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Friday, June 24, 2011

Bronchial asthma no longer used

The term bronchial asthma is no longer used.  The reason is because most asthma cases are bronchial if you think about it.  In the past bronchial asthma was separated from cardiac asthma in that bronchial patients tend to suffer from shortness of breath mainly at night.  Likewise, bronchial patients tend to have trouble exhaling, while cardiac patient don't have trouble exhaling.

Cardiac asthma patients tend to get dypneic with exertion, and those with bronchial asthma only get dyspneic when they are exposed to their asthma triggers.  In this regard, if a patient becomes dyspneic just due to exertion every time exertion occurs, then this is not asthma at all, but cardiac asthma.

Yet even though it was over 200 years ago that the difference between cardiac asthma and bronchial asthma was defined, nurses and doctors still consider all that causes dyspnea as the same:  it's all asthma. And this is why they continue to think that RT needs to be called and a bronchodilator given.

Unlike bronchial asthma, cardiac asthma patients tend to suffer from breathlessness at night but do not develop the characteristic wheezing when exhaling. In fact, the prolonged exhalation associated with asthma is not a part of cardiac asthma. While most texts note that sometimes physicians have trouble differentiating the two, I'd say that 90% of the time physicians cannot differentiate between the two.

This is why most physicians order breathing treatments for any patient that is dyspneic.  I'd also have to add here that about 99% of nurses, most doctors and many RTs cannot differentiate between cardiac and bronchial asthma.  It is for this reason so many nurses call for a respiratory therapist every time a patient becomes dsypneic with exertion. 

When a patient gets better it's not so much the breathing treatment that helps, but the boost of oxygen and rest.  Many times the patient is fine by the time I enter the room. 

This is a common occurrence after nurses and aids help a patient to the pot.


1 comment:

Anonymous said...

But can't patients with bronchial asthma have exercise induced asthma?