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Asthma Attacks

Nurses   (2,789 Views 14 Comments)
by antidote antidote (Member)

4,252 Profile Views; 159 Posts

I was just sitting here and pondering about Asthma Attacks and what exactly you could do for that person without their inhaler! It's never really something I've thought of before, but honestly I'm not really sure what you could do! I mean, I know the symptoms of an asthma attack: chest pain, rapid breathing, increased heart rate, coughing, chest pain, and wheezing.

In any case, what exactly could you do for a person that is having an asthma attack while you're waiting for the EMS to arrive? And quite honestly (this is rather embarrassing to ask) but what could you do for the person while you're even at the hospital? (Yes... I've never dealt with one before okay!) Here is my best guess:

  • Take complete vitals (BP, pulse, temp, listen to heart/lungs)
  • Administer O2 (either non-re breather or BVM depending on RPM)
  • Attempt IV access
  • Consult with Resp. Tech and MD for further treatment (poss. order chest X-Rays, prescription for further attacks, etc.)

Am I right at all? It's just I've never dealt with this before and I'm not really sure as to what the treatment would be! As some of you know, I'm an ICU nurse so I'm not in the ER with people coming in all day with this! Thanks so much in advanced.

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6,487 Posts; 21,377 Profile Views

If the pt is at the hospital, you call RT if there's nebs ordered, otherwise call RT and the doc at the same time. And if you have to resort to the steps listed above, you waited too long. You should never find a pt in an attack so bad that you have to administer O2 and get immediate IV access.

Outside the hospital: relaxation techniques can help a little by lessening the severity just a tad. I don't know if this actually works but I remember a parent telling me that her child's doc had told her to try a big slug of caffeine and then go to the ER.

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159 Posts; 4,252 Profile Views

If the pt is at the hospital, you call RT if there's nebs ordered, otherwise call RT and the doc at the same time. And if you have to resort to the steps listed above, you waited too long. You should never find a pt in an attack so bad that you have to administer O2 and get immediate IV access.

Outside the hospital: relaxation techniques can help a little by lessening the severity just a tad. I don't know if this actually works but I remember a parent telling me that her child's doc had told her to try a big slug of caffeine and then go to the ER.

If we needed to do all of that you're definitely right! I was just listing some steps off the top of my head that might take place.

Thats a pretty interesting technique with the caffeine. I don't think I've ever heard of that. Also Tazzi, I've sent you a PM.

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6,487 Posts; 21,377 Profile Views

Got it and replied.

The caffeine is supposed to be along the lines of giving epi or terb subcu.

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babynurselsa is a RN and specializes in ER, NICU, NSY and some other stuff.

1,129 Posts; 10,086 Profile Views

Yep, I have heard to give them a cup of coffee.

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Multicollinearity is a BSN, RN and specializes in Acute Care Psych, DNP Student.

3,119 Posts; 27,577 Profile Views

Caffeine contains a compound called xanthine, which is a mild bronchodilator.

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herecomestrouble specializes in geriatrics,med/surg,vents.

198 Posts; 4,246 Profile Views

Sometimes when I can feel an attack starting a HOT cup of coffee,as hot as I can stand it,and pursed lip breathing can stop it before I have to use an inhaler.Pursed lip breathing--in through your nose,deep and slow,pucker up like you're going to kiss someone,blow out through your mouth reeeeaaal slow,about twice as long as the inhale.I teach this breathing method to all my asthma pts,but stress that they should keep their inhalers nearby too.

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23 Posts; 1,408 Profile Views

]I have asthma, so I’ll tell you what helps for me when a bad one hits and I don’t have meds.

]Fresh air]. No smoke, dust or potential allergens.

]Sit]. I’m using all of my accessory muscles to move air so it helps to sit to support my torso with my hands on my knees. ]Sometimes arms above the head will move more air, but it’s tiring.

]Calm]. Very important. I have been scared before and have felt the airway close and the muscles stop working. It’s like the panic locks everything down. Then I realize what I’m doing to myself and calm down. It’s a mental decision… one that isn’t going to be easy for some, or for a kid, so it could be up to a caregiver to keep the calm too.

]Help]. Be proactive in getting help… either the pt to the meds or the meds to the pt. Mind over matter only works for so long with a reactive airway disease. Albuterol can turn the tide in seconds. I’ve never tried the caffeine idea but I will keep it in mind. (Hopefully I won’t be a dope and leave my inhaler at home ever again! But... it happens.)

]Comfort]. Breathing like that is hard sweaty work. A cool towel feels good but also be aware of a potential chill. Depends on the environment.

]I’ve had an attack come on suddenly in a restaurant. Had to rush home with the window open… cool wind blowing in my face… aaaaaahhhhhh! :)

]I’ve been so exhausted from trying to fix it on my own for a week or so, that when I went to the ER, the automatic doors closed on me because I was moving so slow.

]I’ve been in the ER, sitting on a gurney, getting a Tx - got sweaty, tunnel-vision, fell over, and woke up intubated.

]Anyway, I hope this helps.

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2,642 Posts; 14,895 Profile Views

Once I'm in the midst of an attack, keeping calm doesn't make it better....but it can slow down the process of it getting worse. Fresh air is also very important for me....even strong perfume can make things worse in the midst of an attack. (The smell of cigarette smoke shuts my lungs down in good situations....so care providers who smell like smoke are deadly to me when I'm in the midst of an attack)

Most of all, this is not the time for a complete history. I'm having a hard enough time breathing without trying to talk at the same time. I'll fill out whatever form you need and tell you my allergies....but a conversation about triggers really needs to wait...and it's really not the time for small talk. This sounds like common sense, but I can't tell you how many times this happens.

And as someone else mentioned, Caffeine is an xanthine....it's the same drug family as theophyline

Peace,

Cathie

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loricatus specializes in ED, ICU, PACU.

1,446 Posts; 13,033 Profile Views

If we needed to do all of that you're definitely right! I was just listing some steps off the top of my head that might take place.

Thats a pretty interesting technique with the caffeine. I don't think I've ever heard of that. Also Tazzi, I've sent you a PM.

A big slug of expresso or black coffee is what I have seen work-it temporily helps with dilation.

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56 Posts; 1,507 Profile Views

Besides being an FNP i'm also a respiratory therapist and I have found over the many, many, many years that having the patient purse lip breathe helps open and relax the airways.

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rn undisclosed name specializes in Telemetry, Oncology, Progressive Care.

351 Posts; 5,489 Profile Views

I recently found out in my hospital that the respiratory therapists are able to administer an emergency neb tmt if we don't have orders from a doctor yet. I have only had this done once. A pt was coming up from the ER and was in emergent need of a tmt and was also on bipap. They write the order and place it in the chart.

Is this done in other hospitals? Just curious. I would also try the O2 and pursed lip breathing but haven't had to do that yet.

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