Being around someone experiencing an Asthma attack?

Martin - Yes.

Presenter - It's quite frightening actually isn't if you don't really know?

Martin - Yes, yes I mean what a good question that is because it's such a common problem. Asthma UK tell us actually that half a million people suffer from some sort of asthma attack every day which is quite an amazing statistic really isn't it? Having said that it's probably worth just saying what an attack is because.

Presenter - Yeah how serious that is I suppose the range is huge.

Martin - It's huge and I actually try and avoid using even in my medical notes using the word asthma attack 'cos that makes it sound like you know being set upon or something and you're about to collapse. But probably what they mean by attack or what he means by and attack is that he's having to consciously having to do something about it that day. And I suppose and asthma attack can be anything from noticing that you're having to use your reliever inhaler more often and that perhaps your exercise it a bit limited that would be a relatively mild asthma attack, but a severe asthma attack would be one where really you're having to concentrate all the time on breathing that your really can't do anything other than sit in a chair. You know a severe asthmatic can't get to the end of a sentence for instance.

Presenter - Mmm and how does that feel? Does your chest tight? I mean have you ever had and attack like that?

Martin - I haven't luckily but I imagine that it must be a very-very worrying thing.

Presenter - Really terrified.

Martin - Because you're absolutely right it's, you know patients describe it a very sort of restricting tightness across their chest here sort of feeling, which is restricting their breathing and actually when you are examining or if you think about their breathing what they will be finding is actually trouble breathing out strangely which makes it different from other conditions like croup where the problem is with breathing in.

Presenter - Mmm.

Martin - But without getting too technical this person who's having quite a severe attack won't be able to get to the end of a sentence without having to take another breathe, their whole body will be concentrating on breathing and they might be using other muscles to help breathe. So you may have see people so are literally sitting like that breathing like this and what they're doing is using what they call the accessory muscles of breathing in that they're actually using their pectoral muscles and their arms muscles to help them breathe.

Presenter - Too move their lungs, move their ribs, move their lungs.

Martin - Now this, yeah, so this person is in trouble and to answer that very good question if you have somebody who is struggling like that to breath, not being able to get to the end of the sentence, and not being able to sort of run around really they're concentrating all the time on breathing, the first thing to do is if they do have their inhaler, their reliever inhaler to give them tow or three puffs you will never do any harm by doing that.

Presenter - Right.

Martin - So that's the first thing to do but I think the question was if they don't have their reliever with them. Really the advice would be to try and keep them calm because as you can imagine somebody in that situation is panicking.

Presenter - Yeah and the more you panic I should imagine the worse it gets.

Martin - The worse it gets, very hard not to panic isn't it?

Presenter - Yeah.

Martin - But just to keep them calm and really the next step would be to call an ambulance because that will be probably one of the most important calls to the ambulance service that day. Don't think that you're wasting the ambulance people's time you know.

Presenter - Right that's a good tip actually isn't it?

Martin - Yeah absolutely don't this is an important call to make because what sometimes can happen with asthmatics is that for a while they can cope with this situation where they're you know gasping to breathe and then after a while very understandably they get tired and at that point things can go you know quite badly wrong.

Presenter - Quite downhill quite rapidly. So will it pass though that asthma attack without medication?

Martin - In that sort of situation the right answer to that question is no. Don't assume that it's going to pass.

Presenter - Oh that's scary.

Martin - This person who's suffering a bad one definitely needs help you know they definitely need to be have medical attention quickly either an urgent, a very urgent appointment with their Doctor within you know half and hour or so, or they need to be in Casualty basically. A milder attack like we were talking about before where it's a bit inconvenient, the person is having to use their inhaler a bit more often that possible will pass, you know if the person just takes it a bit easy uses their reliever a bit more often, doesn't exercise probably it would eventually pass. But this person needs to keep a very careful eye on how often they are using their inhaler because if they're having to use it frequently during that day there should be ringing a little alarm bell in their head something is not right.

Presenter - Right.

Martin - Possibly I need to be thinking of ringing Doctor, ringing NHS Direct somebody like that. So the answer to that question depends a little bit on how bad this attack is

Presenter - Right. Yeah.

Martin - But to be taking

Presenter - If in doubt ring 999.

Martin - Yeah to be taken you know to be taken fairly seriously if that's happening.

Presenter - And if you're out and about I don't know if you're in the countryside or somewhere you've not got your inhaler with you and you're nowhere near a Doctor what would you do? It's quite scary isn't it?

Martin - Yes, I think probably the answer to that is again to try and keep calm. Try and sort of walk slowly somewhere you know the last thing we want is you running and making it worse or trying to run and making it worse. And really try and go to the nearest person, go to the nearest house, go to the nearest person.

Presenter - Right.

Martin - Say look I'm an asthmatic I'm suffering a little bit and really summon help.

Presenter - Yeah.

Martin - 'Cos in that situation there isn't really anything that you personally can do to make this asthma attack pass. The best thing you can do is keep calm and then summon help in the best way that you can. You know this is not likely to pass on it own in other words.

Presenter - Now I've read, or heard about if you have panic attack and you're having problems breathing that you can breathe in and out of a paper bag

Martin - Yes.

Presenter - Would that work with an asthmatic?

Martin - Yes well I'm glad you've asked that question because for panic attacks where somebody's hyperventilating, where they're sort of breathing in and out you know all anxious and so on, this person with the hyperventilation actually has got nothing wrong with their lungs

Presenter - Right.

Martin - and breathing in and out of a paper bag for this person probably would be quite helpful. For an asthmatic this is not the right thing to do.

Presenter - Right.

Martin - Okay because what you're basically doing is you're re-breathing your already used air and for an asthmatic they need all the oxygen they can get and re-breathed air will have some oxygen removed from the previous breath.

Presenter - Right.

Martin - So I guess the answer to that is if you are in doubt as to whether somebody is hyperventilating or having an asthma attack the safe option is to assume that they've got an asthma attack and summon help. If you absolutely know that this person is not asthmatic and is suffering from a panic attack fine get out the paper bag get them to breath you know keep them calm etcetera.

Presenter - But you don't want to make an already bad situation worse do you?

Martin - Absolutely right if in doubt not the paper bag, if you think it might be asthma not the paper bag basically.

Presenter - Right. Okay. Right. Well Charlie from London has written in and he wants to know if it's okay to get drunk if you have asthma?"