Asthmatic status

Asthmatic status is a severe attack of bronchial asthma, in which there is a pronounced respiratory failure due to edema of bronchial mucosa, spasms of the muscles of the bronchi and overlapping viscous mucus airways. In this case, the attack is not stopped even by higher doses of bronchodilators, which usually takes the patient. This condition is life threatening and requires immediate assistance.

Causes of asthmatic status

In patients with bronchial asthma, this complication can develop due to the following factors:

1. Absence of the main therapy of the disease (in particular, inhaled glucocorticosteroids).
2. Overdose of beta-adrenostimulants (excessive reception leads to a decrease in sensitivity and an increase in edema of the bronchi).
3. Effects of allergens (dust, finger plants, wool, feathers, molds, certain foods, etc.).
4. Some medications ( non-steroidal anti-inflammatory drugs , sleeping pills and sedatives, antibiotics, various serums and vaccines).
5. Emotional overstrain.
6. Infectious and inflammatory diseases of bronchopulmonary system.

Symptoms and stages of asthmatic status

The course of the attack is divided into three stages, each of which is characterized by its clinical symptoms:

1. The first stage is a period of relative compensation, manifested by such signs:

• anxiety, fear of the patient;
• significant difficulty in exhaling;
• forced posture to facilitate breathing - sitting or standing with the torso bending forward, with the support of hands;
• painful cough without phlegm;
• loud wheezing in the chest;
• cardiopalmus;
• cyanosis of the nasolabial triangle;
• sweating;
• retraction of intercostal spaces.

At this stage due to the compensatory potential of the body, the gas composition of the blood is maintained within normal limits. The patient is conscious, can communicate.

2. The second stage - the period of decompensation, characterized by such symptoms:

• aggravation of symptoms of the first degree;
• inhibition, periodically arising excitement;
• severe shortness of breath;
• chest in the position of maximum inspiration, its movements are almost invisible;
• the subduction of supra-and supraclavicular pits;
• cyanosis of the lips and skin;
• low blood pressure;
• a weak and frequent pulse.

During this period, spasm of the bronchi increases, there is almost no air movement in the lungs, some parts of the lung are disconnected from the respiration process. This leads to a lack of oxygen and an increase in the amount of carbon dioxide in the body.

3. The third stage - pronounced ventilation disorders, characterized by such manifestations:

• loss of contact with others;
• rare breathing or lack of breath;
• weak arrhythmic pulse;
• convulsions;
• loss of consciousness.

Emergency care for asthmatic status

The first first aid for asthmatic status is as follows:

1. Urgently call an ambulance.
2. Provide the patient with fresh air.
3. Help the patient to take a comfortable position.
4. Give the patient a warm drink.
5. Eliminate the effect of allergens.

Treatment of asthmatic status

Treatment (cupping) of asthmatic status is performed in the conditions of the intensive care unit. At the third stage of the attack, a complex of medical measures is started to be implemented already at home and during transportation. Therapy includes:

• oxygen therapy;
• infusion therapy;
• use of antihistamines ;
• use of bronchodilator drugs.

If necessary, the patient is transferred to the artificial ventilation of the lungs.