The information contained in these pages is intended to give a brief outline of Asthma, how the disease is diagnosed, treatments available and how to look after yourself on a daily basis and during an exacerbation of your condition. The information is intended to be brief and relate to the management of your condition in Fife. Chest Heart & Stroke Scotland and My Lungs My Life websites have in-depth information covering all aspects of a patient’s Asthma journey.
What is Asthma?
Asthma is a condition that affects the airways - the tubes that provide passage for air in and out of the lungs.
When a person with asthma comes into contact with something that irritates their airways (an asthma trigger), the muscles around the walls of the airways can tighten so that airways become narrower and the lining of the airways becomes inflamed / starts to swell. Sometimes sticky mucus or phlegm builds up, which can further narrow the airways.
The combination of muscle tightening, airways lining swelling and new /increased mucus cause the airways to become narrower - making it difficult to breath and leading to symptoms of asthma.
Common / main symptoms include:
- shortness of breath
- tightness in the chest
- Not everyone will get all of these symptoms. Some people experience them from time to time; a few people may experience these symptoms all the time. Some people with asthma only have a cough.
How is Asthma Diagnosed?
The diagnosis of asthma can often be made on the clinical symptoms and can be associated with allergy, childhood wheeze, and a positive family history without any tests, often in the absence of a smoking history.
Tests may be required to support a clinical suspicion of asthma and include peak flow test, spirometry and exhaled nitric oxide test.
- Peak flow test – you blow into a handheld device that measures lung capacity, and this may be done several times over a few weeks to see if it changes over time.
- Spirometry – you blow into a machine that measures how much air you can hold in your lungs.
- FeNO test – you breathe into a machine that measures the level of nitric oxide in your breath, which is a sign of allergy in your lungs.
Asthma Action Plan
If you use an asthma action plan you are four times less likely to have an attack that requires emergency hospital treatment. Fill this in with your GP or asthma nurse. It will help you to know what medicines to take and when, how to recognise when your asthma symptoms change and what to do when this happens.
We have developed local personalised asthma action plans for children and adults, available to download here:
For general education visit Asthma and Lung UK
Education for Health: Supporting Children's Health is free resource for anyone working with children with asthma. Being aware of the condition and its triggers can help to ensure children with asthma in your care are safe and can get involved with the same activities as any other child without issue or harm.
Reports and priorities
National Review of Asthma Deaths - Commissioned by the Healthcare Quality Improvement Partnership, the National Review of Asthma Deaths (NRAD): Why Asthma Still Kills was published in May 2014. This confidential enquiry is the first national investigation of asthma deaths in the UK. The primary aim of the NRAD was to understand the circumstances surrounding asthma deaths in the UK in order to identify avoidable factors and make recommendations to improve care and reduce the number of deaths. The report highlights that asthma can be fatal even in patients with mild to moderate asthma.
A number of key findings and recommendations are outlined in the report. Fife Respiratory Managed Clinical Network (MCN) has begun developing local initiatives in line with the recommendations and there is a Fife Asthma multidisciplinary team meeting for more complex cases which reviews all modern therapy options for patients including biologics.
- The asthma control test looks at how well your asthma is being controlled. www.asthmacontroltest.com
- Using a written asthma action plan and attending your GP for a yearly check-up is vital. You could review some simple steps to take https://www.asthmaandlung.org.uk/conditions/asthma/asthma-attacks/avoiding
- If you are admitted to hospital or need to attend accident and emergency with your asthma, it is recommended you have a health appointment within 48 hours of being discharged home, as the evidence shows you are more likely to have an asthma attack in the near future. You should have your medicines reviewed, your asthma action plan updated, and your inhaler technique checked.
- Make sure you take your medicines as advised by your GP or asthma nurse. Remind yourself how to take your inhalers on https://www.asthma.org.uk/advice/inhaler-videos/
- If you are using your reliever inhaler more than 3 times per week, make an appointment to see your doctor or asthma nurse as this may be a sign your asthma is not as well controlled as it could be.
- Avoid your asthma triggers such as pets or pollen. General advice can be found on https://www.asthma.org.uk/advice/triggers/
- Think about adopting a healthier lifestyle; smoking can trigger asthma and reduce the effectiveness of your asthma therapy. Being overweight can affect your asthma. https://www.chss.org.uk/living-well/