Just a quicky "knowing your jargon" this morning.
In 2013 most asthma councils around the western world changed the term "Asthma Attack" to "Asthma flare-up".
The change was in part due to the notion that the term 'attack' implies sudden and without provocation. The Gurus in asthma wanted to make it clear that a 'well controlled' asthmatic doesn't have acute episode if they are well managed.
Provocative words, but the stance is... If you are an asthmatic and you use your "blue puffer (reliever) medication" more than once /week, then you have poor control of your asthma.
So, interesting and challenging concept. I wonder how many asthmatics out there using their Salbutamol 2-4 times each day to "stay well" , actually believe that they could be better controlled?
If an asthma flare up occurs, most Asthmatics will have a management plan ( often a written down list of "what to do instructions").
The Resus Council, and Asthma Council maintain that asthma flare up treatment includes the following:
4 puffs of salbutamol (1 puff with 4 breaths)
Always use a spacer- never place the puffer in your mouth.
Wait 4 minutes, then
Repeat the 4 puff regimen.
Don't use oxygen unless the patient's saturation is less than 94%.
Remember: 4 puffs, 4 breaths, 4 minutes and repeat. Puffers only hold 200 medicated doses, after that the puffer sprays a propellant gas, that to the patient feels and sounds and tastes like salbutamol. Don't be fooled. Use a new metered inhaler every time.
Bottom line is this is a disease of lower airway bronchoconstriction.
They need a bronchodilator more than anything else.
Steroids, including IV Hydrocortisone won't help an acute flare up, they take 4-6 hours to start working on oedema control.
We have to get air into their distal alveoli and into their bases.
It's all about the Base 😉
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