How To Manage Asthmatic Attacks? Scientific Advice on Preventing and Managing Asthma.

Breathing is so fundamental to living that we seldom give it a second thought. But for individuals who struggle with asthma, each breath may be a stark reminder of the precarious balance between ease and difficulty.

Millions worldwide suffer from asthma, a chronic respiratory ailment with no boundaries regarding age, gender, or socioeconomic status. It is a chronic respiratory condition that causes inflammation and constriction of the airways in the lungs. This results in respiratory difficulties, coughing, wheezing, and chest constriction. Asthmatic attacks occur when these symptoms suddenly worsen.

Researchers believe a combination of hereditary and environmental variables causes it. To have a detailed overview of what is asthma and what can cause it? We have a whole article full of scientific information about this ver condition. Click here to read.

How To Prevent Asthma as a Healthy Person

To prevent the onset of asthma, you must actively maintain your overall health and well-being. Even though asthma can be triggered by genetic and environmental factors, adopting a healthy lifestyle can substantially reduce the likelihood of developing this chronic respiratory condition.

Let us go through a few prevention tips.

Balanced Diet: A diet comprising fruits, vegetables, whole cereals, lean proteins, and healthy lipids is essential for maintaining good lung health and promoting overall well-being. Even a recent 2020 study in the American Journal of Respiratory and Critical Care Medicine found that a diet rich in fruits and vegetables reduces the risk of asthma due to their antioxidants and nutrient content.

Also, it is also recommended to avoid processed foods as additives, and unhealthy lipids found in processed foods can contribute to inflammation and respiratory problems.

Avoid Smoking: According to the guidelines of the Global Initiative for Asthma (GINA), smoking is a significant risk factor for the development of asthma. So avoiding both active and passive smoking is important to prevent asthma.

Minimize Environmental Allergens: It has been found in multiple studies that limiting exposure to indoor allergens such as dust mites and pet dander can aid in asthma prevention. (1) (2) (3)

Avoid Workplace Allergens: It is important to identify asthma triggers in the workplace. Effective preventive measures include using Personal Protective Equipment (PPE), ensuring adequate ventilation, practicing hygiene, and storing chemicals safely.

Stay Hydrated: Staying hydrated is beneficial for overall respiratory health. According to a review published in the Journal of the American College of Nutrition in 2020, adequate hydration enhances mucous membrane function and reduces airway irritation, thus reducing asthma.

Regular Health Checkups: If you want to monitor your health and spot any problems early, the National Heart, Lung, and Blood Institute advises scheduling regular checkups. Prevention plans can be tailored to the individual based on their family history and other risk factors discussed with their doctor.

Managing and Preventive Strategies For Asthmatics

The Asthma and Allergy Foundation of America research revealed that 88% of asthma patients believe their condition is under control. However, 61% have experienced breath catching, 50% stopped exercising during routine, and 48% have been awakened at night due to asthma.

A simple asthma management regimen may be the most viable option for asthmatics to control their symptoms.

1. Know Your Triggers

Individuals with asthma must learn to recognize and avoid their unique triggers to control their disease. According to a small study in 2019, only 59% of asthmatics knew their triggers and how to avoid them.  These triggers can be better managed if identified and recorded in a patient’s medical history.

The best strategy to identify your triggers is to keep a journal of symptoms with all the physical and mental triggers that can affect the asthma attack. These recorded journals can really help asthmatics as well as medical professionals to deduce a plan for treatment.

Another approach that can be used is an Asthma Home Environment Checklist to identify triggers and devise a plan for eliminating or mitigating exposure to each one.

One can also consult the asthma doctor about allergy testing to identify the triggers for the condition. After that, one can discuss these triggers and strategies to avoid them. For example, if an asthmatic person is found to be allergic to dust mites, then they can use the airtight cover in order to prevent penetration of mites inside. One can also take precautions before exercise if diagnosed with exercise-induced asthma.

2. Create an Asthma Action Plan

Creating an asthma action plan is recommended by doctors worldwide for asthmatics. Regular medications, emergency procedures for an asthma attack, and long-term strategies for managing the problem will all be included in the plan.

The American Academy of Allergy, Asthma, & Immunology provides a downloadable plan that, like many others, divides asthma into three color-coded divisions, or “zones.” By remembering how bad your symptoms are, you’ll know when to seek treatment.

Green zone: The green zone denotes good health, with peak flow between 80 and 100 percent, the absence of asthma symptoms, and the ability to engage in everyday activities.

Yellow Zone: The yellow zone indicates worsening asthma, characterized by peak flow being 50% to 80% of personal best. With symptoms like,

• Coughing, wheezing, or difficulty breathing.
• Limited daily activities
• Nighttime awakening due to asthmatic symptoms
• Symptoms persist or worsen for 24 hours.

Red Zone: As the name indicates, the peak flow meters can be as low as 50% of the personal best with symptoms like Severe shortness of breath, inability to perform daily tasks, and quick relieving medications that aren’t helpful at the time. It is best to call 911 or a medical emergency right away.

3. Avoid Smoke

Asthma is usually made worse by smoking; still, 21% of asthmatics smoke, which can worsen their condition. That is why smoke of all kinds, such as from cigarettes, incense, candles, fires, and fireworks, should be avoided as much as possible.

4. Allergy-Proof Your Home

Asthma patients require an allergy-friendly home environment to effectively manage their condition, as allergens can trigger symptoms and exacerbate attacks, thus enhancing their quality of life.

One can reduce the exposure to allergens and the likelihood of an asthmatic attack by taking the following measures wherever you go:

• Keeping Home Clean: Dust surfaces with a moist cloth and run a HEPA-filtered vacuum over carpets, rugs, and upholstery on a regular basis to keep allergens out of the air.
• Choose Asthma-Friendly Flooring: Carpets are not the best choice for those with asthma because they can trap dust mites and other allergens in the fibers. So, instead of installing wall-to-wall carpeting, go with a hard flooring surface like wood, tile, or laminate.
• Invest in Allergen Proof Bedding: Use allergen-proof coverings on your bedding to keep allergens at bay. Dust mites and other allergens are kept out of the beds by the barrier these coverings create. Also, it is best to avoid feather-filled bedding material. They have been found to reduce asthmatic symptoms, according to research done in 2017.
• Washing pillows and Covers: The American College of Asthma, Allergy and Immunology recommends washing sheets, stuffed toys, bed sheet covers, and pillows in hot water (130 degrees Fahrenheit or higher) once weekly to get rid of dust mites and allergens.

Cleaning should not be done by the asthmatic induviduals as it can worsen thier symptoms. 

If you have asthma, though, you should probably have someone else do the cleaning and washing, and you should probably avoid the area while it’s occurring and for a bit after that.

• Control Pests in Home: To prevent pests, remove water and food sources, clean dishes and spills immediately, store food in airtight containers, keep trash closed, and avoid sprays and foggers, as they can trigger asthma attacks.
• Have a Pet-free Zone in Home: If someone in your home suffers from asthma and you have pets, you may want to consider making specific locations off-limits to your pets. Pet dander is a frequent allergy, which can help decrease your exposure to it. Also, people who suffer from allergies to animal dander are sometimes advised by their doctors to avoid owning feathered or furry pets.
• Ensure ventilation: Installing exhaust fans in the kitchen and the bathroom is also recommended to ensure enough ventilation. Indoor air pollution may be mitigated and allergy levels lowered by installing proper ventilation systems.

5. Breathing Exercises

Breathing exercises may be helpful, especially for those who suffer from stress-induced asthma or asthmatic symptoms during a panic attack. One can use them to help relax and concentrate on breathing.

A 2016 study published in the Journal of Asthma and Allergy Educators found that after eight weeks of diaphragmatic breathing training, individuals with moderate asthma improved their symptoms, used fewer rescue inhalers, and improved their quality of life. Another 2017 study found that a simple breathing exercise regimen for 10 minutes a day can significantly improve the breathing patterns in asthmatics.

While medical treatments remain essential, incorporating these exercises into daily routines can enhance lung function, reduce stress, and promote overall respiratory health. You can do many breathing exercises. To learn them, please refer to our article here.

6. Use Humidifiers  and Air Filtration

For some asthmatics, introducing moisture to the air can alleviate symptoms. That is when the use of a humidifier comes into action. Humidifiers increase the amount of moisture in the air by evaporating water.

However, if used improperly, they may exacerbate asthma symptoms. It has been found that too much moisture in the air can promote the proliferation of dust mites. The American Academy of Allergy, Asthma, and Immunology (AAAAI) suggests maintaining a humidity level between 40% and 50% to avoid this issue.

It is also important to regularly clean your humidifier to prevent fungal growth. It is preferable to use distilled or demineralized water, as high mineral concentrations, such as those in tap or bottled water, can promote bacterial proliferation.

An air filtering system can reduce asthma-related triggers such as pet dander, mold, dust, and other allergens. Filters certified as asthma & allergy friendly® remove nearly 98% of airborne allergens with tiny particles (0.3 microns or smaller). So it would be a worthy investment indeed.

7. Getting an Allergy Shot

Immunotherapy has traditionally been used to treat allergic conditions such as hay fever and allergic rhinitis. However, recent research suggests that it could also play a role in preventing the development of asthma, especially in individuals at high risk due to allergies. Even a study published in the New England Journal of Medicine revealed that immunotherapy significantly reduces the risk of asthma in young children.

Immunotherapy is a treatment that modifies the immune system’s response to stimuli, gradually decreasing sensitivity. Immunotherapy for asthmatics is typically administered as allergy shots by physicians or other medical personnel. These shots contain a small amount of allergen that usually triggers a person’s asthmatic attack.

Initially, injections are given once or twice a week, gradually decreasing to once a month, and may continue for three to five years until desensitization occurs.

8. Medical Management For Asthma

Asthma treatments include various drug combinations to alleviate symptoms, decrease inflammation, and avoid exacerbations. These medications are usually divided into two groups, one for daily intake for asthmatics and others to prevent an asthma attack. All these medications are formulated in various methods such as an inhaler, nebulizer, or other device for inhaling medications such as a vapor, a tablet, a liquid, an injection, or an infusion.

Quick Relief Medications 

These are typically inhaled corticosteroid medications that reduce inflammation and reduce the body’s response to triggers if any asthma attack occurs. Preventatives take time to become effective (up to three months of consistent use). If these drugs are required regularly, it may suggest poor asthma control.

Bronchodilators: Also known as Short-Acting Beta-Agonists (SABA). Doctors prescribe bronchodilators to make breathing easier and provide quick relief within 5-15 minutes of administration,  which relaxes the muscles lining the airways. They work quickly to alleviate symptoms once they have developed. They are often given through an inhaler or nebulizer, however, they can also be taken orally or intravenously.

Salbutamol and terbutaline are two examples of short-acting remedies.

Corticosteroids: Oral or liquid medications may be needed if an asthma episode persists after using a relief inhaler. These medications have a rapid onset and speed up recovery, with three to ten days of recommended duration. Severe asthma patients may use these daily alongside their control medication. Prednisone and methylprednisolone are examples.

Anti-Cholinergics: As with other bronchodilators, it acts fast to relax the airways, making breathing easier. They are mostly used to treat emphysema and chronic bronchitis but can also be used to treat asthma. Examples include ipratropium bromide.

Sublingual Immunotherapy Tablets: Instead of having injections, one can ingest small quantities of allergen in pills that dissolve below the tongue and are used in asthma attacks related to allergens.  Pills are often used on a daily basis. Sublingual immunotherapy pills are ineffective for many allergies, although they can assist with grass, ragweed pollens, and dust mites.

Everyone with asthma should carry a rescue inhaler (albuterol), even if they don’t use one regularly.

Long-term Asthma Control Medications

These medications are taken daily to help reduce the frequency and severity of asthma symptoms, but they do not treat the symptoms of an acute asthma attack.

Long-term asthma medications include the following:

• Inhaled Corticosteroids are the most frequent and effective long-term asthma attack medicines. These are not the same as anabolic steroids, which are used to build muscle, and they function by decreasing airway inflammation. Fluticasone, budesonide, and beclomethasone are a few examples. Compared to oral corticosteroids, inhaled corticosteroids have a minimal risk of major adverse effects.
• Anti-inflammatory medications. Corticosteroids and other anti-inflammatory drugs administered via inhaler reduce airway inflammation and mucus production, making breathing simpler.
• Anticholinergic agents. These prevent the constriction of the muscles surrounding the airways. They are typically taken daily with anti-inflammatory medications.
• Leukotriene modifiers: These medications inhibit the effects of leukotrienes, which are immune system substances responsible for asthma symptoms. Leukotriene modifiers can aid in symptom prevention for up to twenty-four hoursr.
• Long-acting bronchodilators.  Also known as Long-Acting beta agonists (LABAs), they are frequently used with inhaled corticosteroids in a single inhaler. They aid in the relaxation of the airway muscles, making it easier to breathe. Salmeterol and formoterol are two examples.

Treating Severe Asthma

Biological  Therapies

Symptoms of asthma can be alleviated by taking biological therapies, which are drugs that target particular molecules in the body. They are prescribed to patients whose severe asthma is poorly managed by existing treatments. Biologics are administered intravenously or subcutaneously to patients with severe, uncontrolled asthma once every two weeks or once a month.

In summary, the medication used over the long term to regulate inflammation and avoid symptoms can be used during acute episodes to give rapid relief. Treatments like biologics and bronchial thermoplasty may be necessary for patients with severe asthma. A person’s severity of asthma and particular demands must be considered while formulating the optimal medicine plan.

Bronchial Thermoplasty

Bronchial thermoplasty is a medical procedure used to assist in opening the airways in severe asthmatics, reducing the adjacent muscle’s size and preventing it from contracting.

This treatment reduces the size of the surrounding muscle and prevents it from constricting by heating the airways within the lungs with an electrode. A physician typically administers this minimally invasive procedure in a clinic or hospital, which takes approximately one hour. This treatment is intended for individuals with severe asthma and can provide up to five years of symptom relief.  Due to the novelty of the procedure, it is not yet broadly accessible.

9. Use Home-Based Air Flow Meter

Using the meter, one can see how efficiently the lungs transport air. The airways constrict when an attack occurs. The meter can provide you advance warning of this happening, thus saving you from worrying and stress. You can then follow your treatment plan and take the necessary drugs to prevent the attack.

Hours or days before one has symptoms, a simple pocket-sized gadget called a peak flow meter can assist in identifying constriction in the airways.

In the same way, you might use a blood pressure cuff to measure high blood pressure or a thermometer to record your temperature. You simply breathe into it as instructed by your doctor to monitor your airways. There are a variety of peak flow meter styles and patterns. Ask your physician which option is best for you. Your physician may divide your peak flow numbers into zones (green = safe; yellow = cautionary; red = emergency) and work with you to devise a plan.

Dealing With Asthmatic Attack

Dealing with asthmatic episodes is a major source of stress for many who suffer from the condition.

These alarming incidents of shortness of breath and wheezing may be managed, and their effects lessened with proper knowledge and preparation. What do you do when you or anyone else suffers from an asthmatic attack?

• Remain Calm: The first and foremost thing to do is keep calm and reassure the individual experiencing the attack. Anxiety can exacerbate the situation, so your presence can be beneficial.
• Sit in Upright Position: During an asthma attack, the airways become constricted, making breathing difficult.

Sitting straight can facilitate breathing by enabling the airways to open more effectively. Encourage them to rest in a comfortable position by providing support.

• Assist With Medication: Help the individual use their prescribed quick-relief inhaler (which typically contains albuterol). Encourage them to inhale the medication with thoughtful, deep inhalation. The recommended criteria is to take two puffs of an inhaler one minute apart. If there is no alleviation, take an additional puff of the inhaled beta-agonist every five minutes. If there is no response after eight breaths or forty minutes, a medical professional should be contacted.
• Sipping Water: You can assist in relaxing their breathing by giving them little sips of water to drink. Don’t flood them with water simultaneously, as it might irritate their cough.
• Loosen up Restrictive Clothing: If the individual is wearing clothing that is too tight around the neck or torso, loosen it gently to improve respiration.
• Stay With Them and Reassure: Watch their condition closely as you wait by their side. Encourage them to keep using the inhaler and reassure them that they are doing the right and will be fine soon.
• Record the Condition: Encourage them to record the triggers, symptoms, and actions following the attack. This information can be useful to the patient’s healthcare provider.
• Seek Medical Assistance: A minor episode should ease within a few minutes. If it doesn’t, they should keep using the inhaler as usual. If they are having trouble breathing, are worsening with fingernails and lips turning blue, or if they become unable to communicate, you should dial 999 immediately. If the attack gets very severe, stay with them. Get someone else to dial 911 if you can’t.

Achieving Controlled Asthma

Controlled asthma is a goal for those suffering from this chronic respiratory ailment. By controlled asthma, we mean,

• There are no gasping or wheezing sounds.
• No breathing difficulties or chest discomfort
• No nighttime awakenings due to asthma symptoms (such as wheezing).
• Not needing to use a rescue inhaler (albuterol) or more frequently than once per week for symptoms.
• Being able to engage in any activity without limitations or side effects.
• Avoiding school and work absences due to asthma symptoms
• Taking prescribed medications without experiencing adverse effects

Most asthmatic people can get asthma under control if they see their doctor twice a year, take their medication as prescribed, and follow their asthma management (action) plan. Asthmatics should be able to lead normal lives after their condition is under control, including sleeping through the night, going on long hikes, playing competitive soccer, and going for extended swims in pools and lakes.

Although asthma can significantly influence one’s everyday life, it can be managed appropriately, and the condition’s interference is reduced with a well-structured treatment plan, avoiding triggers, and eating a well-balanced diet.