Non-drug treatment complements medication for attacks of bronchial asthma and is used to prevent them.
Patient education. They tell the patient about his illness, explain the need to carefully follow all the doctor’s prescriptions, and teach him to behave correctly during attacks. The educational literature is provided by the American Pulmonary Society, the National Institute of Allergy and Infectious Diseases, the National Institute of Heart, Lung and Blood, the American Foundation for Asthma and Allergy, the Society of Mothers of Patients with Asthma and other public and state organizations. With the participation of the patient and members of his family, an approximate treatment plan is developed .
The elimination of factors causing asthma attacks is the most important preventive measure. Find out the habits and hobbies of the patient, especially his nutrition, climatic and living conditions. They specify which infections he suffered, with which allergens he contacts, and which medicines he takes. The decision to change the place of residence or profession is taken only when it is not possible to avoid contact with harmful factors. Measures to combat adverse environmental factors.
Desensitization is effective for exogenous bronchial asthma . Allergens are detected using skin and provocative tests, as well as the determination of specific IgE . Desensitization does not preclude the need to eliminate contact with the allergen.
Relaxation methods . The ability to relax and calm down, especially at the beginning or in the midst of an attack of bronchial asthma, helps to reduce its severity and prevent further development. Since the panic that occurs during an attack leads to an increase in respiratory rate and exacerbates bronchospasm, patients are taught to control their breathing. Relaxation methods are taught in the interictal period:
To facilitate breathing during an attack, it is recommended:
– take a comfortable pose and relax;
– breathe slowly and deeply;
– put your hand on the upper abdomen to control the movement of the diaphragm during breathing;
– inhale through the nose (the abdomen should be lifted), and exhale slowly through the compressed lips (as when blowing out a candle), relaxing the abdominal muscles.
The following is a description of postures that help relax and maintain abdominal breathing. The patient must choose the most convenient for him.
Sitting on a chair:
– Lean forward with your elbows in your lap.
– Lean over the table and put your shoulders, forearms and head on the pillow lying on the table. With prolonged difficulty in breathing, the patient can sleep in this position.
– Stand facing the wall at a distance of 30-45 cm from it, lean on the wall with your forearms. Put your head on your forearms and put one foot forward. This pose helps to relax the abdominal muscles.
– Lean against the wall with your feet at a distance of 30 cm from it.
To reduce anxiety and facilitate breathing, meditation , auto-training , and biological feedback methods are also recommended . Find out what factors cause the attack, and explain to the patient how to avoid them. For emotional disorders, a consultation with a psychiatrist or psychologist is recommended.
Drinking plenty of water prevents dehydration, reduces mucus viscosity and improves sputum discharge. Patients are advised to drink plenty of fluids not only during the attack, but also in the interictal period. Severe attacks of bronchial asthma and asthmatic status are accompanied by dehydration , as fluid intake decreases and its losses increase due to hyperventilation, sweating and vomiting. In this regard, infusion therapy is an integral component of the treatment of these conditions. The volume and rate of fluid administration depend on the degree of dehydration. Keep in mind the possibility of developing pulmonary edema during infusion therapy .
Postural drainage , percussion and vibration massage facilitate sputum discharge during attacks of bronchial asthma complicated by atelectasis and pneumonia . These procedures are also indicated for prolonged course of bronchial asthma, when a large amount of very thick sputum is secreted. Postural drainage and massage are generally well tolerated; improvement usually occurs after 30 minutes. Increased dyspnea is observed only with severe attacks of bronchial asthma, in this case, the procedure is stopped. Postural drainage is best done in the morning after sleep; if necessary, it can be repeated 2-3 times a day. Before the procedure, inhalation of the bronchodilator is prescribed :
– The patient is placed in a position that ensures the outflow of mucus under the action of gravity. For 1-2 minutes, with clasped hands, thrash through the chest over the drained area of the lung. The patient is asked to breathe slowly and deeply. The body position is selected individually, identifying areas of mucus accumulation during physical examination and chest x-ray. P is shown in what position the patient should be and in which parts of the chest should be percussion massage to drain different parts of the lungs.
– Contraindications: hemoptysis, pneumothorax, epilepsy.
– Oxygen must be well moistened. It is served through the nasal cannula, facial mask or venturi mask. Young children do not tolerate the mask and cannulas, so oxygen is usually inhaled in an oxygen tent.
– Oxygen is supplied at a low speed, usually 2-4 l / min, maintaining pa02 in the range of 70-100 mm Hg. Art. With hypercapnia, inhalation of oxygen can increase hypoventilation. This complication is usually observed in patients with COPD.