When my son was barely six months old, I recognized he was having trouble breathing. When he exhaled, there was a wheezing sound. As he struggled to breathe, I noticed that his chest look larger than normal. I knew something was wrong and rushed him to the hospital. It was then that I learned he had a respiratory condition called asthma. I was familiar with this term and condition as it runs in my family. Still, I was surprised and dismayed that he had it as well.

Through many trips to hospitals, seeing respiratory specialists, and spending three years back and forth to McMaster Children’s Hospital, I learned a lot about asthma, its signs and symptoms, prevention and, if necessary, administering life-saving medication.

What is Asthma?

Asthma is a respiratory condition that narrows and constricts the air passages and makes it difficult to breathe. A person may also experience anxiety or feel frightened because they labor to breathe. Asthmatic symptoms can occur at any time, several times a day, or with specific triggers.

During an asthma attack, the muscles around the walls of the airways narrow and tighten. The lining of the airways develop a sticky mucus and as the airways continue to narrow and tighten, the person has difficulty getting air in and out. The severity of the symptoms varies from person to person. When a person has recurrent symptoms, it can result in reduced activity levels, absenteeism both at work and school, sleepiness, and fatigue.

What Causes Asthma?

Asthma is more commonly found in children and young adults. The strongest risk factors for Asthmatic is genetic, such as being born into a family with a history of asthma. External exposures such as pollen, weather changes (both cold and hot), insect bites or stings, or an allergic reaction to foods or medications can also trigger asthma. A person experiencing Emotional distress may also have difficulty breathing.

What Can Trigger Asthma?

Any number of things can trigger an asthma attack both external and internal. Knowing your triggers can help you prevent, control, and even avoid an asthma attack. I often recommend a person who experiences asthma to keep a journal and write down which triggers may have played a role in their breathing emergency. Common triggers include:

• Pollutants and chemical irritants found in the home or the workplace (such as paint thinners, paint, oven cleaners, harsh cleaning compounds, drywall sanding, etc.)
• Animal dander, animal hair, household dust, dust mites, etc.
• Colds and viral infections
• Tobacco smoke or other types of recreational inhalants
• Stress, depression, anxiety, or even laughing too hard can trigger asthma symptoms
• Vigorous exercise or strenuous work
• Nutrition and food allergies/intolerances Hormonal changes such as the onset of puberty, menstrual cycles and fluctuations, pregnancy, perimenopause, and menopause
• Some medications may trigger asthma (speak to your doctor or pharmacist accordingly)
• Pollens, molds, and fungi
• Weather changes

How to Help Someone Use their Life-Saving Medication?

When assisting a person with their inhaler, it is important to follow these steps:

• Recognize the emergency and identify yourself as a first aider
• Ask the person if they have a history of breathing problems, such as Asthma
• Check the Five Rights of Medication (Right Person, Right Medication, Right Dose, Right Time, Right Route/Method)
• Instruct the person to shake their inhaler three or four times
• Assist the person in removing the cap from the inhaler. If they have a spacer and it has a cap, help them to remove it
• Tell the person to put the inhaler into the spacer
• Tell the person to breath out as much as possible (away from the inhaler and spacer)
• When assisting a child, bring the inhaler or spacer to the mouth. Help them to put it between their teeth and to close their lips around it. When assisting an adult, instruct them to put the inhaler between their teeth and to close their lips
• Have the person press the top of the inhaler down once, and to take one slow, full breath. Hold this breath as long as comfortably possible (up to ten seconds) and then slowly breath out
• If the person’s condition does not improve, have them repeat a second dose. If the condition still does not improve, immediately seek medical attention or call your local emergency number (EMS/911)

Special Considerations

One thing I learned through my son is that in the region I reside, September is the most active month of the year for asthma attacks. More people go to the hospital in September than any other month. April is the second most active month. While controllable, asthma is a serious respiratory condition that can result in fatalities if left untreated.

Through journaling, I was able to track his peak times and begin a dialogue of prevention with my family physician and pharmacist. We have made dietary changes, kept our activity moderate during peak months and bad weather days.

Asthma inhalers need to be stored properly (between 15 to 30 degrees Celsius). This means they shouldn’t be stored in hot or cold environments (for example the glove box of your vehicle). I also learned that using a spacer with an inhaler provides the greatest level of effectiveness for the medication to reach the lungs and begin working. Further, once an inhaler has reached its expiration date, it drastically reduces effectiveness. As my son has grown into a young adult and through a rigorous prevention game plan, thankfully, he hasn’t had an asthma attack in almost five years.

When in doubt or unsure of what to do, speak to your doctor, respiratory specialist or pharmacist to better understand your medications, triggers, and create a prevention plan. Attending a first aid course will also help you and your family to familiarize yourself with recognizing an emergency, staying safe in the scene, assisting the person with their life-saving medication, and when needed, to upgrade care to emergency responders.