from someone else. Use the reliever alone if you do not have a spacer.
3. Wait four minutes.
4. If there is little or not improvement, repeat steps two and three. If there is still little or no improvement, ensure that an ambulance has been called immediately (Dial 000). State the person is having an asthma attack.
How to best manage asthma
A new approach to managing moderate to severe asthma - the Asthma 3+ Visit Plan - has been developed by asthma experts. This involves a program of three visits to a GP to help the patient take control of their asthma. Sometimes an extra visit may be needed, depending on how the asthma improves after the first three visits.
During these visits the GP will:
* Fully assess how severe the asthma is
* Develop a written asthma action plan to follow
* Provide the patient with information and education on managing asthma (discussing problems, trigger factors and medications)
* Review how well the medications are working.
After the initial three visits over a period of four months, the patient should only need to see the doctor about every 3-6 months, depending on asthma severity, or if they are experiencing any problems.
Asthma self care
* Do not ignore symptoms of asthma.
* Avoid trigger factors as much as possible (ask a doctor, pharmacist or asthma educator).
* Keep using a preventer even when you feel well. Refer to your Asthma Action Plan or doctor to decrease the dose when your asthma is under control and increase the dose when you begin to feel unwell or know that exposure to triggers is likely, your doctor can help decide when to increase or decrease the dose of preventer medication.
* Always carry a reliever with you.
* Keep fit. Always warm up and, if necessary, use your reliever or symptom controller as prescribed before exercise.
* If you smoke, quit smoking
* Check with your doctor and pharmacist before stopping or starting any medication, including over-the-counter medications and herbal products.
* Have a written asthma action plan and follow it.
Related information
Asthma Australia or the Asthma Foundation in each state or territory. Links to state websites can be found at:
www.asthmaaustralia.org.au or freecall 1800 645 130 for the Advice Line.
Commonwealth Department of Health and Ageing
website: www.health.gov.au/pq/asthma
For information on the 3+ Visit Plan and other initiatives.
General information can be found at:
www. healthinsite. gov. au
National Asthma Council website: www.nationalasthma.org.au or telephone 1800 677 000
