Often asthma attacks begin suddenly, with no warning. They may begin even when a person is at rest. Although symptoms may follow heavy exertion, exposure to allergens or emotional extremes, in a typical attack the person suddenly becomes short of breath. Because asthma is a condition that can afflict able-bodied as well as disabled children, all school bus drivers should be taught how to recognize the symptoms of an asthma attack and how to respond properly. Signs of an asthma attack
Sit or stand the person so that he or she is leaning slightly forward with the back straight and chest upright. For a non-ambulatory person in a wheelchair, make sure he or she has an adequate support for trunk elongation and good body alignment. Or align the person's body lying on his or her side with support to the head and trunk. This position should elevate the head and trunk, leaning the person's body slightly forward. Be supportive, calm and reassuring. Calm and relax the person as much as possible throughout your intervention. Panic tenses muscles and aggravates the symptoms. If this is a first attack or breathing difficulties worsen, call the doctor or emergency medical services at once. Special considerations
Those who are immobile, have physical deformities and/or have oral motor deficits are most at risk for "silent aspirations." Silent aspiration of small amounts of food, fluids, saliva or partially digested food, which may have come back up from the stomach into the esophagus, can result in the above described "asthma-like attack" symptoms. The person will wheeze as the muscles in the airway tighten in an attempt to keep out further invasion or in response to chemical irritation of the food or stomach acid. This results in increased mucus production, and swelling may occur. This causes breathing difficulty and may be mistakenly diagnosed as an allergic reaction or asthma attack, leaving the real problem undiagnosed. Ellen Johnson is a registered nurse who has been teaching at Oklahoma State University in Sweetwater, Okla., for the past eight years.
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