Where There Is No Doctor 2011 167
ASTHMA
A person with asthma has fits or attacks of difficult breathing.
Listen for a hissing or wheezing sound, especially when breathing
out. When he breathes in, the skin behind his collar bones
and between his ribs may suck in as he tries to get air. If the
person cannot get enough air, his nails and lips may turn
blue, and his neck veins may swell. Usually there is no fever.
sitting
up to
breathe
Asthma often begins in childhood and may be a problem
for life. It is not contagious, but is more common in children with relatives who have
asthma. It is generally worse during certain months of the year or at night.
An asthma attack may be caused by eating or breathing things to which
the person is allergic (see p. 166). In children asthma often starts with a cold.
Nervousness or worry may bring on an asthma attack. Asthma can also be caused
by unclean air (air pollution), such as smoke from cigarettes, inside cooking fires,
burning fields, or cars and trucks.
Treatment:
♦ If asthma gets worse inside the house, the person should go outside to a place
where the air is cleanest. Remain calm and be gentle with the person. Reassure him.
♦ Give a lot of liquids. This loosens mucus and makes breathing easier. Breathing
water vapor may also help (see p. 168).
♦ Strong coffee or black tea can help relieve an
asthma attack if you do not have any medicines.
♦ For attacks, treat with the rescue inhaler
salbutamol (albuterol, see p. 384) as often as
needed. This is a spray medicine that you want to
breathe in as deeply as possible.
See p. 384 to
learn how to
make a spacer
for your inhaler.
♦ For frequent attacks, or asthma that makes you gasp for breath while
walking or during mild exercise, also use the controller inhaler (beclomethasone,
see p. 384). Using a controller medicine can prevent attacks, save you money,
and make you feel better than always responding to an asthma emergency.
Using a “spacer” with your inhaler allows more medicine to get to the lungs.
♦ For severe asthma where you cannot get enough air and do not improve with
salbutamol, use prednisolone by mouth right away, and then continue for 3 to 7
days (see p. 385). In emergencies if you have no other medicines you can inject
epinephrine (adrenalin, see p. 385) under the skin.
♦ In rare cases, worms cause asthma. Try giving mebendazole (p. 373) to a child
who starts having asthma if you think she has worms.
♦ If the person does not get better, seek medical help.
Prevention:
A person with asthma should avoid eating or breathing things that bring on
attacks. The house or work place should be kept clean. Keep chickens and other
animals outside. Air bedding in the sunshine. Sometimes it helps to sleep outside
in the open air. Drink at least 8 glasses of water each day to keep the mucus loose.
Persons with asthma may improve when they move to where the air is cleaner.
If you have asthma do not smoke—smoking damages your lungs even more.