The signs of a severe asthma attack. The

The 21st
century is the era of increased air pollution and record breaking environmental
changes that have caused a surge in asthma diagnoses all around the world. Asthma
can affect people of gender, ages, and climates; which is why it is imperative
to know the symptoms of asthma and the signs of a severe asthma attack. The National
Heart, Lung, and Blood Institute define asthma as “…a chronic (long-term) lung
disease that inflames and narrows the airways” (National Heart, Lung, and Blood
Institute). Asthma is a respiratory disease that has definitive symptoms such
as chest tightness and shortness of breath, which makes it an easy disease to
diagnose in adults but a little more difficult to diagnose in children. Understanding
and being able to identify the symptoms of asthma and becoming familiar with
the normal functions of the lungs, as well as treatments is important to know
with increasing air pollution percentages each year.

The
respiratory system is responsible for the exchange of carbon dioxide for oxygen
taken in from the environment. Air is inhaled through the pharynx and larynx
and then travels through the trachea, where is separates into two bronchi in
each lung. Ciliated cells located in each bronchus beat upwards towards the
trachea to try and keep the airways clear of any irritants during respiration. Goblet
cells are on top of the ciliated cells and when there is an asthmatic trigger,
these goblet cells will produce a thick mucous that will trap the dust, pollen,
or bacteria that are inhaled. Now this is where the ciliated cells would be
pushing the mucous and irritants out of the airway to be coughed up or sneezed
out. In each lung, each bronchus then branches off into bronchioles and
continue to the alveoli, where gas exchange occurs. If someone with asthma or
shortness of breath has an asthma attack, this means that the airways are being
constricted by inflammation and that gas exchange is not functioning correctly due
to a build up of mucous and swelling of the airways. Some allergens in the
environment trigger this and the symptoms that accompany an asthma attack
include wheezing, coughing, shortness of breath, and chest tightness (“Learn
How to Control Asthma”, 2017). When an asthmatic irritant enters the airways it
causes the smooth muscle to constrict and produce mucous which decreases the
amount of air coming through and causes the person to wheeze when having an
asthma attack.

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If someone is experiencing these symptoms, one
should see a doctor to make a correct diagnosis before starting treatment.
Before a diagnosis can be made the patient should undergo a physical
examination where a doctor will listen to the lungs respiration sounds and look
at the nose and mouth passages for swelling. A lung function test will also be
performed called a spirometry test that, “measures how much air you can breathe
in and out. It also measures how fast you can blow air out” (National Heart,
Lung, and Blood Institute). A doctor will also look into the family histories,
previous medical records, or perform older tests such as a chest x-ray or an allergy
test to get the most accurate assessment of the symptoms. All these tests help
in determining the cause and severity of asthma in patients. Children in between
the ages of one and seven are at a higher risk of having asthmatic symptoms
whether its genetic or environmental, according to the National Health Survey,
an increase in children’s asthma from 2001-2009 has reached roughly about
9-9.5% versus adults about 7% (National Center for Environmental Health). This
disease has a bigger effect on children because the airways of a child are
significantly smaller than adults, making the inflammation more severe if a
child comes in contact with any asthmatic triggers such as cigarette smoke,
paint fumes, allergens, or excessive physical exercise. Especially since there
has been an increase in the percentage of people affected with asthma, children
seem to be affected more, but adults can start to develop symptoms at any age.
A person with asthma is termed as having hyper-responsive
airways that, “Instead of allowing mucus and cilia to get rid of the perceived
threat, the body overreacts, signaling the immune system to launch an
aggressive attack” (Sheen). The mass
production of mucus makes it extremely difficult to breathe and with already constricted
airways patients need treatments like corticosteroids
to help with the inflammation of the airways. Most people with asthma use an
inhaler to combat attacks since they can manifest from the slightest changes
like in the temperature or pollution percentages.

The
likelihood of having an asthma attack can be increased by many factors such as
environmental conditions, exercise, medications, age, and gender. A study done
in 2001 by UCLA Health (Meng, Babey, Malcolm, Brown, and Chawla) found that
children and youth are at a higher risk of asthma prevalence and that it
decreases around the age eighteen. (Figure 1). Also that more males under the
age of eighteen are diagnosed than females; and females over the age of
eighteen are diagnosed more than males. (Figure 2).

Asthma
symptoms have been clinically defined since the 1980’s, there has been many
studies that have tested the best treatments for different types of asthma;
whether it was genetic or caused by an allergen. However, there is no actual cure
for asthma; just good symptom management methods and allergen prevention. A person
who has multiple asthmatic symptoms increases the severity of their attacks so
they are much more intense and thus increasing the chances of having to be
hospitalized. Asthma attacks can range in severity, if the airways can’t be
alleviated with a prescription inhaler, one could have to be hospitalized for
as long as a week. Immunotherapy shots and dissolvable medicine tablets are
some forms of allergen prevention that can help minimize the chances of having
an asthma attack, but avoiding any irritants is the best prevention method. Patients
can go to the doctors for allergy shots to help the body build up immunity to
the allergen before allergy season comes around. Main treatments that can be
administered at home include bronchodilators such as anticholinergic and
anti-inflammatories. Most of these are inhaled medications which can either be
delivered as short or long acting treatments to “relax the muscles around the
airways” or “reduce the swelling and mucous production inside the airways” (American
Lung Association). Some long term treatments involve immunomodulators, inhaled
corticosteroids, and long- acting inhaled beta2-agonists to improve asthma
control. Some medications can be used simultaneously, while others should not
be combined together. It is important to take medications as directed by a
doctor and only when needed. These short and long term treatments do not cure
symptoms of asthma but maintains them to reduce the amount of asthma attacks
and flare ups.

Asthma can affect any person with sensitive airways
introduced to allergens in the environment that have been inhaled. These
airways are important to keep sterile in order to minimize chest infections and
asthma attacks. When someone is having an asthma attack their airways become inflamed
and constricted with mucous that causes chest tightness and prevents the intake
of oxygen. Learning how the lungs function, how to prevent coming in contact
with allergens, and finding the best treatment plan is the best way to minimize
asthma attacks. Breathing is vital to our survival which is why we have to
continue learning the correct way to manage asthma symptoms and discover better
at treatments for those affected. 

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