Keeping safe -some information for people with asthma

Corona Virus infection and asthma

This information is based on my personal views – intended for people with asthma – and to be used in addition to advice from the persons own doctor (this advice is not intended to replace that from your doctor – its to be used in addition)

Virus infections can cause asthma to go out of control and may result in asthma flare-ups or attacks. The current situation with Corona Virus could put people with asthma at risk. While Corona Virus infection (COVID19) is mild in most people, about 15% of those who have been infected for example in Italy are more severe. About half of these people need hospital admission and some will need intensive care treatment.

People with underlying diseases, like asthma,  are more at risk of having a bad Corona Virus infection. Therefore, it is really important for people with asthma, and carers or parents looking after people with asthma to make sure that medical advice is followed. This includes making sure that preventer medication is taken as prescribed by the doctor – usually twice a day in the case of Inhaled Corticosteroid medication.

If the spread of the COVID19 in the UK follows what’s happening in other countries like Italy, it is possible that people will not be able to get appointments to see a doctor face to face. Therefore it is really important to make sure you know as much as possible about your asthma to enable you to keep safe . This includes knowing the difference between regular, preventer medication and the releiever medication used for symptoms (cough, wheeze and shortness of breath). Most importantly, preventer medication should be taken regularly, as advised by your own doctor.

Two types of inhaled medicines are used for asthma:

  • Controllers / Preventers – these are inhaled Corticosteroids
  • Relievers: These are
    • Short acting (usually blue) – salbutamol or terbutaline
    • Long Acting – Formoterol and Salmeterol

The Controller / preventer inhalers contain inhaled corticosteroids and these must be taken as advised by the doctor. Usually this means taking the inhaler;er twice a day, sometimes people are advised to use this once a day. In some cases, SMART, or MART treatment is advised – this is where the inhaler contains an  Inhaled Corticosteroid and a particular long acting reliever called  Formoterol – in these cases, people will be advised by the doctor to use the inhaler twice a day, and also for relief ( ie rather than the blue short acting reliever) – because this is regarded as safer than just using the Blue inhaler for relief.

Recognising when asthma is going out of control:

Asthma is an ongoing (chronic) disease that is prone to flare ups/ attacks.  There are three main danger signals to be aware of: These are the need to use the blue reliever inhaler; low or dropping Peak Flow Readings and Low or dropping oxygen saturation levels.

  1. Needing to use the blue inhaler for symptoms

If asthma is flaring up, symptoms like cough, wheeze (whistling noise conning from the chest), and shortness of breath/difficulty breathing occur.  When this happens, it is important to use the prescribed reliever (either blue inhaler, or combined Inhaled Corticosteroid-with Formoterol) and this should improve the symptoms. If the relief from a blue inhaler doesn’t last more than 4 hours – medical advice or urgent help should be sought.

2.  If the Peak Expiratory Flow reduces, or is dropping

It is advisable to ask your doctor for a prescription for a Peak Flow Meter. This instrument is used to measure your PEAK Flow – – you need to blow as hard as you can into the meter – and it measures how much air you camn blow out; in other words it measures how tight your air passages are.

In order to know if your airways are tight, you fist need to know what your best (or normal) Peak Flow is. To find this out – you measure your peak flow  (best of three) twice a day for a few weeks while you are well and the highest readings represent your normal or best.

If you get symptoms and your peak flow has dropped by 20% from your best (multiply the best reading by 0.8) then your ashthma is going out of control. If the readings continue to drop, or if they go below 60% of your best, you should seek urgent medical assistance. If the Peak Flow reading has dropped below 30% of the best/normal reading – this is a very serious situation and urgent medical assistance should be sought.

3. If you have severe asthma, or are prone to severe attacks – buy an oximeter 

A pulse oximeter placed on your finger measures the amount of oxygen that is getting through your lungs to your blood. If the reading is below 92% the asthma attack is very serious and urgent medical assistance should be sought.

 

So the key messages are:

  • Take controller / preventer medication regularly
  • Seek urgent medical assistance/ advice if:
    • Short acting reliever is not helping, or if you need to use this more than twice a week
    • Peak Flow is dropping
    • Oxygen Saturation (if you have an oximeter) is dropping

More information available at:

Asthma UK /BLF – UK: manage-your-asthma  ; asthma

My website  for an example of a  self management plan: player.html

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