Asthma

Asthma is a disorder of the airways in the lungs. Most people with asthma have little trouble breathing from day to day. Once in a while, however, asthma will flare up, causing a person to cough, wheeze, and feel short of breath. The airways are responsible for these symptoms.

Muscle in the airway wall squeezes the airway narrower.

The wall of the airway swells, further narrowing the air passage.

The inside lining of the airway produces mucus, which can further block the air passage.

Medication can prevent or reverse an asthma attack, but severe, untreated attacks can be fatal.

The panel on the left is a cross-section through a normal, widely open airway. The changes in the next 3 panels could occur over seconds, minutes, or hours. They show the airway narrowing and the airway wall swelling. Air would be most difficult to move through the airway in the far right panel.
What environmental factors are involved in asthma?
Not surprisingly, many of the environmental factors in asthma relate to air: tobacco smoke, pollution, chemical fumes in certain jobs, and tiny creatures called "dust mites" that cling to dust particles. As Jeff noticed in Colorado, even the temperature and humidity of the air can be a factor.

Other environmental contributors to asthma are not associated with air, for example:

The amount of salt in the diet (more salt, more asthma). Lung infections (can trigger asthma in susceptible people). A dog in the home (makes asthma less likely for non-rural children in later life). Brothers and sisters at home (younger children in a family are less likely to get asthma, and having an older brother is an especially effective prevention).

HEART FAILURE

When the heart is unable to perform its proper function, blood and fluid collects around the lungs and in the body. This condition is called HEART FAILURE. It is typified by the casualty finding it difficult to breathe, and swelling of the ankles and legs as fluid pools in the extremities.

SIGNS AND SYMPTOMS

Pale, cold, clammy skin
Chest discomfort, difficulty breathing
'Bubbly', gasping breaths
Frothy sputum
Swelling of the extremities, especially the ankles, which may show `dimples'
Partial collapse

CARE AND TREATMENT

Call 911 for an ambulance
Position of comfort, usually sitting supported
Oxygen via nonrebreather mask @ 10 liters per min
Do not elevate legs
Reassurance

CARDIAC ARREST

When the heart ceases to function, then the casualty is said to be in CARDIAC ARREST. Whether the heart is at a complete standstill, or Whether it is vibrating rapidly in a chaotic rhythm, it is no longer doing its task. The condition may be due to heart attack, heart failure, electrocution, Drowning, trauma or other medical condition - first aid treatment is the same, CPR!

SIGNS AND SYMPTOMS

Unconsciousness
No pulse
Usually no respirations, though there may be brief irregular, `gasping' breaths

CARE AND TREATMENT

Immediate CPR
Call 911for an ambulance

Congestive Heart Failure

Congestive heart failure (CHF) is a condition in which the heart can't pump
blood effectively to the body's tissues and other organs, usually because
the person has narrowed or hardened coronary arteries (the vessels that
supply blood to the heart muscle), has previously suffered a heart attack,
or has high blood pressure.

In (CHF) the weakened heart pumps less blood than usual -- too little to
push enough circulated blood back into the heart to repeat the journey. So
blood stalls, or congests, in the body's tissues. This makes it even harder
for the heart to push blood through the arteries on the next beat.

With congestion, legs and ankles swell. Fluid collects in the lungs and
interferes with the ability to breathe, especially when lying down. Also, the
kidneys have trouble disposing of sodium and water. The body retains
water, increasing congestion and swelling. Left untreated, congestion
worsens and may prevent the heart from pumping enough blood to keep
the person alive.

Doctors divide CHF cases into four levels of increasing severity:

Class I: Physical activity unaffected, and the patient has no
unusual fatigue, shortness of breath, palpitations, or pain during
normal activities.
Class II: The patient may experience mild fatigue, shortness of
breath, palpitations or pain during normal activities and slight
limitations on normal activities.
Class III: The patient experiences fatigue, shortness of breath,
palpitations or pain during normal activities; activities are
dramatically limited.
Class IV: The patient is uncomfortable even at rest. Discomfort
increases with activity.

In some cases, medications and lifestyle changes enable patients to live
nearly normal lives. Your outlook depends on how well your heart is
functioning, your symptoms, and how well you respond to your treatment
plan.

About 4.5 million Americans have CHF, which contributes to about
260,000 deaths each year. Ten percent of patients with mild CHF and
more than 50% of patients with more severe CHF die annually. CHF is a
growing public health concern worldwide. It is the single most frequent
cause of hospitalization for Americans aged 65 and older.

Symptoms
Sometimes, people with CHF do not have any symptoms. The most
common symptoms of CHF are:

Shortness of breath with exercise or difficulty breathing at rest or
when lying flat
Swollen legs, ankles, or abdomen
Dry, hacking cough or wheezing

Other symptoms include:

Fatigue, palpitations, or pain during normal activities
Weight gain from fluid retention
Increased need to urinate during the night
Dizziness or confusion
Rapid or irregular heartbeats