Adult asthma

What to do in an asthma attack

Asthma attacks are categorized into minor, moderate, or major attacks, and respiratory failure. Attacks can require urgent attention and can sometimes be fatal. In the event of an asthma attack, it is important to discern the severity of the attack and deal calmly with the situation. You should ask your doctor to prescribe “rescue” medication for you to have on hand in case of an attack.
You should also consult with your doctor on how to take medication in an attack. Ask your doctor for an Action Plan (self-care plan) which tells you what to do in case of an attack.

At home

• Get into a comfortable position and practice abdominal breathing.
• Inhale quick-acting beta-2 agonist “rescue” medication (Sultanol, Meptin, etc.).
• Drink warm tea or other soothing beverage.

Call your doctor right away

• When symptoms are so severe the patient cannot lie down, can hardly walk, or has difficulty moving.
• When quick-acting beta-2 agonist “rescue” medication (Sultanol, Meptin, etc.) is needed every 1-2 hours.
• When symptoms do not improve within 3 hours, even with the use of “rescue” medication.
• When symptoms get progressively worse.
• Call an ambulance if the patient is feeling faint or has lost control of bladder or bowels.

Environmental management (patient and family work together to reduce irritants and triggers from the living environment)

Each person has different triggers. It is important to identify triggers and irritants, and take steps to reduce exposure to them in daily life.

Cigarettes, fireworks, etc.

• Cigarette smoke can trigger attacks. Refrain from smoking. Secondhand smoke is just as harmful. Family members who smoke should never do so indoors. Even if a cigarette is smoked outdoors, the components adhere to the smoker’s clothes and body and are brought indoors. The components in cigarettes can also make asthma “rescue” medications less effective. Therefore, it is best for family members to also refrain from smoking.
• Inhaling smoke from fireworks or incense can cause breathing difficulties. Move to an upwind location, or cover your nose and mouth with a towel etc. to avoid inhaling the smoke.

Take measures to reduce indoor allergens

It is important to reduce allergens such as dust mites and mold in the living environment. Key points to reducing allergens are proper cleaning, bedding management, and humidity control.
For indoor allergen control, see “Allergies and Your Living Environment,” a leaflet by the Tokyo Metropolitan Government and Tokyo Medical Association.

Pet allergens

• People can be allergic to dogs, cats, rabbits, hamsters, etc.
• The allergens are pet hair or dander. It is best to avoid keeping furry pets. If you already have a pet, take steps to avoid exposure to the pet’s allergens (wash pet regularly, keep pet outdoors, etc.)

Preventing colds and influenza

Take measures to avoid catching colds or other respiratory infections, such as washing your hands after going out, wearing a mask when outdoors, and getting vaccinated.

Self-care (patient takes an active part in his/her treatment, acquiring the knowledge and judgment required to continue proper management)

It is important to monitor your own condition, maintain control of your asthma, take measures to prevent attacks, and deal with them appropriately should they occur.
Take the following steps.

Have you learn the basics of asthma

Have you understand the types and roles of medicines

Enable you to monitor own condition

Encourage self-care to prevent attacks. Peak flow meters and asthma diaries can be useful.

Peak flow meter

Peak flow meters are devices which you can easily use at home to measure your breathing function. Peak flow refers to the speed at which you can blow air out of your lungs. After taking a deep breath, you blow as hard as you can into the peak flow meter. Peak flow is reduced when respiratory function declines, even in the absence of subjective symptoms. Using a peak flow meter lets you catch such situations early, before your condition worsens. There are many types of peak flow meters available. Consult your doctor as to which type is best for you.

Asthma diary

Keeping an asthma diary containing entries on symptoms, medication, the weather, and daily activities lets you look back on your lifestyle and symptoms. This can help you identify triggers, preliminary signs, and possible preventative steps for your attacks. Your doctor may be able to provide you with an asthma diary, or you can download one for free from various websites.

Environmental management (addressing triggers and causes of attacks)

Please refer to the section on environmental management.

Addressing attacks when they occur

Ask your doctor to formulate an Action Plan (individualized asthma management plan) for you.

Next: How to visit the hospital

How to visit the hospital

To ensure you receive appropriate treatment, it is important to give your doctor detailed information on your symptoms. To explain your condition accurately when you visit the hospital.

• Jot down the points you want to convey and have them ready when you visit the hospital.
• An asthma diary is useful.