Examination of Asthma

You may have read about the articles related to emergency airway in this blog. You want better know about it, the article below is about asthma. Of course you already know about this disease. Please reads....
Asthma is also called reactive airway disease (RAD) is a disease of the airway obstruction is characterized by reversible bronchospasme, inflammation and increased airway reaction to various stimuli

Asthma is divided into:

• Allergic asthma; caused by allergies such as pollen, animal, angry, food, and mushrooms.
• Asthma idiopathic or non-allergic; such as colds, respiratory infections, exercise, emotions, and environmental pollutants can cause an attack, pharmacological agents: agent’s aspirin and anti-inflammatory drugs, hair dyes, beta-adrenergic antagonists, and agent’s sulfite.
• Asthma combined; a form of asthma is the most common. It is characterized by allergic asthma and idiopathic nonalergic.

• Levels of asthma

1. Level I, clinically normal, no abnormalities of physical examination and lung function. But the patients experienced problems when their bodies are experiencing physical or emotional weakness
2. Level II. Patients without complaints and abnormalities on physical examination. Showed lung function and airway obstruction often found after recovering from asthma
3. Level III. In patients with no complaints but the physical examination and pulmonary function abnormalities that indicate airway obstruction, usually patients who had recovered from asthma but did not seek treatment on a regular basis
4. Level IV. Patients with shortness of breath, the breath sounds on physical examination and airway obstruction
5. Level V. Patients with status asthmatics where circumstances severe asthma and needed medical help emergency.

• Signs and Symptoms of Asthma

1. Wheezing (sound like squeaks during breathing)
2. Dispend with expiratory time; use of accessory respiratory muscles extra nose, pulling his chest, and Strider.
3. Dry cough (not productive) because of thick secretions and airway lumen.
4. Tachipnoe, ortopnea
5. Restless
6. Diaphoreses
7. Abdominal pain due to involvement of the abdominal muscles on respiratory
8. Fatigue
9. Not tolerant of activities, eating, playing, walking and even talking.
10. Anxiety, labile, and changes in level of consciousness
11. Increasing Anteroposterior diameter (barrel chest)
12. Sudden attack or gradual

• Causes of Asthma:

• Intrinsic Factor

1. Infection: the influenza virus, pneumonia.
2. Physical: cold weather, changes in temperature, chemical irritants, air pollution (CO, smoke and perfume)
3. Emotional: fear, anxiety, and tension
4. Excessive activity

• Extrinsic factor

1. Antigen and antibody reaction, due to inhalation allergen (dust, pollen, dust, animal fur).

• Examination of Asthma

1. X-ray; during an acute episode of chest x-ray may show hyperinflation diaphragm.
2. Examination of lung function, can be found decreased tidal volume, vital capacity, increased eosinophils in the blood or sputum
3. Examination allergies; test (+) that causes skin blisters and a big reaction that can identify the specific allergen.
4. Pulse Oximetry; found in the peripheral O2 saturation decreased (Cyanosis)
5. Blood gas analysis; indicates hypoxia during the acute attack, there was initially hipokapnea and respiratory alkalosis, low Pco2.

• Help

• Acute attacks with a nasal or face mask oxygen.
• Parenteral fluid therapy
• Appropriate medication therapy program: Agonists beta-adrenergic receptors, the best treatment for the treatment of asthma and prevent asthma attacks may be triggered by exercise. Bronkodilatator; stimulate airway dilation by beta-adrenergic receptors. (Terbutalin, Salbutamol, Fenetotol, Theophylline). Corticosteroid; inflames blocking response and very effective in reducing asthma symptoms. If used in the long run, will lead to a gradual reduction in the trend of asthma attacks by reducing airway sensitivity to some stimuli. Ant cholinergic drugs work blocking smooth muscle contraction and the formation of excessive mucus in bronchus acetylcholine.
• Nebulizer therapy in severe acute attacks of asthma, drug can be given a form adrenergic agents epinephrine, albuterol, metaproterenol, isopoterenol and terbutalin.

source
Crompton. G. (1980) "Diagnosis and Management of Respiratory Disease". Blacwell Scientific Publication.