Symptom of choking. Children’s Choking Symptoms: Recognizing and Responding to Airway Obstructions

26.06.197220.08.2021 by alexxlab

What are the common causes of choking in children. How can you identify the signs and symptoms of choking. What immediate steps should be taken when a child is choking. How does choking management differ for infants versus older children. Why are children more susceptible to choking hazards.

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Understanding Choking: A Potentially Life-Threatening Emergency

Choking occurs when a foreign object partially or completely obstructs the airway, impeding the normal flow of air into and out of the lungs. This obstruction can range from mild discomfort to a severe, life-threatening emergency requiring immediate intervention. The severity depends on the degree of blockage and how quickly it can be resolved.

Children, especially infants and toddlers, are particularly vulnerable to choking incidents. According to the Australian Institute of Health and Welfare, suffocation or choking accounted for 11% of injury-related deaths in infants between 1999 and 2003. This alarming statistic underscores the importance of understanding choking risks, prevention strategies, and proper response techniques.

Why are children more susceptible to choking?

Smaller airways: Children have narrower air passages, making them more easily obstructed by small objects.
Developing chewing and swallowing skills: Young children may not fully chew their food before swallowing.
Curiosity: Infants and toddlers often explore their environment by putting objects in their mouths.
Lack of awareness: Children may not recognize the danger of certain foods or objects.

Common Causes of Choking in Children

Understanding the frequent culprits behind choking incidents can help parents and caregivers take proactive steps to prevent these dangerous situations. Here are some of the most common causes:

Foods: Small, round, or hard foods like grapes, nuts, hard candies, and hot dogs
Toys: Small parts from toys, marbles, or balloons
Household items: Coins, batteries, or small magnets
Eating habits: Consuming food too quickly or not chewing thoroughly

Is there a way to make mealtimes safer for children? Absolutely. Parents can cut food into small, manageable pieces, encourage slower eating, and supervise mealtimes closely. Additionally, teaching children to sit still while eating and avoiding activities that may cause laughter or talking with a full mouth can significantly reduce choking risks.

Recognizing the Signs and Symptoms of Choking

Prompt recognition of choking symptoms is crucial for timely intervention. The signs may vary depending on the severity of the obstruction and the nature of the object causing it. Here are key indicators to watch for:

Sudden difficulty breathing
Inability to speak or cry
Clutching at the throat or neck
Persistent coughing or gagging
Wheezing or unusual breathing sounds
Facial color changes (turning blue or red)
Panic or distress

Can a choking child always make noise? No, it’s a common misconception that a choking person will always cough or make sounds. In severe cases, when the airway is completely blocked, the child may be silent and unable to breathe at all. This “silent choking” is particularly dangerous and requires immediate action.

Immediate Steps When a Child is Choking

When faced with a choking child, quick and appropriate action can be life-saving. Here’s a step-by-step guide for responding to a choking emergency in children over one year of age:

Encourage coughing: If the child can cough, encourage them to do so as this may dislodge the object.
Assess the situation: Determine if the airway is partially or completely blocked.
Call for help: If coughing doesn’t clear the obstruction, call emergency services immediately.
Perform back blows: Bend the child forward and deliver up to five sharp blows between the shoulder blades with the heel of your hand.
Check for clearance: After each blow, check if the object has been dislodged.
Administer abdominal thrusts (Heimlich maneuver): If back blows are ineffective, give up to five abdominal thrusts.
Alternate techniques: Continue alternating between five back blows and five abdominal thrusts until the object is expelled or help arrives.
Be prepared for CPR: If the child becomes unconscious, begin cardiopulmonary resuscitation (CPR) immediately.

Should you attempt to remove the object with your fingers? It’s generally not recommended to blindly sweep the mouth with your fingers, as this may push the object further into the airway. Only attempt to remove an object if you can clearly see and easily grasp it.

Choking Management for Infants: A Different Approach

When it comes to infants under one year of age, the approach to managing choking differs slightly due to their small size and delicate nature. Here’s the recommended procedure:

Call for emergency assistance immediately.
Position the infant face-down along your forearm, supporting their head.
Deliver up to five firm back blows between the shoulder blades.
If unsuccessful, turn the infant face-up and perform up to five chest thrusts.
Alternate between back blows and chest thrusts until the object is expelled or help arrives.
If the infant loses consciousness, begin infant CPR.

Why is the technique different for infants? Infants have more delicate structures and different proportions compared to older children. The modified approach takes these factors into account, providing a safer and more effective method for clearing obstructions in very young children.

Prevention: The Best Defense Against Choking Hazards

While knowing how to respond to a choking incident is crucial, prevention remains the most effective strategy. Here are some key measures to reduce choking risks in children:

Supervise mealtimes closely, especially for young children.
Cut foods into small, manageable pieces appropriate for the child’s age.
Avoid high-risk foods such as whole grapes, nuts, and hard candies for young children.
Teach children to chew their food thoroughly and not to talk or laugh with food in their mouths.
Keep small objects, toys with tiny parts, and potential choking hazards out of reach.
Regularly inspect toys for loose or broken parts that could pose a choking risk.
Educate older siblings about potential dangers and the importance of keeping small objects away from younger children.

How can you determine if an object poses a choking hazard? A simple test is to see if the item can fit through a toilet paper roll. If it can, it’s generally considered a potential choking risk for young children.

The Importance of First Aid Training

While this article provides valuable information on recognizing and responding to choking incidents, it’s no substitute for proper first aid training. Certified courses offer hands-on practice and in-depth knowledge that can make a critical difference in emergency situations.

Why is formal training so important? In high-stress emergencies, having practiced these techniques can help you respond more confidently and effectively. Training also covers a wider range of scenarios and provides regular updates on best practices in emergency response.

Benefits of First Aid Training:

Hands-on practice with mannequins
Learning proper technique under expert guidance
Understanding the latest guidelines and recommendations
Gaining confidence in emergency situations
Learning to assess and prioritize in complex scenarios

Where can you find reputable first aid courses? Many organizations offer certified training, including the Red Cross, St. John Ambulance, and local community centers. Some workplaces and schools also provide first aid training opportunities.

Beyond Choking: Comprehensive Child Safety

While choking prevention and response are critical aspects of child safety, they’re part of a broader spectrum of measures to keep children safe. A comprehensive approach to child safety encompasses various areas:

Home safety: Childproofing, secure storage of hazardous materials
Water safety: Supervision around water, swimming lessons
Car safety: Proper use of car seats and seat belts
Fire safety: Smoke detectors, escape plans
Poison prevention: Secure storage of medications and chemicals
Outdoor safety: Playground awareness, helmet use for cycling

How can parents create a culture of safety at home? Regular family discussions about safety, leading by example, and involving children in age-appropriate safety practices can help instill a lasting awareness of potential risks and how to avoid them.

Building a Safety-Conscious Community

Extending safety awareness beyond the home can create a safer environment for all children. Consider these community-oriented approaches:

Organize neighborhood watch programs
Advocate for safe play areas in your community
Share safety information with other parents and caregivers
Support local initiatives for child safety education
Encourage schools to incorporate safety lessons into their curriculum

Can community efforts really make a difference in child safety? Absolutely. Collaborative efforts can lead to policy changes, improved public spaces, and a collective vigilance that benefits all children in the community.

Emotional Impact and Recovery After a Choking Incident

The aftermath of a choking incident can be emotionally challenging for both the child and the caregiver. It’s important to address these psychological aspects for complete recovery and future prevention.

For the Child:

Fear of eating or trying new foods
Anxiety during mealtimes
Nightmares or flashbacks of the incident

For the Caregiver:

Guilt or self-blame
Hypervigilance during mealtimes
Anxiety about future choking incidents

How can families cope with these emotional challenges? Open communication, reassurance, and gradual reintroduction to normal eating habits can help. In some cases, professional counseling may be beneficial for both children and caregivers to process the experience and develop coping strategies.

Strategies for Emotional Recovery:

Maintain a calm and supportive environment during mealtimes
Encourage the child to express their feelings about the incident
Gradually reintroduce foods in a safe, controlled manner
Seek support from other parents or support groups
Consider professional help if anxiety persists

Can a choking incident lead to long-term eating disorders? While rare, severe choking experiences can sometimes contribute to the development of feeding or eating disorders. If concerns persist, consulting with a pediatric psychologist or feeding specialist can provide valuable guidance and intervention.

Technological Advances in Choking Prevention and Response

As technology continues to advance, new tools and innovations are emerging to aid in choking prevention and response. While these should never replace proper training and vigilance, they can provide additional layers of safety and support.

Innovative Choking Prevention Devices:

Smart food cutters that automatically slice food into safe sizes
Wearable devices that detect choking and alert caregivers
AI-powered home monitoring systems for early choking detection
Advanced first aid training simulators for more realistic practice

Are these technological solutions reliable? While promising, many of these innovations are still in development or early adoption stages. They should be viewed as supplements to, rather than replacements for, traditional safety measures and first aid knowledge.

Mobile Apps for Emergency Response:

First aid instruction apps with step-by-step guides
Emergency service locators for quick access to help
CPR timing apps to guide compressions during resuscitation
Community alert systems to quickly summon nearby trained responders

How can technology improve response times in choking emergencies? Mobile apps and community alert systems can potentially reduce response times by providing immediate guidance and summoning nearby help. However, they should be used in conjunction with, not instead of, calling emergency services.

As we continue to advance in our understanding of choking risks and prevention strategies, staying informed and prepared remains crucial. Regular review of safety practices, ongoing education, and community engagement can help create a safer environment for children, reducing the risk of choking incidents and ensuring prompt, effective response when they do occur.

Choking

Choking occurs when a foreign body (eg. a mouthful of food) partly or completely blocks a person’s airway making breathing difficult. Choking is a medical emergency. If the object causing the blockage cannot be easily removed call 000 immediately.

What is Choking?

The respiratory tract begins at the nose, nasal passages and mouth, joining at the throat to form an air pipe (called the trachea) which is held open by C-shaped pieces of cartilage. When a foreign body partly or completely blocks a person’s airway, the passage of air into and out of the lungs may be compromised. Depending on how much the airway is blocked will determine how severe this compromise may be. In extreme cases, no air at all may be able to pass into the lungs, signalling a medical emergency as the brain can only be deprived of oxygen for a few minutes before damage begins. In less severe cases, air entry may not be reduced, although discomfort or pain may be experienced.

Choking is more common in infants and the elderly. The Australian Institute of Health and Welfare estimated that between 1999-2003 suffocation or choking accounted for 11% of injury related deaths in infants. Young children are particularly at risk of choking due to their smaller airways, reduced ability to bite and chew their food and their tendency to explore their surroundings by placing objects in their mouth.

Common Causes of Choking

eating or drinking too quickly

swallowing food before it has been sufficiently chewed

swallowing small bones or objects

inhaling small objects

Signs and Symptoms

The signs and symptoms of choking may vary according to the severity of the obstruction and the object itself:

clutching at the throat

neck or throat pain

inability to speak, breathe or swallow

coughing

wheezing or other unususal breathing sounds

gagging

a change in colour (eg. blue lips or red face)

chest pain

collapse

Management

The following information is not a substitute for first aid training. It is recommended that everybody undertake a first aid course, such that in the event of an emergency, you have been trained to manage the situation.

If the patient is over one year of age the following management is recommended:

ask them to cough to remove the object

encourage them to relax and breathe deeply

if this does not remove the blockage call 000

While waiting for the Ambulance:

bend the patient forward and give them a sharp hit in the middle of their back between the shoulder blades with the heel of your open hand

check to see if this has dislodged the object

if the objected is still lodged, repeat this procedure up to five times

it is important to bend the patient forward before delivering the blow to the back, if a patient is in the upright position dislodging the object may cause it to move further down the respiratory tract

If the blockage has still not cleared:

place one hand over the middle of the patient’s back and the other hand over the breast bone (in the CPR position)

give one chest thrust

check to see if the obstruction has cleared

repeat up to five times

if this fails to clear the object, repeat the five back hits with the heel of your open hand and alternate with five chest thrusts

continue this until the ambulance has arrived

if the patient collapses or loses consciousness at any point, begin cardio pulmonary resuscitation (CPR)

In a child under one year of age, the management is slightly different:

call 000 immediately

position the child with head downwards and stomach along your forearm

support the child’s head with your hand

hold the infant’s mouth open with your fingers

deliver a sharp blow to the back and check to see if the object has become dislodged

repeat up to five times. if this fails to dislodge the object, turn the child onto their back and remove any loose material from the infant’s mouth

if the blockage is still present, perform up to five chest thrusts with two fingers in the CPR position on the breast bone

alternate between chest thrust and back blows until the obstruction is removed or the ambulance arrives

if the child loses consciousness at any point, begin CPR

If YOU are choking:

stay calm

attempt to call for assistance

forcefully cough to expel the object

do not allow anyone to hit your back whilst you are in the upright position, in case this lodges the object further down the airways

Depending on how serious the choking event is, you make be required to spend some time in hospital until your health care professional is satisfied that no injuries were obtained.

Help and assistance:

Choking is a medical emergency. If the object causing the blockage cannot be easily removed call 000 immediately.

If you have any other symptoms from or concerns about choking please contact one of our Registered Nurses at 13 HEALTH by phoning 13 43 25 84.

Otolaryngology | Children’s Choking Symptoms

A foreign body in the airway (choking) constitutes a medical emergency and requires immediate attention. The foreign body can get stuck in many different places within the airway. According to the American Academy of Pediatrics, death by choking is a leading cause of death and injury among children younger than 4 years of age.

As with other foreign body problems, children tend to put things into their mouths when they are bored or curious. The child may then inhale deeply and the object may become lodged in the “airway” tube (trachea) instead of the “eating” tube (esophagus). Food may be the cause of obstruction in children who do not have a full set of teeth to chew completely, or those children who simply do not chew their food well. Children also do not have complete coordination of the mouth and tongue which may also lead to problems. Children under the age of four years are in the greatest danger of choking on small objects, including, but not limited to, the following:

seeds
toy parts
grapes
hot dogs
pebbles
nuts
buttons
coins

Children need to be watched very closely to avoid a choking emergency.

What are the symptoms of foreign bodies in the airway?

Foreign body ingestion requires immediate medical attention. The following are the most common symptoms that may indicate a child is choking. However, each child may experience symptoms differently. Symptoms may include:

Choking or gagging when the object is first inhaled
Coughing at first
Wheezing (a whistling sound, usually made when the child breathes out)

Although the initial symptoms listed above may subside, the foreign body may still be obstructing the airway. The following symptoms may indicate that the foreign body is still causing an airway obstruction:

Stridor (a high-pitched sound usually heard when the child breathes)
Cough that gets worse
Child is unable to speak
Pain in the throat area or chest
Hoarse voice
Blueness around the lips
Not breathing
The child may become unconscious

Treatment for foreign bodies in the airway

Treatment of the problem varies with the degree of airway blockage. If the object is completely blocking the airway, the child will be unable to breathe or talk and his or her lips will become blue. This is a medical emergency and you should seek emergency medical care. Sometimes, surgery is necessary to remove the object. Children that are still talking and breathing but show other symptoms also need to be evaluated by a physician immediately.

Dysphagia (swallowing problems) – NHS

Dysphagia is the medical term for swallowing difficulties.

Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow at all.

Other signs of dysphagia include:

coughing or choking when eating or drinking
bringing food back up, sometimes through the nose
a sensation that food is stuck in your throat or chest
persistent drooling of saliva
being unable to chew food properly
a gurgly, wet-sounding voice when eating or drinking

Over time, dysphagia can also cause symptoms such as weight loss and repeated chest infections.

When to seek medical advice

You should see your GP if you, or someone you care for, have difficulty swallowing or any other signs of dysphagia so you can get treatment to help with your symptoms.

Early investigation can also help to rule out other more serious conditions, such as oesophageal cancer.

Your GP will assess you and may refer you for further tests.

Treating dysphagia

Treatment usually depends on the cause and type of dysphagia.

Many cases of dysphagia can be improved with careful management, but a cure isn’t always possible.

Treatments for dysphagia include:

speech and language therapy to help people recover their swallowing with special exercises and techniques
changing the consistency of food and liquids to make them safer to swallow
other forms of feeding – such as tube feeding through the nose or stomach
surgery to widen the oesophagus, by stretching it or inserting a plastic or metal tube (stent)

Causes of dysphagia

Dysphagia is usually caused by another health condition, such as:

Children can also have dysphagia as a result of a developmental or learning disability, such as cerebral palsy.

Read more about the causes of dysphagia.

Complications of dysphagia

Dysphagia can sometimes lead to further problems.

One of the most common problems is coughing or choking, when food goes down the “wrong way” and blocks your airway. This can lead to chest infections, such as aspiration pneumonia, which require urgent medical treatment.

Aspiration pneumonia can develop after accidentally inhaling something, such as a small piece of food.

Warning signs of aspiration pneumonia include:

a wet, gurgly voice while eating or drinking
coughing while eating or drinking
difficulty breathing – breathing may be rapid and shallow

If you, or someone you care for, have been diagnosed with dysphagia and you develop these symptoms, contact your treatment team immediately, or call NHS 111.

Dysphagia may mean that you avoid eating and drinking due to a fear of choking, which can lead to malnutrition and dehydration.

Dysphagia can also affect your quality of life because it may prevent you from enjoying meals and social occasions.

Dysphagia in children

If children with long-term dysphagia aren’t eating enough, they may not get the essential nutrients they need for physical and mental development.

Children who have difficulty eating may also find meal times stressful, which may lead to behavioural problems.

Information:

Social care and support guide

If you:

need help with day-to-day living because of illness or disability
care for someone regularly because they’re ill, elderly or disabled (including family members)

Our guide to care and support explains your options and where you can get support.

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Page last reviewed: 04 March 2021
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Dysphagia (Difficulty Swallowing): Causes, Diagnosis & Treatment

Overview

What is Dysphagia?

Dysphagia is simply defined as a swallowing disorder. It can occur in any of the three phases of swallowing:

Oral
Pharyngeal
Esophageal

Dysphagia is often noted in stroke survivors and can affect the oral and/or pharyngeal phase of swallowing. The patient may cough or choke while attempting to swallow saliva, liquids, or food. A speech-language pathologist often assesses a patient’s ability to swallow in order to determine the risk of aspiration, (food or liquid going into the lungs) which potentially may lead to a lung infection or pneumonia.

Stroke survivors are at risk for silent aspiration. Silent aspiration is when food and liquid enter into the lungs without any coughing or choking. In these patients, there are no outward signs or symptoms of a swallowing problem.

What does it mean to have difficulty swallowing?

When we swallow, many muscles and nerves work together to get food or drink from our mouths into our stomachs. Trouble with swallowing can originate anywhere in the mouth, throat or esophagus. The esophagus is a muscular tube in your throat that carries food and water to your stomach.

Swallowing problems can be mild or severe. The treatment varies depending on what’s causing the problem. Sometimes, doctors can prescribe medication to help you swallow. If you’re unable to swallow anything at all, you may need a feeding tube to get the nourishment you need.

Possible Causes

What can cause difficulty swallowing?

Many disorders, diseases and conditions can cause trouble swallowing. Doctors separate swallowing problems into three types:

Oral cavity dysphagia: The problem is in the mouth. Typical causes include tongue weakness after stroke, difficulty chewing food or neuromuscular problems.
Oropharyngeal dysphagia: The problem is in the throat. This can be a result of a neurological or muscular problem.
Esophageal dysphagia: This is a problem of the esophagus. This can be caused when something blocks or compresses the esophagus, there’s a muscular disorder or there are pouches in the esophagus.

What conditions can cause swallowing problems?

Possible causes of swallowing difficulties can include:

Nervous system and brain disorders: Certain conditions affect your brain and nervous system (the network of nerves that controls muscles and organs). Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS) and stroke can lead to swallowing difficulties.
Muscle disorders: Myasthenia gravis (an autoimmune condition) and muscular dystrophy affect muscles all over the body. Disorders of the esophagus, such as achalasia, systemic sclerosis (scleroderma), cricopharyngeal spasms and esophageal spasms can affect your ability to swallow.
Esophagus narrowing and blockages: Esophageal cancer, a tumor or a swollen thyroid gland can constrict the esophagus (make it narrower). A narrowed esophagus can make swallowing a challenge. Some people develop webs or Schatzki rings (pieces of tissue inside the esophagus). This tissue narrows the tube and makes it hard to swallow chunks of food. Disorders of the opening of the esophagus can also contribute to difficulty swallowing such as cricopharyngeal hypertrophy. Swallowing can be difficult or impossible if anything is stuck in your throat.
Scarring from acid reflux: Scar tissue can form in your esophagus as a result of GERD (acid reflux disease). GERD can lead to Barrett’s esophagus (irritation in the esophagus lining).
Infection: Tonsillitis (sore throat) causes pain and inflammation. It can make swallowing painful.

Care and Treatment

How is dysphagia diagnosed?

Diagnostic tests for swallowing disorders vary. Typical tests include:

Flexible laryngoscopy: This test is done by an ENT (ear, nose and throat) specialist. It involves placing a small scope in your nose and looking at your throat and vocal cords.
Fiberoptic endoscopic evaluation of swallowing (FEES): Performed by a speech therapist, this test involves passing a small camera into your nose and feeding you dyed liquids and food to see how you are swallowing. During the test, your provider will also look to see if the food is getting into your airway (aspiration).
Modified barium swallow: During this test, a speech therapist gives you different foods and liquids to chew and swallow. The food will be covered with barium, a minty tasting liquid or pasty material. Barium allows images of your mouth, throat and esophagus to be seen on X-ray images. The speech therapist will tell you when to chew and swallow and the radiologist will take X-ray images while you’re swallowing.
Esophagram: In this test, you drink barium and the radiologist takes pictures of your esophagus.
Esophagoduodenoscopy (EGD) or upper endoscopy: This test involves a healthcare provider called a gastroenterologist (GI) who places a scope down your throat. The scope continues down your throat, into your esophagus and down into your stomach. This test is used to look for any narrowing, tumors or Barrett’s esophagus.

How is dysphagia treated?

Treatment for difficulty swallowing depends on the cause and severity of the problem. Your treatment might include:

Antibiotics: Your doctor may prescribe antibiotics to treat bacterial tonsillitis (strep throat).
Medication and lifestyle changes: Treatment for GERD includes drugs to control acid reflux. Your doctor may also recommend changing your diet and eating habits.
Other medical therapy: If a neurological condition makes it difficult for you to swallow, your doctor can offer solutions. Your options might include botulinum toxin (Botox®) injections to relieve muscle spasms or surgery to enlarge the esophagus.

What kinds of rehabilitation help with swallowing problems?

Some people find rehabilitation helpful. A speech-language pathologist (SLP) can teach you exercises to strengthen your swallowing muscles. To swallow safely, your SLP may recommend:

Changing how you eat and drink: Your therapist will guide you to take smaller bites and chew food thoroughly. You may need to add a special thickening powder to your drinks, since watery liquids can be tough to swallow.
Sitting upright while eating: To reduce the risk of choking, your therapist will show you the best way to sit while eating. You can also learn to tilt your head to make swallowing easier. These techniques reduce the risk of liquid getting into your airway (aspiration).
Clearing your throat: Therapists can teach you how to clear your throat with a little cough if liquid or a small piece of food gets stuck.

Will I need a feeding tube for difficulty swallowing?

If you can’t get enough of the vitamins and nutrients you need, you are losing significant amounts of weight, or if you have a high risk of choking, your doctor may recommend a feeding tube. This medical device delivers nutrients directly to your intestines or your stomach. Your doctor will discuss your options with you.

When to Call the Doctor

When should I call my doctor about difficulty swallowing?

You should see your doctor to determine the cause of your swallowing difficulties. Call a doctor right away if you’re also having trouble breathing or think something might be stuck in your throat. If you have sudden muscle weakness or paralysis and can’t swallow at all, call 911 or go to the emergency room.

St John guide to first aid in a choking emergency

In partial airway obstruction the patient will be able to breathe and cough, although there may be a ‘crowing’ noise (stridor) as air passes through a narrowed space. Usually the patient can clear a small foreign body by coughing and, although the breathing may be noisy, air can still enter and leave the lungs. At this stage it is important to avoid giving back blows which may cause a foreign body to move and become a total obstruction.

Symptoms and signs – Not all may be present

Partial airway obstruction:
- breathing laboured, gasping or noisy
- some air escaping from the mouth
- patient coughing or making a ‘crowing’ noise
- extreme anxiety or agitation
Total airway obstruction:

the person will be unable to effectively cough, breathe or speak, with no air movement
the person will be making obvious efforts to breathe with in-drawing of spaces between the ribs and above the collarbones
the person may be clutching the throat with both hands (the universal sign for choking)

Partial airway obstruction

How you can help

Never use back blows on a person who is able to cough effectively or breathe.

Ask the patient ‘are you choking?’ to determine whether their airway is completely blocked. If they are unable to answer or make noise, treat as for total airway obstruction.

If they can answer or breathe:

1. Reassure and encourage the patient

Stay with the patient until full recovery has occurred.
Encourage the patient to cough and expel the foreign body.

If the obstruction is not relieved – call for 111 an ambulance.

Total airway obstruction

How you can help

Call 111 for an ambulance.

1. If patient is conscious, give up to 5 back blows

With an adult or child, standing or sitting (and leaning forward), and using the heel of one hand, give the back blows between the patient’s shoulder blades.
Check between each back blow to see if the item has been dislodged.
Place a baby face down on your lap for the back blows. Ensure you support the baby’s head. Give firm back blows, checking between each to see if the item is dislodged.

2. If unsuccessful, give up to 5 chest thrusts

With an adult or child, standing or sitting, wrap both arms around the patient, at chest level.
Place one fist with the thumb side against the middle of the breastbone.
Grasp that fist with your other hand and give up to 5, separate, inward and upward thrusts.
Check between each chest thrust to see if the item has been dislodged.
Place a baby face upwards on a firm surface and give up to 5 sharp chest thrusts just below the nipple line, checking between each thrust.

The back blows and chest thrusts are given separately with a check after each one to see if the obstruction has been relieved.

3. If the obstruction has not been relieved

Ensure an ambulance has been called.
Continue alternating back blows and chest thrusts until the ambulance arrives.
If the person becomes unresponsive, begin CPR.

Unresponsive patient

How you can help

Call 111 for an ambulance.
Quickly check the mouth
- Use your fingers to remove any visible solid obstruction.
Begin CPR
- Begin CPR and continue until the ambulance arrives.

There may be some resistance to inflations at first until the object has been dislodged.

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Swallowed or Inhaled Objects | Michigan Medicine

Have you swallowed or inhaled an object?

Yes

Swallowed or inhaled object

How old are you?

Less than 12 years

12 years or older

Are you male or female?

Why do we ask this question?

If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you swallowed or inhaled something that might be poisonous?

Yes

Ingested known or suspected poison

Did you pass out completely (lose consciousness)?

If you are answering for someone else: Is the person unconscious now?

(If you are answering this question for yourself, say no. )

Are you back to your normal level of alertness?

After passing out, it’s normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.

Yes

Has returned to normal after loss of consciousness

Did the loss of consciousness occur during the past 24 hours?

Yes

Loss of consciousness in past 24 hours

Are you having trouble breathing (more than a stuffy nose)?

Yes

Difficulty breathing more than a stuffy nose

Have you swallowed an object that was sharp (like a toothpick, pin, bone, or needle) or long?

Long means at least 2 in. (5 cm) for adults and older children and at least 1.25 in. (3 cm) for babies and young children.

Yes

Swallowed sharp or long object

Do you have pain in your throat, chest, or belly after swallowing or inhaling an object?

Yes

Pain in throat, chest or belly since swallowing or inhaling object

Have you had mild pain for more than an hour?

Yes

Mild pain for more than 1 hour

Within the past 2 days, did an object get caught in your throat and cause you to choke?

Yes

Choking episode within past 2 days

Are you coughing or wheezing?

Yes

Coughing or wheezing now

Are you coughing up blood?

This means blood that is coming up from your chest or throat. Blood that is draining down from your nose into your throat (because of a nosebleed, for example) is not the same thing.

Were back blows or the Heimlich maneuver used to dislodge the food or object from the throat?

Yes

Back blows or Heimlich maneuver was used

Are you gagging or having trouble swallowing?

Yes

Gagging or having trouble swallowing

Are you drooling and not able to swallow?

Yes

Drooling and unable to swallow

Do you think an object may be stuck in your throat?

Yes

Feels like object is stuck in throat

Have you vomited blood or what looks like coffee grounds?

If there is only a streak or two of blood that you are sure came from your nose or mouth, you are not vomiting blood.

Yes

Has vomited blood or what looks like coffee grounds

Have you vomited more than once?

Yes

Vomited 2 or more times

Vomited less than 2 times

Has it felt like something has been stuck in your throat for more than 30 minutes?

Yes

Object in throat for more than 30 minutes

Have you had any changes in your bowel movements after swallowing an object?

Yes

Changes in bowel movements after swallowing an object

Have you had:

At least 1 stool that is mostly black or bloody?

At least 1 stool mostly black or bloody

At least 1 stool that is partly black or bloody?

At least 1 stool partly black or bloody

Streaks of blood in your stool?

Streaks of blood in stool

Have you swallowed a coin?

Did you swallow the coin more than 24 hours ago?

Most coins pass through the body without a problem in 24 hours. If you don’t pass the coin in this time frame, it’s best to follow up with your doctor.

Yes

Swallowed coin more than 24 hours ago

Has the coin passed out of your body in your stool?

Yes

Coin has passed out of body in stool

Do you still have concerns more than a week after swallowing an object?

Yes

Concerns about object swallowed more than 1 week ago

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.

A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.

A large amount of blood in the stool may mean a more serious problem is present. For example, if there is a lot of blood in the stool, not just on the surface, you may need to call your doctor right away. If there are just a few drops on the stool or in the diaper, you may need to let your doctor know today to discuss your symptoms. Black stools may mean you have blood in the digestive tract that may need treatment right away, or may go away on its own.

Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.

If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Pain in adults and older children

Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

You cannot talk at all.
You have to work very hard to breathe.
You feel like you can’t get enough air.
You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

It’s hard to talk in full sentences.
It’s hard to breathe with activity.

Mild trouble breathing means:

You feel a little out of breath but can still talk.
It’s becoming hard to breathe with activity.

Severe trouble breathing means:

The child cannot eat or talk because he or she is breathing so hard.
The child’s nostrils are flaring and the belly is moving in and out with every breath.
The child seems to be tiring out.
The child seems very sleepy or confused.

Moderate trouble breathing means:

The child is breathing a lot faster than usual.
The child has to take breaks from eating or talking to breathe.
The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

The child is breathing a little faster than usual.
The child seems a little out of breath but can still eat or talk.

Disc batteries are small, round batteries used in toys, cameras, watches, and other devices. Because of the chemicals they can release, they can cause serious problems if they are swallowed or get stuck in an ear or the nose. Small magnets used in household items and objects that contain a lot of lead (such as bullets, buckshot, fishing weights and sinkers, and some toys) also can cause problems if swallowed.

If a disc battery is stuck in the ear or nose:
- The battery needs to be removed right away—within 1 hour if possible.
- Use tweezers to try to remove the battery. If you can’t remove it, get medical help.

If you have swallowed a disc battery, magnet, or lead object:
- Get medical help right away.
- Do not try to vomit.
- Do not eat or drink anything.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don’t have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don’t have one, seek care in the next hour.
You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.

Poisoning

Choking (for Parents) – Nemours Kidshealth

What Is Choking?

When a child is choking, it means that an object — usually food or a toy — is stuck in the

trachea(the airway). When this happens, air can’t flow normally into or out of the lungs, so the child can’t breathe properly.

The trachea is usually protected by a small flap of tissue called the

epiglottis. The trachea and the
esophagusshare an opening at the back of the throat. The epiglottis acts like a lid, snapping shut over the trachea each time a person swallows. It allows food to pass down the esophagus and prevents it from going down the trachea.

But every once in a while, the epiglottis doesn’t close fast enough and an object can slip into the trachea. This is what happens when something “goes down the wrong pipe.”

Most of the time, the food or object only partially blocks the trachea, is coughed up, and breathing returns to normal quickly. Kids who seem to be choking and coughing but still can breathe and talk usually recover without help. It can be uncomfortable and upsetting for them, but they’re generally fine after a few seconds.

Is Choking an Emergency?

Sometimes, an object can get into the trachea and completely block the airway. If airflow into and out of the lungs is blocked and the brain is deprived of oxygen, choking can become a life-threatening emergency.

A child may be choking and need help right away if he or she:

can’t breathe
is gasping or wheezing
can’t talk, cry, or make noise
turns blue
grabs at his or her throat or waves arms
appears panicked
becomes limp or unconscious

In these cases, if you’ve been trained, immediately start abdominal thrusts (also known as the Heimlich maneuver), the standard rescue procedure for choking.

What Are Abdominal Thrusts (the Heimlich Maneuver)?

If you have kids, it’s important to get trained in both cardiopulmonary resuscitation (CPR) and the technique of abdominal thrusts (the Heimlich maneuver). Even if you don’t have kids, knowing how to perform these first-aid procedures will let you help if someone is choking.

When a person does abdominal thrusts, a sudden burst of air is forced upward through the trachea from the diaphragm and will dislodge a foreign object and send it flying up into (or even out of) the mouth.

Though the technique is pretty simple, abdominal thrusts must be done with caution, especially on young children. They are safest when done by someone trained to do them. If done the wrong way, the choking person — especially a baby or child — could be hurt. There’s a special version of abdominal thrusts just for infants that is designed to lower the risk of injury to their small bodies.

The technique of abdominal thrusts and CPR are usually taught as part of basic first-aid courses, which are offered by YMCAs, hospitals, and local chapters of the American Heart Association (AHA) and the American Red Cross.

What Should I Do?

Call 911 for any serious choking situation.

Here are several possible situations you might face and tips on how to handle them:

If a child is choking and coughing but can breathe and talk:

This means the airway is not completely blocked. It’s best to do nothing. Watch the child carefully and make sure he or she recovers completely. The child will likely be fine after a good coughing spell.
Don’t reach into the mouth to grab the object or even pat the child on the back. Either of these steps could push the object farther down the airway and make the situation worse.
Stay with the child and remain calm until the episode passes.

If a child is conscious but can’t breathe, talk, or make noise, or is turning blue:

The situation calls for abdominal thrusts.
Call 911 or tell someone nearby to call 911 immediately.
Begin the thrusts if you’ve been trained to do so.
If you haven’t been trained, and no one else is available who has been, wait until help arrives.

If the child was choking and is now unconscious and no longer breathing:

Shout for help and call 911, or tell someone nearby to call 911 immediately.
Start CPR right away, if you’ve been trained in it.
If you have not been trained, and no one else is available who has been, wait until help arrives.

When Should I Call the Doctor or Go to the ER?

After any major choking episode, a child needs to go to the ER.

Get emergency medical care for a child if:

The child has a lasting cough, drooling, gagging, wheezing, trouble swallowing, or trouble breathing.
The child turned blue, became limp, or was unconscious during the episode, even if he or she seemed to recover.
You think the child has swallowed an object, such as a toy or battery.

If a child had an episode that seemed like choking but fully recovered after a coughing spell, there is no need to get emergency medical care, but you should call your doctor.

How Can We Prevent Choking?

All kids are at risk for choking, but those younger than 3 are especially at risk. Young kids tend to put things in their mouths, have smaller airways that are easily blocked, and don’t have a lot of experience chewing, so they might swallow things whole.

To help protect kids:

Avoid foods that pose choking risks (like hot dogs, grapes, raw carrots, nuts, raisins, hard or gummy candy, spoonfuls of peanut butter, chunks of meat or cheese, and popcorn), which are a similar size and shape as a child’s airway.
At mealtime, be sure to serve a child’s food in small bites. That means cutting whole grapes into quarters, cutting hot dogs lengthwise and into pieces (and remove the tough skin), and cooking vegetables rather than serving them raw. Teach kids to sit down for all meals and snacks and not to talk or laugh with food in their mouths.
Toys and household items also can be choking hazards — beware of deflated balloons, coins, beads, small toy parts, and batteries. Get down on the floor often to check for objects that kids who are learning to walk or crawl could put in their mouths and choke on.
Choose safe, age-appropriate toys. Always follow the manufacturer’s age recommendations — some toys have small parts that can cause choking. To determine if a toy is too small, see if it passes easily through an empty cardboard toilet paper tube. If it does, it’s too small.

Take the time now to become prepared. CPR and first-aid courses are a must for parents, other caregivers, and babysitters. To find one in your area, contact your local American Red Cross, YMCA, or American Heart Association chapter, or check with hospitals and health departments in your community.

90,000 Bronchial asthma is a chronic inflammatory disease of the bronchi, the main manifestations of which are attacks of suffocation, wheezing, coughing caused by reversible narrowing of the lumen of the bronchi, disturbing the patient mainly at night

Bronchial asthma – chronic inflammatory disease of the bronchi, the main manifestations of which are attacks choking, wheezing, coughing caused by reversible narrowing of the bronchial lumen, disturbing the patient mainly at night or early in the morning.

Bronchial asthma is a fairly common disease and, like many other chronic diseases, it requires a very attentive attitude to treatment, compulsory training in the basics of self-control over the course of the disease and regular visits to the doctor. Today it is absolutely obvious that those people who carefully follow the doctor’s prescriptions and care about their health are 10 times less likely to suffer from exacerbations of bronchial asthma and almost always avoid serious complications of the disease.The seeming complexity of treatment eventually becomes part of your lifestyle and in the future will significantly help improve your well-being. Proper treatment is the key to an active life, which, in terms of quality and duration, practically does not differ in any way from people who do not suffer from asthma!

Symptoms

An asthma attack (acute shortage of air) with a sharp obstruction of exhalation is the main manifestation of bronchial asthma. Most often, suffocation occurs after inhalation of dust, smoke, pungent odors, against the background of physical activity. Other signs of asthma include a dry cough, chest discomfort, and wheezing. Most often, these symptoms bother at night or early in the morning.

In some people, the disease is seasonal in nature (symptoms occur mainly in spring and summer – for example, during the flowering of various plants) or appear only upon contact with an allergen (for example, with animals). This form of bronchial asthma is called episodic, or intermittent. In other people, symptoms may be disturbing throughout the year – in this case, they speak of a constant (persistent) form of bronchial asthma. In any case, even with mild persistent bronchial asthma, treatment is necessary !!!

Complications

With proper treatment, complications of bronchial asthma are practically impossible.

However, inadequate treatment may result in persistent narrowing of the bronchi (chronic obstructive pulmonary disease), destruction of the “respiratory apparatus” of the lungs – alveoli (emphysema) and persistent respiratory failure.

In the absence of anti-inflammatory therapy and an overdose of short-acting beta2-adrenergic agonists (for example, salbutamol), asthma attacks can be very difficult and the so-called status asthma can develop – a pronounced narrowing of the bronchi with the formation of mucous plugs in the small airways.Independent disappearance of this complication, as well as its independent treatment, is impossible, urgent hospitalization is necessary!

With a severe attack of bronchial asthma, spontaneous pneumothorax can also develop – air penetration into the pleural cavity through a rupture in the lung, which also requires emergency hospitalization.

Diagnostics

The diagnosis is established on the basis of the description of the typical manifestations of bronchial asthma. The rapid effect (reduction of shortness of breath) after inhalation of a bronchodilator is also of diagnostic value.It is important to clarify the hereditary predisposition, factors provoking attacks. A complete examination, especially during the initial visit, includes general clinical tests (general blood test with an assessment of the leukocyte formula; determination of the level of total protein and assessment of protein fractions; study of immunoglobulins M, G, E; general sputum analysis), a study of the function of external respiration ( spirometry ) chest x-ray, identification of possible allergens, most often using skin allergy tests.

The means of “self-diagnosis” and self-control include peak flowmetry (peak flowmetry), which helps to determine the expiratory flow rate and, with constant conduct, to fix the incipient exacerbation of bronchial asthma in time.

Based on the frequency of asthma symptoms and indicators of respiratory function, the severity of the disease is determined and, depending on its degree, an adequate treatment is selected.

Treatment of bronchial asthma

1. In case of development of asthma attacks or before anticipated physical activity, inhalation of fast-acting bronchodilators prescribed by a doctor, from the group of beta2-adrenergic agonists (for example, salbutamol, fenoterol), is necessary.

These medicines must not be abused (no more than 12 inhalations per day)!

It is important to perform the inhalation correctly, it is advisable to use a spacer (see “Rules for the use of inhalers”). Unfortunately, almost all untrained people make a lot of inhalation mistakes. Take this very seriously!

After inhalation, rinse your mouth with plain water!

In case of a severe attack of bronchial asthma, which is not relieved by inhalation of a fast-acting bronchodilator, it is necessary to seek medical help without delay.

2. The treatment of bronchial asthma is based on the use of inhaled glucocorticoids (the only exception is the intermittent form of bronchial asthma). These substances suppress inflammation in the bronchi, reduce the frequency and severity of asthma attacks and other symptoms of the disease. Because inhaled glucocorticoids are inhaled, only a small portion of the drug gets into the bloodstream, and therefore, adverse drug reactions are rare. You can reduce the frequency of their development if you rinse your mouth with plain water after using inhalers.

Remember, without the use of inhaled glucocorticoids, you are not treating your disease! Correct inhalation, use of a spacer and rinsing the mouth with water after using these drugs is very important when using inhaled glucocorticoids, do not neglect this!

It is possible to use (1-2 times a day) long-acting drugs (long-acting beta2-adrenergic agonists, leukotrienes, theophylline) to prevent the development of bronchial asthma attacks.In severe forms of bronchial asthma, it is possible to use oral glucocorticoids and antibodies to immunoglobulin E.

3. For allergy sufferers, antiallergic agents may be recommended. In the case of a known allergen and poor disease control, allergen specific immunotherapy (allergen specific immunotherapy) is possible.

In addition, it is important to eliminate exposure to allergens using simple measures.

Place impervious covers on mattresses, pillows and blankets.
Wash bedding weekly in hot water (55-60 ° C).
Remove carpets and carpets if possible.
Treat all carpets with acaricides and / or tannin acid.
Dispose of upholstered furniture if possible.
Use blinds or curtains that are easy to wash in hot water.
Wash soft toys in hot water or freeze periodically. Children should not sleep with soft toys in bed.
Take measures to reduce exposure to pet allergens.
Use air cleaners.
Limit outdoor exposure to pollutants (air pollutants).
Avoid smoking and smoky areas.
Avoid contact with dust and other irritants such as hair spray, paint, strong odors or any kind of smoke.

4. In case of bronchial asthma, certain medications should not be used (for example, acetylsalicylic acid and similar drugs are contraindicated in many patients, as they can contribute to the narrowing of the bronchi).

5. It is extremely important to timely and correctly treat infectious diseases of the respiratory tract!

How effectively do you treat your disease?

With adequate treatment, you can achieve full remission (no signs of the disease), which is determined by the following main components:

Asthma symptoms occur no more than 2 times a week.
You have no restrictions on your normal daily activities, including moderate physical activity.
You do not wake up at night due to choking or coughing.
You do not need to use inhalers more than 2 times a week.
Respiratory function is normal or close to normal values, and fluctuations in peak expiratory flow rate during the day are no more than 20%.

Rules for the use of inhalers

Using metered-dose aerosol inhalers without a spacer

Shake the inhaler before use.
Exhale deep .
Gently grasp the mouthpiece of the inhaler with your lips (your teeth seem to bite the inhaler).
Start inhale slowly .
Immediately after the start of inhalation press the inhaler one times.
Slowly continue inhalation to the maximum.
Hold your breath for 10 seconds or, if it is impossible for that long, hold your breath as much as possible, preferably without removing the inhaler from your mouth.
Exhale through the mouth.
Repeated inhalation not earlier than after 30 seconds.
Rinse mouth with water.

The use of metered-dose aerosol inhalers with a spacer

The use of a special device – a spacer – significantly increases the efficiency of aerosol inhalation. Be careful, the algorithm for using an aerosol inhaler with a spacer has several significant features.

Shake inhaler before use.
Attach the inhaler to the spacer
Exhale deep .
Grasp the mouthpiece of the spacer tightly with your lips .
Press the inhaler once times.
Slowly start inhaling.
Slowly continue inhalation to the maximum.
Hold your breath for 10 seconds or, if it is impossible for that long, hold your breath as much as possible, without removing the spacer from your mouth.
Exhale through the mouth back into spacer .
Again, a slow inhalation through the mouth without injecting of a new inhalation dose of the drug
Again holding the breath and exhaling through without the spacer.
Repeated inhalation not earlier than after 30 seconds.
Rinse mouth with water.

Using powder inhalers

Remember that unlike aerosol inhalers, when using powder inhalers, you should take a strong deep breath, hold your breath for 5 seconds! If you find it difficult to take a strong and deep breath, be sure to pay the attention of your doctor, he may recommend an aerosol inhaler with a spacer or a portable nebulizer.
When using powder inhalers, the spacer is not used.
Remember to rinse your mouth with water after inhalation.

Bronchial asthma – signs, symptoms, diagnosis

Bronchial asthma is an inflammatory process in the airways, often accompanied by coughing, shortness of breath and suffocation. People of all ages suffer from bronchial asthma, but most of them are children. In whom this disease often goes away with age.

Bronchial asthma is the most common type of asthma and has several subspecies: exertional asthma, cough, occupational, nocturnal, aspirin.

Stress asthma. Signs of the progression of this disease appear, as a rule, during intense physical activity. The patient has shortness of breath, severe cough. The maximum airway is narrowed 5–20 minutes after the start of certain exercises. Treatment of such a condition comes down to the fact that the patient will need to use inhalers to control the occurrence of such attacks.

Cough asthma. The main symptom of the disease is a severe cough that lasts for a long time. Cough asthma is very difficult to diagnose and difficult to treat. Most often, exercise and respiratory infections can provoke the progression of the pathology. If the patient has repeatedly developed coughing attacks, then it is necessary to immediately consult a doctor for a diagnosis. A test should be passed that will help determine the presence of an ailment – a test of lung functions.

Occupational asthma. The causative agents of this type of asthma are located directly at the human workplace. Most often, a person notes that an exacerbation of the disease develops in him on weekdays, and on weekends the symptoms decrease. The main symptoms: cough, runny nose, watery eyes. The development of such asthma is observed in people of the following professions: hairdresser, farmer, carpenter, artist.

Nocturnal asthma. In the case of the development of this disease, the symptoms appear more intensely at night, during sleep.The main symptoms are: severe cough; labored breathing; wheezing. It is worth noting that according to statistics, more deaths due to asthma occurred at night. This is due to many factors: Bronchial asthma; decreased lung performance during sleep; horizontal position of the body; violation of the circadian rhythm, etc.

Aspirin asthma. A variant of asthma, in which one of the factors contributing to the narrowing of the bronchi are non-steroidal anti-inflammatory drugs (NSAIDs), including acetylsalicylic acid.It consists of a triad of symptoms (Fernand-Vidal triad): polypous rhinosinusitis, asthma attacks and intolerance to NSAIDs.

Signs and symptoms of bronchial asthma

The first symptoms by which bronchial asthma can be recognized are:

Severe cough. Difficult and dry, when a person seems to be unable to clear his throat. When the attack ends, a small amount of moisture is likely to appear in the form of mucus.
Frequent breathing.The attacks can often be with shortness of breath. When it is difficult for the patient to inhale air, and it is even more difficult to exhale.
Wheeze. Attacks of bronchial asthma are accompanied by wheezing, which can be heard even from a distance.
Attack of suffocation. Choking or shortness of breath can happen very suddenly. Both at night during sleep and during the day with any physical activity. When a person breathes in dust, smoke, or polluted air.

The more severe the stage of the disease, the more severe its symptoms can be, for example: heart palpitations (up to 125-135 beats per minute, when 90 beats per minute is considered the norm for asthmatics) or pronounced dizziness (a sign of lack of oxygen in bronchial asthma) …

Diagnostics

In order to diagnose bronchial asthma, you first need to carefully examine your family, up to grandparents for the presence of this disease.

Then contact a specialist who will check the patient for rashes on the skin, which indicate the patient’s sensitivity to various allergens and listen to the lungs for wheezing. After that, special tests and samples of blood and sputum may be taken.

The diagnostic program may include:

spirometry – lung function test;
peak flowmetry – studies to determine the air flow rate;
chest x-ray;
tests to identify allergies – to determine the cause of the development of the disease;
test for determining the concentration of air oxide – this allows you to diagnose inflammation of the upper respiratory tract.

Based on the results of the diagnosis, the doctor will select a treatment in accordance with the severity of your symptoms.This disease is not completely cured. But if you follow the correct lifestyle and doctor’s recommendations, you can prolong the period of remission and minimize the frequency of seizures.

90,000 “I couldn’t breathe, a hysteria began”: the story of a patient from Belarus who survived the coronavirus in Britain

Alina Isachenko
BBC

March 30, 2020

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Video caption,

A 34-year-old native of Belarus told the BBC how she was sick with coronavirus in Britain.

When 34-year-old Eugenia Tyler developed a cough and a runny nose, she became alarmed and called the hospital – but she was told that it was a mild cold and should not be worried. A week later, gasping and barely conscious, her boyfriend brought her to the emergency room. Looking at the X-ray of Evgenia’s lungs, the doctor immediately said that she had Covid-19.

In an interview with the BBC Russian Service, Evgenia spoke about the symptoms, treatment and conditions in a British hospital, as well as the role that thyroid problems played in her illness.

Symptoms. “I was told it was a common cold”

At the beginning I had a mild cold, a runny nose and a sore throat. A week later, I developed a severe runny nose, a cold, a heaviness in the nose, and sore eyes. There was no temperature. This condition lasted for a couple of days. I then called 111 (British health system hotline – BBC)

They said that these were not symptoms of coronavirus, but a common cold.

Photo author, Jenya Tyler

Caption,

When Evgeniya called the emergency hotline, she was told that she had a common cold

Aggravation.

“I couldn’t breathe, I was hysterical.”

Coughing started on Tuesday afternoon. He was not strong, I coughed a little. By 11 o’clock in the evening, my chest suddenly squeezed. There was a feeling that someone stepped on my chest. I lost the opportunity to take a deep breath, it became very scary and difficult.

My boyfriend and I tried to call the hotline. We waited 40 minutes for an answer. I got hysterical and couldn’t breathe.

My boyfriend wanted to take me to the hospital – I sobbed, asked not to go, thought that I would be kicked out.When it became really hard for me to breathe, my boyfriend took me in an armful and took me to the hospital. He said: “If you are going to die already, you’d better die on the steps of the hospital – there the chances are much higher that you will receive medical care.”

Photo author, Jenya Tyler

Photo caption,

Evgenia spent the night in the emergency department. I was in the ward with my boyfriend

When we got to the hospital, I stayed outside, and my boyfriend went inside. He was talking to a woman in protective uniform.She asked if I had symptoms. In three minutes I was already in the hospital, in my bed.

I was waiting for the nurse to take a blood test, they brought me an inhaler to make it easier to breathe.

Diagnosis and Treatment

They took a blood sample from me and sent me for an X-ray of my lungs. After the doctor saw my X-ray, he said that I had a coronavirus.

I was in the emergency room. Spent the night there. I was in the ward with my boyfriend. They put me on two droppers, gave me two inhalers with Ventolin (a bronchodilator drug, including used to relieve attacks of bronchial asthma – BBC) .

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Video caption,

BBC correspondent on how life in Britain has changed dramatically in a matter of days.

When I was taken off the IV, I walked down the corridor to the toilet and mostly saw wards with women over 45 and already quite elderly. All on ventilators.

“The doctors responded with lightning speed”

What impressed me most was how quickly I was received and how quickly the nursing staff knew what to do and how to ease my breathing difficulties.I did not have time to finish the sentence, to say what was happening to me, and the doctors and nurses were already nodding – they knew what to do.

Doctors, it seems to me, are ready for what is happening now.

When the crisis situation passed and I began to breathe normally, they let me go home.

Someone suggests that warm weather can slow the spread of the virus.

Considering that there is no medicine yet, I’d better be at home. But the doctors said that I could ask for help again if it gets worse.

Coronavirus.

“I was very upset”

When I found out that I had a coronavirus, I felt very upset. Given that I have weak immunity, we tried to maintain social distancing three weeks before I got sick.

I did not use public transport, my boyfriend worked from home and occasionally took me to work. Therefore, I had very limited contact with others, and this is doubly offensive.

Immunity.”My previous illness played a big role”

In 2009, I had thyroid cancer. I was undergoing radiation therapy. Therefore, I have a weakened immune system. But I would not call myself a sick person. I play sports and I feel fine.

But in the situation with this virus, my early illness played a big role.

Photo author, Jenya Tyler

Caption,

Evgenia’s boyfriend also contracted Covid-19, but the doctors told him to just wait out

My boyfriend also got Covid-19.At the hospital, we were told that, based on his symptoms – cough and weakness – he also had coronavirus. We live together, and this would be difficult to avoid.

But no treatment was prescribed for him, no test was done, they just told him to wait it out.

Treatment at home. “Told me to isolate myself even after I recovered”

My symptoms of shortness of breath are controlled by the drugs I was given at the hospital. But upon returning home, I began to develop a runny nose with phlegm of the upper respiratory tract.

I was prescribed antibiotics to kill the infection that was developing.

Photo by Jenya Tyler

Caption,

“What impressed me most was how quickly the nursing staff knew how to ease my breathing difficulties.” the medications I was prescribed. Therefore, my friends gave me ventolin and nibulator (inhaler).

The doctors told me to continue self-isolation and social distancing even after I recovered – it is not yet clear how the immune system will behave.

Editor’s note: a list of symptoms of coronavirus can be found on the WHO websites and Rospotrebnadzor . The described symptoms and methods of treatment are individual and should not be used as a recommendation for action.

Heavy breathing

12.07.2017

Heavy breathing

How to minimize the risk of developing bronchopulmonary diseases

Diseases of the respiratory system can be associated with both the harmful effects of external factors on the lungs – smoking, various allergens, poor ecology, and heredity, infections.The most common of these are pneumonia, chronic obstructive pulmonary disease (COPD), and asthma.

About bronchopulmonary problems and their prevention, we talked with the head of the 2nd therapeutic department of the First City Hospital, pulmonologist Natalya Veshchagina.

Pneumonia does not sleep all year round

The leader among bronchopulmonary diseases is pneumonia – an acute inflammation of the lower respiratory tract, usually of an infectious nature (viruses, bacteria, including atypical, etc. )etc.). It is manifested by fever, respiratory failure, and the appearance of foci of darkening on chest radiographs.

Risk factors for the development of pneumonia include: age over 65 and under five years, the presence of chronic diseases of the lungs, heart, kidneys, diabetes mellitus, alcoholism, smoking, exhaustion, decreased immunity, recent viral infection and a number of others.

– Patients with pneumonia are hospitalized all year round, and the peak usually occurs in February-March and October-November, says Natalya Veshchagina.- This is an infectious disease, each of us can face it under the most ordinary circumstances: cold air, high humidity, people don’t dress for the weather … It is manifested primarily by severe respiratory failure. Patients with severe bilateral lung damage were admitted to our hospital during an influenza epidemic; their intensive treatment was carried out in intensive care conditions.It would seem a banal truth, but it should not be taken lightly: if you get sick, be sure to consult a doctor. During an acute period of influenza or SARS, observe bed rest and take prescribed antiviral drugs.

As for the prevention of pneumonia, the most important thing here is the annual flu vaccination.

– Some categories of patients who have the above risk factors also need pneumococcal vaccination, which is carried out once every five years, explains Natalya Albertovna.

Allergies can “grow” into asthma

The word “asthma” in Greek means “choking”. Bronchial asthma is a major medical problem. Despite the fact that this pathology has been known for a very long time, special attention has been paid to it in the last 40 years.

– The main symptoms of the disease are episodic cough, wheezing, tightness in the chest, shortness of breath and suffocation, often appearing at night or early in the morning. These symptoms are provoked by inhalation of allergens, cold air, physical activity, stress, SARS, tobacco smoke and dust, taking certain medications, says Natalya Veshchagina. – Bronchial asthma occurs in people of all ages, characterized by a widespread increase in its prevalence. Genetic predisposition, harmful emissions into the atmosphere, smoking of the mother during pregnancy contribute to an increase in the level of immunoglobulin E, and in the future – the development of bronchial hyperreactivity and bronchial asthma.

Chronic obstructive pulmonary disease (COPD) also presents with difficulty breathing. It all starts with a prolonged cough (three months or more) and sputum appearing at the same time, then shortness of breath joins the listed symptoms.

– COPD in most cases occurs due to damage to the lungs over the years, usually as a result of smoking. Continuous inhalation of tobacco smoke irritates the airways and destroys the elastic fibers in the lungs. Passive smoking in this sense is also very harmful, – emphasizes Natalya Veshchagina. – Other factors that can cause COPD include inhalation of chemical fumes, dust and polluted air for a long time (ecology of the environment and home), genetic factors, low socio-economic status.

The risk of COPD can be predicted using the World Health Organization’s Smokers Index (ICI). It is calculated as follows: the number of cigarettes smoked per day is multiplied by the number of months in the year that a person smoked. If the index is less than 120, it speaks of the prerequisites for the formation of COPD, if more than 160 – a person at risk, if more than 240 – COPD is inevitable.

Doctors note that patients in such a situation often seek medical help late.It takes many years for lung tissue to break down before serious symptoms develop, which is why the diagnosis of COPD is most common in people over 40.

– Due to the high prevalence of smoking among adolescents, COPD is getting younger. Mortality in this disease has increased significantly since the 70s of the twentieth century. According to the WHO, by 2020, mortality in COPD is expected to be in third place, explains Natalya Albertovna. – People reason like this: I smoke, I cough – there is nothing wrong with that, my grandfather smoked until he was a hundred years old, nothing happened to him and nothing will happen to me. It must be understood that comparison with previous generations is wrong. Then there was a different ecology and people were generally healthier, now everything contains a lot of “chemistry”, there is an allergization of the population and so on.

There are no harmless cigarettes

It is better not to smoke at all – this is an axiom. The existence of less hazardous cigarette substitutes is a myth.

“Some people choose light cigarettes as a compromise, but do not take into account that they inhale more deeply, smoke more often, and as a result receive even larger doses of hazardous substances,” says Natalya Veshchagina.- Hookah, electronic cigarettes are also harmful. What is vaping? Vaping is the use of electronic cigarettes. In fact, it is an electric inhaler, which contains nicotine in various dosages and a cocktail of various chemicals (glycerin, propylene glycol, flavorings). And such a mixture is hardly less harmful to the body! The main function of this gadget is to make sure that the person remains addicted to nicotine. In addition, with their help, no one has quit smoking yet; you should not indulge yourself with such illusions.At least, if a person seriously wants to quit smoking, then he needs to tune in to giving up any cigarettes. And the most important role here is played by motivation. If a person has not “matured” before and is not ready to make efforts in this direction, everything else will not give a result. It is in your power not to succumb to weaknesses for the sake of momentary pleasure, but to live a full, healthy life. Nicotine patch and other similar products can help ease the process of quitting cigarettes.

Ideally, experienced smokers who decide to quit tobacco should see a doctor.After all, it is no coincidence that they say: it’s easy to quit – I’ve done it a hundred times, it’s hard to resist.

– If a person lasts six months without a cigarette, only after that it can be considered that he has quit smoking. There are a lot of relapses, but it doesn’t matter. The main thing is not to despair and resume attempts to quit smoking, including with the help of specialists, explains Natalya Veshchagina. – Before giving up cigarettes, it is imperative to undergo diagnostics: fluorography and spirometry are a method of examining the function of external respiration, which includes measuring the vital capacity of the lungs and respiratory rate indicators.If COPD has already developed, then a different tactic of behavior is needed when quitting smoking. The patient will be prescribed basic bronchodilator therapy. All this will be of help to a person, and he will more easily survive the process of quitting smoking. Useful tips that you can give to quitting smoking: if you want to take up a cigarette, drink a glass of water in small sips, eat something non-nutritious, for example, a carrot or an apple. In the first two to three weeks, it is better to completely give up alcohol, its use will provoke you to smoke again.

Quitting smoking is always challenging, but worth it. Do not forget that the lungs themselves, like the entire body, age. Smoking contributes to a faster aging of the body, the appearance of early wrinkles, discoloration of the skin, and most importantly – it is a serious factor in the development of cancer, cardiovascular accidents, bronchopulmonary diseases, venous thrombosis . .. Do not neglect prevention and those who do not smoke.

– Unfortunately, many Russians are not very careful about their health, but, as one proverb says, what we have – we do not store, when we lose – we cry, – says Natalya Veshchagina.- It so happens that the patient acts, you ask when the previous fluorography was, he cannot even remember – 15 years ago.

The rules of prevention that are relevant for everyone are simple: to lead a healthy lifestyle, maintain immunity, be examined regularly (fluorography every 1-2 years is mandatory for everyone), exercise, enjoy every day.

Digit

635 patients with bronchopulmonary diseases were treated in 2016 at the First City Hospital, 618 of them were admitted to the ambulance line.

Natalia SENCHUKOVA
newspaper “Arkhangelsk – the city of military glory” No. 53 (641) dated July 12, 2017

90,465 90,000 causes, symptoms and treatment at the Medinef clinic in St. Petersburg and Kirishi

The best treatment for heart failure is its prevention, which includes the treatment of arterial hypertension, prevention of atherosclerosis, a healthy lifestyle, exercise and diet (primarily salt restriction).
Early treatment for heart failure significantly improves a patient’s life prognosis.

The main function of the heart is to supply oxygen and nutrients to all organs and tissues of the body, as well as to remove their waste products. Depending on whether we are resting or actively working, the body requires a different amount of blood. To adequately meet the needs of the body, the frequency and strength of heart contractions, as well as the size of the vascular lumen, can vary significantly.

A diagnosis of heart failure means that the heart has stopped supplying enough oxygen and nutrients to tissues and organs. The disease is usually chronic and the patient can live with it for many years before being diagnosed.
Tens of millions of people around the world suffer from heart failure, and the number of patients with this diagnosis is increasing every year. The most common cause of heart failure is narrowing of the arteries that supply oxygen to the heart muscle. Although vascular disease develops at a relatively young age, the manifestation of congestive heart failure occurs most often in the elderly.

According to statistics among people over 70 years old, 10 out of 1,000 patients are diagnosed with heart failure. The disease is more common in women, because men have a high percentage of deaths directly from vascular disease (myocardial infarction) before they develop into heart failure.

Other factors that determine the development of this disease are hypertension, alcohol and drug addiction, changes in the structure of heart valves, hormonal disorders (for example, hyperthyroidism – excessive thyroid function), infectious inflammation of the heart muscle (myocarditis), etc.

Classification of heart failure

The following classification has been adopted worldwide, based on the effects manifested at different stages of the disease:

Class 1: no limitation of physical activity and no impact on the patient’s quality of life.
Class 2: mild limitation of physical activity and no discomfort during rest.
Grade 3: Perceptible decrease in performance, symptoms disappear with rest.
Class 4: Total or partial loss of working capacity, symptoms of heart failure and chest pain occur even during rest.

Symptoms of heart failure

Depending on the nature of the course of the disease, acute and chronic heart failure are distinguished.

The manifestations of the disease are:

slowing down the speed of general blood flow,
decrease in the amount of blood ejected by the heart,
increase in pressure in the heart chambers,
accumulation of excess blood volumes, which the heart cannot handle, in the so-called “depots” – the veins of the legs and abdominal cavity.

Weakness and rapid fatigue are the first symptoms of heart failure.

Due to the inability of the heart to cope with the entire volume of circulating blood, excess fluid from the bloodstream accumulates in various organs and tissues of the body, usually in the feet, calves, thighs, abdomen and liver.

As a result of an increase in pressure and accumulation of fluid in the lungs, a phenomenon such as dyspnea or respiratory failure can be observed.Normally, oxygen easily passes from the capillary tissue of the lungs into the general bloodstream, but when fluid accumulates in the lungs, which is observed in heart failure, oxygen does not fully penetrate the capillaries. The low concentration of oxygen in the blood stimulates faster breathing. Often, patients wake up at night from attacks of suffocation.

For example, US President Roosevelt, who suffered from heart failure for a long time, slept while sitting in a chair due to breathing problems.

The release of fluid from the bloodstream into tissues and organs can stimulate more than breathing problems and sleep disorders. Patients gain dramatically in weight due to soft tissue edema in the feet, lower legs, thighs, and sometimes in the abdomen. Swelling is clearly felt when pressed with a finger in these places.

In severe cases, fluid can accumulate inside the abdominal cavity. A dangerous condition arises – ascites. Ascites is usually a complication of advanced heart failure.

When a certain amount of fluid from the bloodstream is released into the lungs, a condition called pulmonary edema occurs. Pulmonary edema is common with chronic heart failure and is accompanied by pink, bloody sputum when coughing.

Insufficient blood supply affects all organs and systems of the human body. From the side of the central nervous system, especially in elderly patients, there may be a decrease in mental function.

Left side or right side?

The various symptoms of heart failure are due to which side of the heart is involved. For example, the left atrium (the upper chamber of the heart) receives oxygenated blood from the lungs and pumps it into the left ventricle (lower chamber), which in turn pumps blood to the rest of the organs. If the left side of the heart cannot effectively move blood, it is thrown back into the pulmonary vessels, and excess fluid penetrates through the capillaries into the alveoli, causing breathing difficulties.Other symptoms of left-sided heart failure are general weakness and excess mucus (sometimes mixed with blood).

Right-sided insufficiency occurs in cases of difficulty in the outflow of blood from the right atrium and right ventricle, which happens, for example, with poor functioning of the heart valve. As a result, pressure increases and fluid accumulates in the veins ending in the right chambers of the heart – the veins of the liver and legs. The liver swells, becomes painful, and the legs swell a lot.With right-sided insufficiency, a phenomenon such as nocturia or increased nighttime urination is observed.

With congestive heart failure, the kidneys cannot handle large volumes of fluid and renal failure develops. Salt, which is normally excreted by the kidneys along with water, is retained in the body, causing even greater swelling. Renal failure is reversible and disappears with adequate treatment of the main cause, heart failure.

Causes of heart failure

There are many reasons for the development of heart failure.Among them, the most important place is occupied by ischemic heart disease or insufficient blood supply to the heart muscle. Ischemia, in turn, is caused by blockage of the heart vessels with fat-like substances.

A heart attack can also cause heart failure due to the fact that some part of the heart tissue dies and heals.

Arterial hypertension is another common cause of the development of insufficiency. The heart requires much more effort to move blood through the spasmodic vessels, which leads, as a result, to an increase in its size, in particular, the left ventricle.In the future, weakness of the heart muscle or heart failure develops.

The reasons influencing the development of heart failure include cardiac arrhythmias (irregular contractions). The number of strokes more than 140 per minute is considered dangerous for the development of the disease, because the processes of filling and ejection of blood by the heart are disrupted.

Changes in the heart valves lead to disturbances in the filling of the heart with blood and can also cause the development of heart failure.The problem is usually caused by an internal infection (endocarditis) or rheumatic disease.

Inflammation of the heart muscle caused by infection, alcoholic or toxic damage, also leads to the development of heart failure.

It should be added that in some cases it is impossible to establish the exact cause of the failure. This condition is called idiopathic heart failure.
Diagnosis of heart failure

Using a stethoscope, the doctor listens for unusual noises in the lungs due to the presence of fluid in the alveoli.The presence of fluid in a particular area of the body can also be detected using X-rays.

The doctor listens to heart murmurs arising during filling and ejection of blood, as well as during the work of heart valves.

Blue limbs (cyanosis), often accompanied by chills, indicates insufficient oxygen concentration in the blood and is an important diagnostic sign of heart failure.

Swelling of the extremities is diagnosed by finger pressure.The time required to smooth out the compression area is noted.

To assess the parameters of the heart, methods such as echocardiogram and radionuclide cardiogram are used.

In cardiac catheterization, a thin tube is inserted through a vein or artery directly into the heart muscle. This procedure allows you to measure the pressure in the heart chambers and identify the site of the blockage of blood vessels.

An electrocardiogram (ECG) allows you to graphically evaluate changes in the size and rhythm of the heart.In addition, with the help of an EKG, you can see how effective drug therapy is.
What are the body’s defenses to combat deficiency?

In cases where an organ or system of the body is unable to cope with its functions, defense mechanisms are activated and other organs or systems take part in solving the problem. The same is observed in the case of heart failure.

First, there are changes in the heart muscle. The chambers of the heart increase in size and work harder to supply more blood to organs and tissues.

Secondly, the heart rate increases.

Third, a compensatory mechanism called the renin-angiotensin system is triggered. When the amount of blood expelled by the heart decreases and less oxygen reaches the internal organs, the kidneys immediately begin to produce the hormone renin, which allows you to retain salt and water excreted in the urine and return them to the bloodstream. This leads to an increase in the volume of circulating blood and an increase in pressure.The body needs to make sure that enough oxygen is being delivered to the brain and other vital organs. This compensatory mechanism, however, is only effective in the early stages of the disease. The heart is unable to work in an increased mode for many years under conditions of increased pressure.

Treatment of heart failure

For the drug therapy of heart failure, the following groups of drugs are used: diuretics, cardiac glycosides, vasodilators (nitrates), calcium channel blockers, beta-blockers and others.In severe cases, surgical treatment is performed.

Diuretics have been used since the 1950s. The drugs help the heart by stimulating the excretion of excess salt and water in the urine. As a result, the volume of circulating blood decreases, blood pressure decreases, and blood flow is facilitated.

The most important in heart failure is a group of drugs derived from the digitalis plant or “cardiac glycosides”. These medicinal substances were first discovered in the 18th century and are widely used to this day.Cardiac glycosides affect the internal metabolic processes inside the cells of the heart, increasing the strength of the heart contractions. Thanks to this, the blood supply to the internal organs is noticeably improved.

Recently, new classes of drugs have been used to treat heart failure, for example, vasodilators (vasodilators). These drugs primarily affect the peripheral arteries by stimulating their dilation. As a result, due to the facilitation of blood flow through the vessels, the work of the heart improves.Vasodilators include nitrates, angiotensin-converting enzyme blockers, calcium channel blockers.

In urgent cases, surgical intervention is performed, which is especially necessary when the insufficiency is caused by disorders of the heart valves.

There are situations when a heart transplant is the only way to save a patient’s life.

Predictions

It is estimated that about 50% of patients diagnosed with heart failure live with the disease for more than 5 years.However, the prognosis for each individual patient depends on the severity of the disease, concomitant diseases, age, effectiveness of therapy, lifestyle and much more. Treatment of this disease pursues the following goals: improving the work of the left ventricle of the heart, restoring work capacity and improving the patient’s quality of life.

You can make an appointment by phone: 8 (812) 603-03-03

We are located at St. Petersburg, st. Botkinskaya d.15, building 1
(5 minutes walk from the metro station Ploshchad Lenina, exit to Botkinskaya street).

90,000 Bronchial asthma and pregnancy 9,0001

Bronchial asthma is one of the most common lung diseases in pregnant women.

This disease is characterized by inflammation and temporary obstruction of the airways and occurs against the background of increased irritability of the airways in response to various influences.

Symptoms

Regardless of the form of bronchial asthma, there are three stages of its development: pre-asthma, asthma attacks and asthmatic status.All forms and stages of the disease occur during pregnancy. In the initial stage of asthma, asthma attacks develop periodically. They start more often at night, lasting from several minutes to several hours. Choking is preceded by a scratching sensation in the throat, sneezing, runny nose, tightness in the chest. The attack begins with a persistent paroxysmal cough, no sputum. There is a sharp difficulty in exhaling, tightness in the chest, nasal congestion. Breathing becomes noisy, sibilant, hoarse, audible from a distance.The face becomes bluish. The skin is covered with perspiration. By the end of the attack, sputum begins to separate, which becomes more and more liquid and abundant.

Features of the course of bronchial asthma during pregnancy and childbirth

With the development of pregnancy in women with bronchial asthma, pathological changes occur in the immune system, which have a negative impact on both the course of the disease and the course of pregnancy. Bronchial asthma usually begins before pregnancy, but may first appear during pregnancy.In some patients, asthma attacks develop at the beginning of pregnancy, in others – in the second half. Asthma that occurs at the beginning of pregnancy, like early toxicosis, can disappear by the end of the first half of it. In these cases, the prognosis for the mother and fetus is usually quite favorable. According to some reports, during pregnancy, 20% of patients retain the same condition as before pregnancy, 10% improve, and most women (70%) have a more severe disease, with moderate and severe forms of exacerbation prevailing with daily repeated attacks suffocation, periodic asthmatic conditions, unstable treatment effect.Asthma usually worsens in the first trimester of pregnancy. In the second half of it, the disease is easier. Attacks of bronchial asthma during childbirth are rare, especially with the prophylactic use of glucocorticoid drugs (prednisolone, hydrocortisone) or bronchodilators (aminophylline) during this period. After childbirth, the course of bronchial asthma improves in 25% of women (these are patients with a mild form of the disease). In 50% of women, the condition does not change, in 25% it worsens. Patients with bronchial asthma more often than healthy women develop early toxicosis, the threat of termination of pregnancy, abnormalities in labor, rapid and rapid labor, which results in high birth traumatism, premature and low birth weight babies can be born.Cases of fetal death before and during childbirth are noted only in severe disease and inadequate treatment of asthmatic conditions. The mother’s illness can affect the baby’s health. In 5% of children, asthma develops in the first year of life, in 58% – in subsequent years. In newborns of the first year of life, diseases of the upper respiratory tract often occur. The postpartum period in 15% of puerperas with bronchial asthma is accompanied by an exacerbation of the underlying disease. Patients with bronchial asthma during full-term pregnancy usually give birth through the vaginal birth canal, since asthma attacks during childbirth are not difficult to prevent.Frequent attacks of suffocation and asthmatic conditions observed during pregnancy, ineffectiveness of the treatment is an indication for early delivery at 37-38 weeks of pregnancy.

Treatment of bronchial asthma during pregnancy

When treating bronchial asthma in pregnant women, it should be borne in mind that all drugs used for this purpose pass through the placenta and can harm the fetus, and since the fetus is often in a state of hypoxia (oxygen starvation), a minimum amount of drugs should be administered.If asthma does not worsen during pregnancy, there is no need for drug therapy. However, it should be borne in mind that severe and poorly treated asthma poses a much greater risk to the fetus than the drug therapy used to treat it. But in all cases, a pregnant woman suffering from bronchial asthma should use medications only as directed by a doctor. …

Prevention of pregnancy complications

It is necessary for the woman to eliminate the risk factors for the exacerbation of the disease.In this case, removal of the allergen is very important. This is achieved by damp cleaning of the room, excluding food from food that cause allergies (oranges, grapefruits, eggs, nuts, etc.), and nonspecific food irritants (pepper, mustard, spicy and salty foods). In some cases, the patient needs to change jobs if it is associated with chemicals that play the role of allergens (chemicals, antibiotics, etc.). Pregnant women with bronchial asthma should be registered with a therapist of the antenatal clinic.Each “cold” disease is an indication for antibiotic treatment, physiotherapy procedures, expectorants, for the prophylactic administration of drugs that dilate the bronchi, or to increase their dose. With an exacerbation of asthma at any stage of pregnancy, hospitalization is carried out, it is better to go to a therapeutic hospital, and in case of symptoms of a threat of termination of pregnancy and two weeks before the due date, to a maternity hospital to prepare for childbirth. Bronchial asthma, even its hormone-dependent form, is not a contraindication for pregnancy, since it is amenable to drug-hormonal therapy.Only with recurring asthmatic conditions can the question of abortion in the early stages of pregnancy or early delivery of a pregnant woman arise.

Pulmonologist Loiko Alla Vladimirovna

90,000 Pneumonia: Dangers, Symptoms, Prevention and Treatment – Biographies and References

TASS-Dossier. Pneumonia (or pneumonia) is an acute respiratory infection that causes damage to the lung tissue. Although the disease is ubiquitous, children and families in South Asia and Africa (south of the Sahara Desert) are most affected, according to the World Health Organization (WHO).

According to WHO statistics, this disease is the cause of death of 15% of children under 5 years of age worldwide (99% of deaths occur in poorly and moderately developed countries of the world).

World Pneumonia Day was established to raise awareness of this issue. It has been held on November 12 with the support of WHO, since 2009. On this day, health institutions organize preventive measures, conduct medical examinations, volunteers tell people about pneumonia, distribute information leaflets and booklets.

Symptoms

The manifestations of the disease largely depend on the causative agent and the extent of the lesion of the lung tissue. However, almost all types of pneumonia are characterized by common symptoms: weakness and fatigue, headache, chills, a sharp rise in temperature (in the acute form of the disease), cough (in the first days – dry, then becomes wet with abundant sputum with an admixture of blood), pain in the chest (on the side of the damaged lung), shortness of breath (the larger the focus of inflammation, the stronger it is), blue skin.

Course of the disease, complications

Pneumonia can occur in acute, subacute (protracted) or chronic forms, in severe cases, death is possible. Mixed viral-bacterial infection aggravates the course of the disease. Depending on the involvement of the lungs in the inflammatory process, unilateral (when one lung is affected) and bilateral (both lungs) pneumonia are distinguished.

The disease can lead to complications such as pleurisy, edema or lung abscess, acute cardiopulmonary failure, myocarditis, endocarditis, meningoencephalitis, meningitis, sepsis, infectious toxic shock, etc.

Exciters

Pneumonia can be caused by various microorganisms: mainly bacteria (pneumococci, Haemophilus influenzae, staphylococci, streptococci, etc.), viruses (influenza, respiratory syncytial virus, rhinoviruses, adenoviruses, etc.), rarely fungi and parasites (ascaris, others, strongyloids and .).

Recently, there has been a tendency to an increase in the number of atypical pneumonia caused by uncharacteristic (atypical) pathogens: for example, viruses and intracellular bacteria legionella, mycoplasma, chlamydia.

The pathogen most often enters the lungs by inhalation, and can also penetrate the blood or lymph from other foci of infection in the body. In addition, microbes can be carried into the lungs with food particles and vomit that accidentally enter the respiratory tract.

Risk group

The likelihood of pneumonia increases with hypothermia, respiratory diseases, stress, overwork.

The risk group includes small children (under 5 years old), the elderly (over 65 years old), people with a weakened immune system (for example, patients with diabetes mellitus, AIDS, cancer, etc.), with congenital defects of the bronchopulmonary system, with chronic diseases (heart disease, pyelonephritis, etc.), asthmatics, bedridden patients, as well as smokers and alcohol abusers.

Treatment

The main treatment for the disease is medication. Antibiotics are prescribed in the form of tablets, intramuscularly or intravenously (depending on the severity of the disease), antibacterial and antifungal drugs (if a bacterial or fungal infection is detected). If necessary, the patient is prescribed immunostimulants, mucolytic and expectorant drugs, vitamins.If necessary, oxygen inhalation may be prescribed. In most cases, with pneumonia, the patient must be admitted to a hospital – the department of therapy or pulmonology.

During the acute period of illness, it is recommended to stay in bed, consume warm drinks up to 1.5-2 liters per day (in the form of tea with lemon, fruit drinks, juices), exclude fatty foods and confectionery from the diet.

Prevention

There is no universal vaccination against pneumonia.However, there are vaccines that act against certain microorganisms: against pneumococcus, some types of streptococcus, measles and pertussis (in childhood), etc. Given that pneumonia often occurs as a complication after influenza, annual influenza vaccinations are indicated.

For prevention, you should lead a healthy lifestyle with adequate nutrition and rest, avoid stress.