Asthma is a very common condition in Australia. Around 11.2% of the Australian population are known to suffer from asthma – that’s one in nine. So if you have more than ten people in the room with you, it’s pretty likely one of them will have an asthma inhaler on them somewhere. A little under 40,000 Australians are hospitalised with asthma symptoms every year, and it generally kills around 400-500 people.
Asthma has been recognised as a medical condition for a long time. It’s mentioned in writings from ancient Egypt and was actually named around 450 BC by Hippocrates – widely known as the “Father of Medicine” and responsible for the Hippocratic Oath (the oath taken by doctors to “do no harm”). The word ásthma is actually ancient Greek for “panting”.
But what is asthma, and exactly what does it do. Can it be cured, and how can you help someone suffering from it?
What is asthma?
Put simply, asthma is a long-term inflammatory disease of the lungs and airways. Under certain conditions, it causes the lungs’ airways to constrict, limiting airflow and making breathing difficult. This can show itself as wheezing & shortness of breath.
Asthma is not contagious in any way – you can’t catch asthma from someone else. The cause of asthma is still not entirely understood, but genetics often plays a part – particularly in children with asthma. Other things known to increase the likelihood of asthma include long-term exposure to airborne pollutants such as cigarette smoke, industrial chemicals, dust and pollen.
There is currently no cure for asthma, but it can often be controlled and managed to have a limited impact on a person’s life. This is usually through medication and by controlling factors that can cause an asthma attack.
Many things have been known to aggravate asthma and potentially trigger an attack. These include:
- Respiratory illness (including colds and flu)
- Vigorous exercise
- Inhaled dust, pollen, and other allergens
- Smoke – including cigarette smoke
- Changes in the weather
- Some medications
- Workplace chemicals
What does asthma feel like?
Asthma narrows the airways, restricting the flow of air to the lungs. What this means for the sufferer is that they experience resistance when trying to breathe – it’s harder work to draw the breath that you need.
Think about sucking air through a straw and then using the same straw to suck up a milkshake. Sucking air through the straw feels relatively easy, but once the straw goes into the drink, it becomes more difficult to suck – the milkshake requires you to suck harder, and there’s a sense of the milkshake pulling back in the other direction as you drink.
This is a little like what asthma sufferers experience when trying to breathe during an asthma flare-up. The airways constrict to become narrower, so less air can travel through them. Thus the person needs to work harder to draw enough air into their lungs. When the symptoms are severe, this can be pretty alarming for the sufferer as they struggle to breathe. This is especially true if the muscles in their lungs start to feel fatigued, and there’s no clear way to get relief. It’s not like you can stop breathing for a while to rest those muscles.
So what are the symptoms of asthma?
Under normal circumstances, a person with asthma might have no noticeable symptoms. Some mild sufferers might go weeks without any visible signs of their condition. Others may experience wheezing or a persistent cough – sounding like they have cold symptoms even when they’re quite healthy.
When suffering an asthma flare-up – when something triggers their airways to begin to constrict – there are a number of common asthma symptoms that tend to show.
- Shortness of breath
- Tightness in the chest
- Persistent coughing
- The sound of phlegm in their breathing and cough
There’s no set time frame for an asthma flare-up. They can strike in a matter of minutes or build up over several days – and everything between.
It’s worth knowing that while asthma often shows itself in childhood, it’s not unusual for adults to develop it later in life. Thus a previously healthy adult might begin to show asthma symptoms. If you notice yourself (or someone close to you) consistently exhibiting the symptoms mentioned above, it’s worth talking to a doctor about it. Diagnosing asthma is a complicated process, but respiratory troubles are always worth getting checked out.
What is an asthma attack?
An asthma attack (also known as an exacerbation) is when a sufferer’s asthma symptoms become progressively worse, potentially making it dangerously hard to breathe. Someone suffering an attack may exhibit all the signs of a flare-up listed above but may also show some of the following:
- An increased heart rate
- Agitation or confusion
- Blue lips
They may show noticeable difficulty breathing and struggle to speak in whole sentences – needing to take breaths mid-sentence. In the most severe cases, they may pass out from lack of oxygen.
As with any asthma flare-up, this could be a fast process or something that grows steadily worse over several days.
An asthma attack is potentially life-threatening – in 2019 there were 461,000 deaths from asthma worldwide, including 436 Australians. If you see any signs that an asthma flare-up is becoming an attack, you should call 000 as soon as possible.
Asthma first aid
Generally, people with asthma will be aware of their condition. They’ll have access to asthma medications and be able to self-administer first aid. This isn’t always the case, however. Someone who’s developed asthma late in life may not be 100% aware of their condition and may not have access to medication or the knowledge of how to use it. In some cases (such as thunderstorm asthma), it’s possible for people who have never had asthma previously to find themselves suffering its effects. And someone suffering a severe asthma attack might not be in a condition to help themselves.
As such, it’s possible for someone to be suffering an asthma attack but not realise what’s going on or what they can do about it.
If someone is struggling with asthma symptoms, it’s worth seeing if anyone in the area has first aid training – current first aid courses include asthma training as part of the course.
If you have a close friend or family member who has asthma and is prone to attacks, it’s worth considering investing a day in getting first aid training yourself. You don’t want to be desperately googling “asthma first aid” when a loved one is struggling to breathe.
Your first port of call for someone struggling with asthma symptoms is generally an asthma puffer or inhaler. More specifically, you’re looking for an asthma reliever (also known as a bronchodilator). These contain fast-acting medication (such as salbutamol) to rapidly open up the airways, allowing the person to breathe more freely. These generally work immediately (within a few breaths), making them an excellent short term solution to asthma symptoms. They’re also quite hard to overdose on, so you can generally use one as much as you need – up to 10 puffs every 15 minutes is generally safe.
You should note – asthma relievers are generally blue/grey in colour. If someone has an asthma puffer that’s in an autumn leaf colour – orange or red – then that’s probably an asthma preventer. These are medications that improve the condition of someone’s asthma over time – lessening how often they experience symptoms. But they do very little when someone’s suffering an asthma flare-up. You need the blue/grey inhaler!
If symptoms persist, or if the reliever is not proving to be very effective, you’re probably looking at a full-blown asthma attack, and you’re going to need medical help. At this point, you should be calling 000 ASAP to signal for an ambulance. Never be afraid to call for aid in an emergency – most Ambulance officers would much rather be called out when they’re not needed than arrive too late to save someone’s life.
While you’re waiting for help, get the person to sit upright (don’t lie down), and take slow, steady breaths. Help them to remain calm as much as possible. And continue using the asthma puffer to provide short term relief.
What does an inhaler do for someone without asthma?
If someone not diagnosed with asthma is suffering asthma-like symptoms, you might be wondering if it’s safe to use an asthma preventer on them. The good news is that asthma preventers like salbutamol are relatively harmless. Side effects are mostly limited to an increased heart rate and possible shaking hands. This means that if someone is struggling to breathe with asthma-like symptoms, you shouldn’t do them any harm by trying an inhaler.
What is thunderstorm asthma?
Thunderstorm asthma is an unusual and highly specific set of circumstances where a thunderstorm can cause widespread asthma attacks – even in people who’ve never previously had asthma. This is due to pollen granules swelling up due to moisture and bursting due to the storm. It’s extremely rare but can be quite dangerous – the worst ever case (in Melbourne in 2016) put 14,000 people in hospital and left ten dead.
Although such storms happen so rarely that it’s hard to plan for them, it’s a good reminder – asthma doesn’t just affect long term sufferers.