May 3, 2022 marks the 24th World Asthma Day, and this year’s theme is “Bridging the gaps for a homogeneous management of asthma.”
In recent decades, countries and regions around the world have been promoting and strengthening the standardized treatment and management of asthma, but the level of asthma control is still not ideal.
There are still many gaps in asthma management around the world. The theme of World Asthma Day is to call on respiratory practitioners, asthma patients and their families around the world to work together. Eliminate disparities and promote asthma management programs or methods that can be implemented and applied locally and globally to reduce the pain and medical expenses caused by uncontrolled asthma, and ultimately achieve the same regional and different levels of hospitals. Qualitative asthma management to achieve overall control of asthma, so that every asthma patient can breathe smoothly and live a normal life.
Current gaps in asthma management include the following:
1. The disparity in access to equal diagnosis and treatment. Disparities in asthma management across socioeconomic levels, ethnicity and age, and disparities in disease management and care between rich and poor regions or countries.
2. Gap in communication and asthma management among different levels of medical institutions. There are disparities in the form of communication and education provided to asthma patients by different healthcare facilities.
3. The gap between medical staff’s knowledge and awareness of asthma. This is reflected in the gap between physicians prescribing inhaled medication and the actual ability to monitor patient compliance and proper use of inhalation devices. There are also regionally specific or specific gaps, as well as gaps in public (non-asthmatic) and health-care workers’ perceptions of the nature of asthma.
1
What are the causes of asthma?
Asthma is caused by gene-environment interactions. Among them, 60% to 70% of patients have allergic asthma.
First, people who are prone to asthma have genetic factors. People with allergic diseases in family members have a 25-50% genetic predisposition.
Second, environmental factors that cause asthma include: Allergens (inhalation and ingestion), i.e. various specific and non-specific inhalants such as dust mites, Pollen, fungi, animal dander, etc.; chemicals, such as sulfur dioxide, ammonia, paints; food, such as fish, shrimp, crab, eggs, milk, etc.; Drugs, such as propranolol, aspirin, etc.; infections/microorganisms, such as cells, viruses, protozoa, parasites, etc.; nutritional factors, Such as lack of vitamin D; environmental pollution, such as smoky environment, smog, engaged in home decoration.
2
What are the symptoms of asthma?
Asthma patients often have comorbid allergic diseases such as allergic rhinitis, eczema or urticaria. Symptoms of Asthma:
1. Episodic When a predisposing factor is encountered, the episodic exacerbation occurs.
2. Rhythmicity often occurs or worsens at night and in the early morning.
3. Seasonal often occurs or worsens in spring or autumn and winter.
4. Reversible The use of bronchodilators usually relieves symptoms, and there may be significant periods of remission during the course of asthma (which can range from months or even years without period of remission of symptoms, thus also causing patients to have a fluke without treatment).
3
What are the characteristics of wheezing caused by asthma?
An asthma attack may present with different main symptoms due to the degree of airway stenosis, such as cough, chest tightness, shortness of breath, wheezing, etc. (from mild to severe).
Asthma is characterized by recurrent episodes of wheezing, shortness of breath, with or without chest tightness or coughing (asthma in which coughing is the sole or predominant manifestation is called cough variant asthma) , which occurs mostly at night and in the early morning, and is often related to exposure to allergens, cold air, physical and chemical stimulation, upper respiratory tract infection and exercise; these symptoms can be relieved after treatment or relieved on their own. The remission period can be asymptomatic as normal people. The most common coexistence of asthma is allergic rhinitis.
4
Which wheeze is not associated with asthma?
Asthma is different from wheezing in other diseases: It is mainly due to different accompanying symptoms and different underlying diseases.
1. The wheezing caused by cardiac insufficiency is mostly aggravated by lying down at night, and relieved after sitting upright. Most of the patients had underlying heart disease such as hypertension and coronary heart disease in the past.
2. The wheezing caused by COPD is mainly shortness of breath and wheezing after activities, and the wheezing is relieved after sitting down and resting. The patient had a history of smoking or exposure to biofuels.
3. Chest tightness and wheezing caused by acute/chronic pulmonary embolism are mostly chest tightness, which is aggravated after activities. Most of the patients have varicose veins in the lower extremities or long-term sedentary or bed rest after surgery.
5
Who is more likely to develop asthma?
People whose parents or relatives have asthma or allergic rhinitis or other allergic diseases have a 25% to 50% genetic predisposition.
People with allergies are at increased risk of developing various allergic reactions or allergic diseases, such as asthma in people with eczema, food allergies, skin allergies, drug allergies, etc. since childhood increased risk.
People who have been exposed to various allergens for a long time, such as pollen, pets, dust mites, mold, etc.
A person who does certain special jobs, such as cleaners, painters, textile workers, etc.
6
What should people with asthma be aware of?
High-risk groups need to pay attention to the symptoms of their allergic diseases, early detection and early treatment.
Asthmatic patients are advised to perform allergen testing to understand their own allergens, and try to avoid exposure in life, which can delay the progression of the disease and reduce the severity of asthma.
Allergic rhinitis patients should be actively treated to delay the transformation of rhinitis into asthma.
Asthma patients must not take chances and need standardized treatment to avoid asthma exacerbation and reduce hospitalization or death. Because asthma exacerbations can cause death!
7
How to recognize an asthma exacerbation?
Every asthma sufferer needs to learn to recognize an asthma exacerbation!
The presence of any one or more of the following symptoms indicates an acute exacerbation of asthma, depending on the severity of the symptoms: sudden exacerbation of wheezing, increased wheezing frequency, marked shortness of breath , increased heart rate, or even orthopnea, cyanosis, speaking a single word, sweating profusely, increased breathing, and even drowsiness and disturbance of consciousness.
Every asthma sufferer needs to learn to help themselves!
8
How to deal with an asthma attack?
When a patient experiences an acute exacerbation of asthma, the patient and his/her family must be able to master basic management methods.
Patient himself
In the event of an acute asthma attack, immediately inhale a fast-acting bronchodilator (such as albuterol aerosol), first inhale 2 to 4 puffs, and re-inhale after 20 minutes if the wheezing is not relieved 2~4 puffs, if there is no relief after 20 minutes, you can inhale 2~4 puffs again, and at the same time call the “120” emergency number, seek medical treatment as soon as possible, and go to the hospital for further treatment.
Patient’s family or companion
Help the patient find the most comfortable position, help the patient sit up, lean forward slightly, and allow the patient to breathe plenty of fresh air and oxygen if necessary.
Get medication and inhalation device ready for the patient quickly, and help the patient apply rapid-relief medication (eg, albuterol aerosol).
Patients with moderate and severe asthma attacks should be given 2-4 inhaled bronchodilators (such as albuterol aerosols) first, The patient was transported to the nearest hospital for treatment.
Relieve the patient as much as possible, relieve their tension, assist the patient in expectoration, guide the patient to breathe, give the patient a hormonal drug if necessary to relieve the condition, and send the patient to the hospital as soon as possible .
(Source: Healthy China)