3 May 2022 marks the 24th World Asthma Day, and this year's theme is "Closing gaps and achieving homogeneous management of asthma".
In recent decades, various countries and regions around the world have been continuously promoting and strengthening the standardized treatment and management of asthma, but the level of asthma control is still not ideal.
Globally, there are still many gaps in all aspects of asthma management, the theme of World Asthma Day prevention and treatment is to call on practitioners in the respiratory field, asthma patients and families around the world to work together to eliminate the gap, promote asthma management programs or methods that can be implemented and applied from local areas to the world, in order to reduce the pain of diseases and medical expenses caused by uncontrolled asthma, and finally realize the homogeneous asthma management of hospitals in various regions and different levels, and achieve overall control of asthma. Let every asthma sufferer breathe smoothly and live a normal life.
At present, the gaps in asthma management are mainly as follows:
1. Gaps in access to equal diagnostic and treatment opportunities. Gaps in asthma management at different socioeconomic levels, ethnicities and ages, and in disease management and care between rich and poor areas or countries.
2. Gaps in communication and asthma management between different levels of medical institutions. There are gaps in the forms of communication and education offered to asthma patients in different health facilities.
3. Gaps in healthcare workers' knowledge and awareness of asthma. This is reflected in the gap between the doctor's actual ability to prescribe inhalation drugs and monitor patient compliance and the correct use of inhalation devices. There are also some gaps in the characteristics or specificities of different regions, as well as gaps in public (non-asthmatic) and healthcare workers' perceptions of the nature of asthmatic diseases.
1
What are the causes of asthma?
Asthma is caused by genetic-environmental interactions. Among them, 60% to 70% of patients have allergic asthma.
First, people susceptible to asthma have genetic factors, and people with allergic diseases in family relatives have a genetic predisposition of 25 to 50%.
Second, the environmental factors that cause asthma include: allergens (inhalation and ingestion), that is, various specific and non-specific inhalants, such as dust mites, pollen, fungi, animal dander, etc.; chemical substances, such as sulfur dioxide, ammonia, paints; food, such as fish, shrimp, crabs, 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 smoke environment, smog, engaging in home decoration.
2
What are the symptom characteristics of asthma?
Asthma sufferers often have comorbid allergic diseases such as allergic rhinitis, eczema, or urticaria. Symptoms and features of asthma:
1. Episodic exacerbation when encountering precipitating factors.
2. Rhythmic onset or aggravation is often at night and in the early morning.
3. Seasonality often occurs or worsens in spring or autumn and winter.
4. Reversible use of bronchodilators can usually alleviate symptoms, and there may be a significant period of remission in the course of asthma (there can be asymptomatic remission period of several months or even years, so it also leads to the patient's untreated fluke mentality).
3
What are the characteristics of asthma-induced wheezing?
During an asthma attack, different symptoms may be presented with different symptoms due to the degree of airway stenosis, such as cough, chest tightness, shortness of breath, wheezing, etc. (from mild to severe).
Symptoms of asthma are recurrent wheezing, shortness of breath, with or without chest tightness or cough (asthma with cough as the only manifestation or predominant manifestation, called cough variant asthma), which occurs at night and in the early morning, and is often associated with exposure to allergens, cold air, physical and chemical irritation, and upper respiratory tract infections and exercise; these symptoms can be relieved after treatment or resolve on their own. The remission period can be as asymptomatic as normal people. The most common combination of asthma is allergic rhinitis.
4
Which wheezing is not related to asthma?
Asthma is different from asthmatics from other diseases: mainly with different concomitant symptoms, different for underlying diseases.
1. Wheezing caused by cardiac insufficiency, mostly worsening when lying flat at night, and reducing wheezing after sitting up. Patients have had underlying heart diseases such as hypertension and coronary heart disease in the past.
2. Wheezing caused by COPD, mainly shortness of breath after activity, wheezing is alleviated after sitting down and resting. The patient has a history of smoking or exposure to biofuels.
3. Chest tightness and wheezing caused by acute/chronic pulmonary embolism are mostly based on chest tightness, which is aggravated after activity. Patients often have varicose veins in the lower extremities or prolonged sedentary or bedridden 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 genetic predisposition of 25% to 50%.
People with allergies are at increased risk of developing a variety of allergic reactions or allergic diseases, such as people with eczema, food allergies, skin allergies, drug allergies, etc. who have developed asthma since childhood.
People who are exposed to various allergens for a long time, such as pollen, pets, dust mites, mold, etc.
People who do certain special jobs, such as cleaners, painters, textile processing, etc.
6
What do asthmatics need to be aware of?
High-risk groups need to pay attention to the symptoms of autosensory diseases, early detection, early treatment.
It is recommended that asthma patients undergo allergen testing, understand their own allergens, and avoid contact as much as possible in life, which can delay the progression of the disease and reduce the severity of asthma.
Patients with allergic rhinitis should be treated aggressively, which can delay the transition of rhinitis to asthma.
Asthma patients must not take chances, and need to carry out standardized treatment to avoid asthma exacerbations and reduce hospitalization or death events. Because, an acute attack of asthma can cause the occurrence of death events!
7
How to identify an acute asthma attack?
Every asthmatic learns to recognize an acute asthma attack!
Any of the following symptoms or symptoms indicate an acute exacerbation of asthma, but the symptoms differ only in severity: sudden exacerbation of wheezing symptoms, increased frequency of wheezing, pronounced shortness of breath, increased heart rate, or even sitting breathing, cyanosis, speech, sweating, increased number of breathing, and even drowsiness and confusion.
Every asthma sufferer needs to learn to help themselves!
8
How to deal with an acute asthma attack?
When a patient has an acute exacerbation of asthma, the patient and his family should be able to master the basic management methods.
Patient himself
When asthma is acute, immediately inhale a rapidly acting bronchodilator (such as salbutamol aerosol), first inhale 2 to 4 sprays, after 20 minutes of wheezing does not relieve the inhale can be inhaled again 2 to 4 sprays, 20 minutes later still no relief, you can inhale 2 to 4 sprays again, while dialing the "120" emergency telephone, seek medical treatment as soon as possible, to the hospital for further treatment.
Family members or accompanying personnel of the patient
Help the patient find the most comfortable position, help the patient sit up, lean forward slightly, let the patient breathe a lot of fresh air, and inhale oxygen if necessary.
Quickly prepare medications and inhalation devices for the patient and help the patient apply rapidly relieved medications (e.g., salbutamol aerosols).
Patients with moderate and severe asthma attacks are first helped to inhale 2 to 4 injections of bronchodilators (e.g., salbutamol aerosol) and are quickly transported to the nearest hospital for treatment.
Try to comfort the patient, eliminate their nervousness, assist the patient to discharge sputum, guide the patient to breathe, and if necessary, quickly give the patient hormone drugs to alleviate the condition, and send it to the hospital as soon as possible.
Author: Su Nan, chief physician of the Department of Respiratory and Critical Care Medicine of the National Respiratory Medicine Center and China-Japan Friendship Hospital
Audit: National Health Science Popularization Expert Database Expert,
Yang Ting, chief physician of the Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital
Curator: Tan Jia
Editor: Liu Yang
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