Optimizing Prehospital Asthma Care: Management and Interventions

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Added on  2024/07/22

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This report provides a detailed overview of managing asthma in the prehospital environment, emphasizing strategies to reduce hospital admissions. It begins by defining asthma as a chronic inflammatory disease affecting the airways and lungs, highlighting the importance of effective prehospital management to prevent exacerbations. The report discusses the causes of asthma, including allergies, infections, and environmental irritants, and explains the pathophysiology involving inflammation, airflow obstruction, and increased airway responsiveness. Key management and treatment approaches include periodic assessment, written action plans, allergen reduction, and pharmacological therapies such as corticosteroids and inhaled beta-agonists. The report concludes that implementing these strategies can significantly decrease hospitalization rates for asthma patients, underscoring the benefits of extended care and monitoring.
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MANAGING ASTHMA IN THE
PREHOSPITAL ENVIRONMENT

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ABSTRACT
Introduction

Asthma is a very common cause for admission into hospital beds. Asthma

is a long-term inflammatory disease that affects the air passage ways and

lungs. Admission to hospital due to an attack of asthma denotes letdown

of pre hospital management to check or bring its reduction (
Rognås, et al,
2011)
. Numerous factors have been recognized that may impact and avert
the admission of patients to hospital with an attack of asthma.
The pre-
hospital management of asthma has been discussed in the following

abstract. The pre hospital management includes proper monitoring,
regular
treatment by a physician (every three months), providing of an individual

with written management plan,
suitable for early controlling of asthma in
the home, good understanding with preventive treatment,
and an
satisfactory level of asthma knowledge (
Torgerson, et al, 2011) .
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Body
Asthma is a chronic disease of the airways that makes inhalation and

exhalation difficult due to temporary contraction of the passage that carry

oxygen to the lungs. This results in asthmatic indications, which includes

coughing, breathlessness and wheezing(
Prosen, et al, 2011) . It is also
referred to as "bronchial asthma". When the body is functioning normally,

the smooth muscles that surround the airways is relaxed, and air moves

easily. But in people with asthma, allergens, respiratory virus, and

environmental causes prompts the bands of muscle surrounding the

airways tighten (
Snyder, et al, 2011) . The people with asthma have
particularly sensitive airways (
Lötvall, et al, 2011).
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Causes
Asthma can occur at any age, though it's more usual in people under the

age of 40. People who have a family record of asthma have an increased

vulnerability of developing the disease. Allergies and asthma often appear

together. There are various causes of asthma, which includes infections

such as sinusitis and colds, weather; variation in temperature or humidity,

cold air etc. (Beasley, et al,
2015). Irritants from perfumes or cleaning
solutions, air pollution, and allergens such as pollens, fungus, pet dander,

and dust mites are also some of the common causes of chronic asthma.

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The other types of asthma include exercise induced asthma and aspirin
sensitive asthma (
Edwards, et al, 2012).
Pathophysiology

The pathophysiology of asthma is complex and comprises airway

inflammation, recurrent airflow blockade, and increased bronchial

responsiveness. During asthma attack there is sudden worsening of the

symptoms and the airways constrict by either swelling, fill with mucus.

There is bronchospasm, which leads to coughing, shortness of breath,

chest pressure (
Lim, et al, 2010) . Due to hypersensitivity caused by the
allergens,
the inflammatory process occurs along the entire air passage
from nose to the lungs. Once the airway becomes puffed-up and inflamed,

it becomes constricted, and less air gets through to the alveoli of lungs.

Management and Treatment

Understanding of asthmatic symptoms and the various types of asthmas

can help in discovering the right treatment and management of the

condition. Periodic assessment and monitoring is necessary to maintain

regular pulmonary function, and prevent recurrent attacks of asthma and

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the need for frequent hospitalizations. Several types of monitoring which
are recommended are signs and symptoms of asthma, history of

exacerbations, pharmacotherapy, and quality of life and patient provider

communication.

Patients with moderate to severe asthma are recommended to be provided

with a written action plan in accordance with the individual’s signs and

symptoms. Exposure of sensitive patients to allergens should be reduced

so that there is reduction in asthmatic attacks.

Pharmacological therapy includes long-term medications to regulate

persistent asthma, and quick relief medications aimed at treating

exacerbations and symptoms. Corticosteroids can be helpful in

maintaining normal lung functions (
Pollart, 2011).
However, patient and provider communication remains the cornerstone for

management of asthma. Self-management education, tailored for

individuals is also extremely helpful. Inhaled beta-agonist therapy is one

of the extensively suggested first choice of treatment for pre hospital

management, but anticholinergic agents may also be used (
Network, G.A.,
2014).

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Conclusion
Pre hospital management can prevent the requirement of hospital presence

in most cases if they apply currently acclaimed actions or treatments for

exacerbations. This would effect in a drop in rates of hospitalization for

asthma. Extended care and monitori
ng can benefit the patients of asthma.
REFERENCE

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Beasley, R., Semprini, A. and Mitchell, E.A., 2015. Risk factors for
asthma: is prevention possible?.
The Lancet, 386(9998), pp.1075-
1085.

Edwards, M.R., Bartlett, N.W., Hussell, T., Openshaw, P. and
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infections due to 13 respiratory viruses detected by multiplex PCR

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Snyder, S.R., Santiago, M. and Collopy, K.T., 2011. Wheezing in
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Torgerson, D.G., Ampleford, E.J., Chiu, G.Y., Gauderman, W.J.,
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