Asthma attack device guideline

1- What is Asthma attack?

Asthma is a condition in which your airways narrow and swell and produce extra mucus. This
can make breathing difficult and trigger coughing, wheezing and shortness of breath.For some
people, asthma is a minor nuisance. For others, it can be a major problem that interferes with
daily activities and may lead to a life-threatening asthma attack.Asthma can't be cured, but its
symptoms can be controlled. Because asthma often changes over time, it's important that you
work with your doctor to track your signs and symptoms and adjust treatment as needed.

2- Symptoms
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have
symptoms only at certain times — such as when exercising — or have symptoms all the time.

What Happens During an Asthma Episode?

During normal breathing, the airways to the lungs are fully open. This allows air to move in and
out of the lungs freely. Asthma causes the airways to change in the following ways:

1. The airway branches leading to the lungs become overly reactive and more
sensitive to all kinds of asthma triggers
2. The linings of the airways swell and become inflamed
3. Mucus clogs the airways
4. Muscles tighten around the airways (bronchospasm)
5. The lungs have difficulty moving air in and out (airflow obstruction: moving air out
can be especially difficult)

Seek medical help immediately for:

 Fast breathing with chest retractions (skin sucks in between or around the chest plate and/or
rib bones when inhaling)
 Cyanosis (very pale or blue coloring in the face, lips, fingernails)
 Rapid movement of nostrils
 Ribs or stomach moving in and out deeply and rapidly
 Expanded chest that does not deflate when you exhale
 Infants with asthma who fail to respond to or recognize parents
Asthma signs and symptoms include:

 Shortness of breath
 Chest tightness or pain
 Trouble sleeping caused by shortness of breath, coughing or wheezing
 A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in
children)
 Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or
the flu

 wheezing, coughing and chest tightness becoming severe and constant

 being too breathless to eat, speak or sleep
 breathing faster
 a fast heartbeat
 drowsiness, confusion, exhaustion or dizziness
 blue lips or fingers
 fainting

 your reliever inhaler (usually blue) isn't helping

 you're too breathless to speak, eat or sleep
 your breathing is getting faster and it feels like you can't catch your breath
 your peak flow score is lower than normal

Signs that your asthma is probably worsening include:

 Asthma signs and symptoms that are more frequent and bothersome
 Increasing difficulty breathing (measurable with a peak flow meter, a device used to
check how well your lungs are working)
 The need to use a quick-relief inhaler more often

Signs of an asthma attack

If you do not know if you have asthma, these 4 symptoms could be signs that you do:

 Coughing that sometimes wakes you up at night.

 Wheezing, or a whistling sound when you breathe. You may hear it more when you
breathe out. It can start as a low-sounding whistle and get higher.
 Breathing problems that include having shortness of breath, feeling like you are out of
breath, gasping for air, having trouble breathing out, or breathing faster than normal.
When breathing gets very difficult, the skin of your chest and neck may suck inward.
  Chest tightness

Other Warning Signs

Other early warning signs of an asthma attack are:

 Dark bags under your eyes

 Fatigue
 Being short-tempered or irritable
 Feeling nervous or edgy

Danger Signs

Call 911 or your local emergency number right away if you have any of the following symptoms.
These are signs of a serious medical emergency.

 You are having trouble walking or talking because it is so hard to breathe.

 You are hunching over.
 Your lips or fingernails are blue or gray.
 You are confused or less responsive than usual.

3- Triggers
What Causes or Triggers Asthma?

People with asthma have inflamed airways which are sensitive to things which may not bother
other people. These things are “triggers.”

Asthma triggers vary from person to person. Some people react to only a few while others react
to many.

If you have asthma, it is important to keep track of the causes or triggers that you know provoke
your asthma. Because the symptoms do not always occur right after exposure, this may take a bit
of detective work. Delayed asthma episodes may occur depending on the type of trigger and how
sensitive a person is to it.

The most common asthma triggers include:

Allergies (Allergic Asthma)

Substances that cause allergies (allergens) can trigger asthma. If you inhale something you are
allergic to, you may experience asthma symptoms. It is best to avoid or limit contact with known
allergens to decrease or prevent asthma episodes.

Common allergens that cause allergic asthma include:

 Dust mites
 Cockroach
 Pollen
 Molds
 Pet dander
 Rodents

Learn more about allergic asthma,

Irritants in the Air

Irritants in the environment can also bring on an asthma episode. Although people are not
allergic to these items, they can bother inflamed, sensitive airways:

 Smoke from cigarettes

 Air pollution such as smog, ozone and others
 Wood fires
 Charcoal grills
 Strong fumes, vapors or odors (such as paint, gasoline, perfumes and scented soaps)
 Dust and particles in the air
 Chemicals

Other Health Conditions

Certain comorbid conditions can also compound the symptoms of asthma. These include:

 Allergic bronchopulmonary aspergillosis (ABPA)

 Obstructive sleep apnea
 Chronic obstructive pulmonary disease (COPD)
 Food Allergies
o Food-induced anaphylaxis
o Sulfites in food
o Hormonal changes during the menstrual cycle
  Food-induced anaphylaxis
 Gastroesophageal reflux disease (GERD)
 Obesity
 Nasal polyps
 Pregnancy
 Respiratory Infections
o Colds
o Flu (influenza)
o Pneumonia
o Sinusitis or sinus infections
o Sore throats
 Rhinitis

Exercise

Exercise and other activities that make you breathe harder can affect your asthma. Exercise –
especially in cold air – is a frequent asthma trigger. Exercise-induced bronchoconstriction (EIB)
is a form of asthma that is triggered by physical activity. It is also known as exercise-induced
asthma (EIA). Symptoms may not appear until after several minutes of sustained exercise. (If
symptoms appear sooner than this, it usually means you need to adjust your treatment.) With
proper treatment, you do not need to limit your physical activity.

Learn more about exercise-induced asthma.

Weather

Dry wind, cold air or sudden changes in weather can sometimes bring on an asthma episode.

Thunderstorm asthma can also affect people with asthma if a thunderstorm hits during high
pollen and high humidity. The rain can hit pollen and break the grains into smaller pieces. Wind
from the storm spreads these particles around, making it easier for people to inhale them.

Feeling and Expressing Strong Emotions

 Anger
 Fear
 Excitement
 Laughter
 Yelling
  Crying

When you feel strong emotions, your breathing changes – even if you don’t have asthma. It may
cause wheezing or other asthma symptoms in someone with asthma.

Medicines

Some medicines can also trigger asthma, such as:

 Aspirin and NSAIDs (nonsteroidal anti-inflammatory drugs)

 Medicines known as beta blockers – they can also make asthma harder to control

Talk to your health care provider about your asthma and your triggers. Be sure to discuss any
changes in your asthma management.

*Triggers in Children

Some triggers particularly affect children with asthma and can make the inflammation in their
lungs even worse. The common cold is one of the most frequent triggers for asthma attacks in
very young children. Others include:

 Smoke
 Exposure to allergens (such as animal dander, dust mites or pollen)
 Strong smells (perfumes or other odors)
 Changes in weather; cold air
 Running or playing hard
 Crying or laughing

Triggers 2.0
An asthma trigger is anything that irritates your airways and sets off
your asthma symptoms

1. Alcohol

 Alcoholic drinks most likely to trigger your asthma symptoms are red wine, white wine, cider
and beer.
 Clear spirits like gin and vodka are sometimes considered more ‘asthma friendly’ because they
contain less histamine and fewer sulphites, but the evidence isn't clear, so it's best to be cautious
if you know your asthma is triggered by alchohol.
So, why does alcohol make asthma symptoms worse?
Alcohol contains substances known to trigger asthma symptoms:
 Histamine is a natural food chemical. It’s the same substance that’s released in your body when
you have an allergic reaction. There are high levels of it in wine. And it could trigger asthma
symptoms if you’re sensitive to it.
Sulphur dioxide is a type of sulphite. Sulphites are used in a range of foods and drinks as
preservatives. They are produced naturally when beer and wine are made, and more may be
added to wine to stop it continuing to ferment in the bottle. Some people are more sensitive to
sulphites.

2. Emotions

How do emotions trigger asthma?

Strong emotions can affect the way we breathe. This can trigger asthma symptoms, such as
coughing, wheezing, finding it hard to catch your breath, or a tight chest. Asthma symptoms may
come on very quickly and could turn into an asthma attack without treatment.

 Your breathing might be quicker and less regular if you’re stressed or panicky, or laughing or
crying a lot. You might find you’re taking short, deep breaths through your mouth.
 This kind of fast, irregular mouth breathing can trigger asthma symptoms because the air isn’t
warmed first by passing through your nose. Instead, it hits your airways while it’s dry and cold.

3. Recreational drugs

The facts about recreational drugs and asthma

 Taking drugs can trigger asthma symptoms and make your asthma worse, increasing your
risk of a life-threatening asthma attack.
 Drug use can lead to stress, anxiety and depression, which have all been linked to making
asthma worse.
 Some drugs contain unknown harmful ingredients and it’s impossible to know what
effect these will have on your asthma.
 Research has shown that taking recreational drugs means it’s more likely you'll miss
taking your asthma medicines every day as prescribed. This increases your risk of having
a life-threatening asthma attack.

The effects of certain drugs on your asthma

 Cannabis can trigger asthma symptoms and lead to long-term lung damage, especially if
it’s smoked with tobacco.
 Cocaine use (both snorted and smoked) can lead to much worse asthma symptoms and
asthma attacks.
  Crack cocaine (made by heating cocaine powder with baking soda) can lead to serious
lung damage, especially if it’s smoked.
 DXM, PCP and ketamine – hallucinogens and dissociative drugs – can lead to breathing
problems especially if they’re mixed with alcohol.
 Heroin – and other opioids, such as fentanyl – may cause your breathing to slow down
and block air from entering your lungs making asthma symptoms worse.
 Inhalants – highly concentrated chemicals in solvents or aerosol sprays, such as lighter
fluid, can cause breathing difficulties.
 New psychoactive substances (NSPs), such as spice and mephedrone, contain one or
more chemical substance to mimic the effects of other illegal drugs. There’s not enough
known about many of these drugs to know about their strength, their effects on people, or
what happens when they’re used with other substances or alcohol.
 Poppers – liquid nitrates inhaled from the bottle or a cloth or cigarette dipped in the
liquid – are absorbed into the lungs almost instantly. Any inhaled substances can irritate
your lungs and trigger asthma symptom

4. Stress

Why is stress an asthma trigger?

Stress makes you more likely to react to your usual asthma triggers – like pets, pollen or colds
and flu.
It can trigger symptoms indirectly too. You may get angry more easily when you’re under stress,
and anger is an emotional asthma trigger.
For some of us stress means we drink or smoke more, both things which put us more at risk of
asthma symptoms.
And if your stress levels stay high for a long time, you may notice you react to asthma triggers
more often, and with worse symptoms.

Too much stress can sometimes lead to feelings of anxiety or panic attacks. In a panic attack,
stress hormones are released to prepare us to either run away from danger or fight it (the ‘fight or
flight’ response).

We react with symptoms such as a faster heart rate, tense muscles and breathing that is shallow
and fast (hyperventilating).

This change to our breathing pattern can put us at a higher risk of all our usual asthma
symptoms, such as tight chest and coughing.

5. Exercise

Tips for exercising in cold weather when you have asthma

In colder weather, symptoms are even more likely during exercise, because cold, dry air can
irritate your already sensitive airways.

 One way to avoid this problem is to exercise indoors during the winter months.
 Or, consider doing less vigorous exercise if you’d like to be outside – go for a power
walk instead of a run, for example.
 Make sure your chest and throat are covered and keep a scarf around your nose – this
helps warm up the air, so it’s less likely to set off your symptoms.

Why exercise can set off asthma symptoms or an asthma attack

Scientists think the most likely reason is that when you get your pulse rate up, you tend to
breathe faster and through your mouth, meaning the air that’s going into your lungs is colder and
drier than normal.

Some people’s lungs react to this change in temperature and humidity, meaning the airways get
narrower. This can trigger symptoms like coughing, wheezing and breathlessness. That’s why a
lot of our advice is about warming up the air that’s going into your lungs.

Why does sex trigger asthma symptoms?

Sex is like any exercise. It gets your heart pumping and lungs working hard. But it’s not just
breathlessness that could trigger your asthma symptoms. Other reasons could be:

 Your breathing getting quicker or changing (you might start breathing through your
mouth)
 Experiencing big emotions during sex
 The environment you’re having sex in. For example, being surrounded by perfumed
candles, a dusty floor, house dust mites, or the cat staring at you from the corner of the
room…
 Stress can be a trigger, so you end up having asthma symptoms during sex because
you’re worrying about having asthma symptoms during sex

6. Weather

Cold weather
Whether it’s icy cold, there’s snow on the ground, or it’s cold, damp and foggy, when the
temperature drops you may notice more asthma symptoms.

This could be because:

 when cold weather gets into your airways it can trigger them to go into spasm, causing asthma
symptoms like coughing, wheezing, shortness of breath and tightness in the chest.
 on still, cold days air pollution can sometimes be worse
 during the winter more colds and flu viruses are going around

Hot weather
Mostly we think of asthma symptoms being worse in the winter. But hot summer weather can
trigger asthma symptoms for some people too.
The causes are not clear but two possible reasons are:
 Breathing in hot air can cause the airways to narrow, leading to coughing and shortness
of breath.
 When it’s hot in summer, there are often higher levels of pollutants and pollens in the
air.

7. Food

Why can food increase your risk of asthma symptoms?

Food could be an asthma trigger for you because you’re:

 allergic to certain foods. This means you can have an allergic reaction very quickly when you
come into contact with your food allergen. And the allergic reaction quickly brings on your
asthma symptoms such as wheezing, coughing and difficulty breathing. People with food
allergies need to strictly avoid the food they react to.
 sensitive to certain foods, or additives in foods, such as preservatives. Being sensitive to certain
foods is not the same as a true allergy, and there’s less clear-cut evidence to show a link to
asthma symptoms. But some people with asthma tell us that other kinds of chemicals and
ingredients in food products trigger their asthma symptoms.

8. Smoking
When you smoke, or breathe in smoke, the chemicals in cigarette smoke irritate and inflame the
airways and lungs. It can make symptoms come on quite quickly.

Whether you’re a smoker, or someone who’s regularly around other people who smoke, you'll
have more symptoms and need more medicines to keep on top of your asthma. If your asthma
symptoms get worse, you're at risk of an asthma attack.

Even if you're not a smoker yourself, symptoms can come on quite quickly when you come into
contact with someone else smoking.
 4- Treatments
 Peak flow. This test is done at home with a simple hand-held device called a peak flow
meter. A peak expiratory flow measurement indicates how fast you can force air out of
your lungs. Peak flow readings are sometimes gauged as a percentage of how your lungs
work at their best. This is called your personal best peak flow.
 Spirometry. Spirometry tests can be done at your doctor's office with a machine called a
spirometer. Some people use a hand-held spirometer to take measurements at home.

Spirometry tests measure how much air your lungs can hold and how much air you can exhale in
one second after you've taken a deep breath. This measurement is called forced expiratory
volume (FEV1). Your FEV1 measurement is compared with the typical FEV1 for people who
don't have asthma. As with your peak flow reading, this comparison is often expressed as a
percentage.

There are two main types of medications used to treat asthma:

 Long-term control medications such as inhaled corticosteroids are the most important
medications used to keep asthma under control. These preventive medications treat the
airway inflammation that leads to asthma symptoms. Used on a daily basis, these
medications can reduce or eliminate asthma flare-ups.
 Quick-relief inhalers contain a fast-acting medication such as albuterol. These
medications are sometimes called rescue inhalers. They're used as needed to quickly open
your airways and make breathing easier. Knowing when to use these medications can
help prevent an impending asthma attack.

Long-term control medications are the key to keeping your asthma controlled and in the green
zone. If you frequently use a quick-relief inhaler to treat symptoms, your asthma isn't under
control. See your doctor about making treatment changes.

Make sure you know how to use your asthma medications properly. They will only keep your
asthma under control if you use them correctly.

1- Long-term asthma control medications, generally taken daily, are

the cornerstone of asthma treatment. These medications keep asthma under control on a
day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term
control medications include:

 Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase,

Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan
HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar),
mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta).
You may need to use these medications for several days to weeks before they reach their
maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively
low risk of side effects and are generally safe for long-term use.

 Leukotriene modifiers. These oral medications — including montelukast (Singulair),

zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms for up to 24
hours.

In rare cases, these medications have been linked to psychological reactions, such as agitation,
aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for
any unusual reaction.

 Long-acting beta agonists. These inhaled medications, which include salmeterol

(Serevent) and formoterol (Foradil, Perforomist), open the airways.

Some research shows that they may increase the risk of a severe asthma attack, so take them only
in combination with an inhaled corticosteroid. And because these drugs can mask asthma
deterioration, don't use them for an acute asthma attack.

 Combination inhalers. These medications — such as fluticasone-salmeterol (Advair

Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) —
contain a long-acting beta agonist along with a corticosteroid. Because these combination
inhalers contain long-acting beta agonists, they may increase your risk of having a severe
asthma attack.
 Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep
the airways open (bronchodilator) by relaxing the muscles around the airways. It's not
used as often now as in past years.

2- Quick-relief (rescue) medications are used as needed for rapid, short-

term symptom relief during an asthma attack — or before exercise if your doctor
recommends it. Types of quick-relief medications include:

 Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within

minutes to rapidly ease symptoms during an asthma attack. They include albuterol
(ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex).

Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer — a
machine that converts asthma medications to a fine mist — so that they can be inhaled through a
face mask or a mouthpiece.

 Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to

immediately relax your airways, making it easier to breathe. Ipratropium is mostly used
for emphysema and chronic bronchitis, but it's sometimes used to treat asthma attacks.
 Oral and intravenous corticosteroids. These medications — which include prednisone
and methylprednisolone — relieve airway inflammation caused by severe asthma. They
 can cause serious side effects when used long term, so they're used only on a short-term
basis to treat severe asthma symptoms.

If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if
your long-term control medications are working properly, you shouldn't need to use your quick-
relief inhaler very often.

Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler
more often than your doctor recommends, see your doctor. You probably need to adjust your
long-term control medication.

3- Allergy medications may help if your asthma is triggered or worsened by

allergies. These include:

 Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your
immune system reaction to specific allergens. You generally receive shots once a week
for a few months, then once a month for a period of three to five years.
 Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is
specifically for people who have allergies and severe asthma. It acts by altering the
immune system.

5- Existing devices
The global intelligent asthma monitoring market was valued at $20 million in 2017, and is
projected to reach $655 million by 2025, growing at a CAGR of 54.5% from 2018 to 2025.

1- ADAMM
The Wearable

A patch-type, flexible wearable with a rechargeable battery that can be worn anywhere on the
upper torso, front or back. Move it around from day to day as you choose.

Symptom Detection

Cough counting, respiration, wheeze and heart rate. Provides notifications, inhaler detection and
voice journaling.
Journaling & Reminders

Journaling, medication reminders, symptom displays, wearable graphical user interface and
treatment plans.

The patch includes sensors that track a patient’s movement, heart rate, respiratory rate, the
amount of oxygen in the blood, skin impedance and wheezing in the lungs.

http://healthcareoriginals.com/asthma/

2- https://www.mpo-mag.com/contents/view_breaking-news/2016-06-01/new-devices-
wearable-system-aim-to-predict-prevent-asthma-attacks/

3- https://www.springwise.com/innovation/health-wellbeing/afflo-ai-wearable-device-for-
asthmatic-symptoms

4- https://www.intechopen.com/books/wearable-devices-the-big-wave-of-
innovation/breathing-monitoring-and-pattern-recognition-with-wearable-sensors

5- https://dzone.com/articles/why-thunderstorm-asthma-needs-iot

6- https://www.youtube.com/watch?v=rYM5YAM8PvY

7- https://indianexpress.com/article/technology/science/wearable-device-to-monitor-and-
manage-asthma-in-the-works-4668192/

8- https://www.jamesdysonaward.org/2019/project/afflo/
9- https://www.machinedesign.com/automation-iiot/article/21837586/new-wearable-
respiratory-sensor-will-monitor-a-childs-every-breath

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