Présentation rapide de l'Asthme

L'éducation de l'asthmatique

Présentation rapide de l'Asthme

L'asthme est une pathologie à caractère familiale qui touche 4 à 5 /100 de la population

On la définie comme suit : Syndrome clinique caractérisé par des accès de dyspnée intermittentes, sibilantes à prédominance nocturne, associé à un syndrome fonctionnel caractérisé par une hyperréactivité bronchique.

Sur le plan clinique , on distingue :

  • la crise simple qui apparaît le plus souvent la nuit et brutalement. Chez le sujet apparaît alors une dyspnée avec ralentissement expiratoire. Les signes d'apparition sont la toux et les sifflements. La crise passe après inhalation de Béta-2-mimétiques ( broncodilatateurs )

  • Asthme à dyspnée continue avec un sujet en permanence essoufflé.

  • Attaque d'asthme qui se définit comme une succession de crises souvent causées par une infection ORL. Le patient peut alors passer à l'état de mal Asthmatique ( Asthme aigu grave: AAG )qui est la forme grave de l'asthme et qui nécessite hospitalisation

2- Hygiène de vie

Les conseils portant sur l'hygiène de vie sont applicables à tous les asthmatiques d'une façon générale. C'est le cas du tabac par exemple. Les autres seront fonction du bilan médical; un sujet âgé non allergique ne devra pas entreprendre une lutte contre les acariens ,un adolescent allergique, par contre, devra être informé de la manière la plus précise possible

A éviter

A conseiller

AIR

sec, chaud, poussiéreux, pollution atmosphériqueAérer au maximum les pièces, température entre 18° et 20°, humidifier les pièces.

Acariens

Balayage, moquette, tapis, coussins, matelas et oreillers de laine ou plumes, fauteuils en tissu, peluches-Passer l'aspirateur régulièrement

- Opter pour carrelage, revêtements lavables sans tissu.

- Ensoleillement des pièces

- Nettoyer les surfaces avec un chiffon humide

-Envelopper matelas et oreillers dans des housses spéciales anti-acariens.

 

Moisissures

 Ensoleillement, aération, entretien régulier des endroits sombres et humides

Animaux

Animaux à poils et à plumesSi animaux, les faire vivre à l'extérieure, les laver régulièrement avec shampooing spécial.

Produits domestiques

Produits délivrés en aérosols : vernis, cires, décapants pour four, insecticides, solvants, peintures, cosmétiques, parfums.Produits non agressifs et non irritants.

Tabac

Le tabagisme personnel ou passifProscription à domicile, respect de la réglementation dans les locaux publics.

Activité/profession

Éviter les métiers ou l'empoussiérrage est important ou ceux qui imposent de manipuler des produits irritantsSi existence d'une maladie professionnelle reconnue, des mesures de protection pourront être appliquées, ou une possibilité de reclassement professionnel sera envisagée. Il est important de sensibiliser les enfants allergiques ou à risques à ce type de difficultés afin de pouvoir les oriente différemment.

Sport

Équitation, effort violent sans entraînement, plongée en apnée et avec bouteille ( interdit)Tous les autres sports, particulièrement la natation, entraînement progressif à l'effort, possibilité de prendre un médicament préventif ( broncodilatateurs ) selon prescription médicale.

Loisirs

Éviter de se promener au moment de la floraisonPréférer la montagne en moyenne altitude. Avoir avec soi un calendrier pollinique. Ne pas oublier sa trousse de médicaments en voyageet le débitmètre de pointe.

Allergies médicaments.

Certains peuvent déclencher une crise :

- Aspirine

- Anti-inflammatoire non stéroidiens.

- certains antibiotiques
( péni...)......

Il est important de connaître la liste des dérivés de ces produits contenus dans l'alimentation, dans certain produits de beauté et dans d'autres médicaments.

 

Il est bien évident que ces conseils d'hygiène de vie doivent s'associer à un traitement adapté, mais aussi, à une connaissance des facteurs favorisant la survenue d'une crise :

  • infections ORL

  • reflux gastro-oesophagien

  • dérèglement hormonaux

  • facteurs psychologiques

Bien que difficile, l'éducation et la prévention améliorent la qualité de vie du sujet asthmatique et doivent lui permettre de mener une vie normal sur le plan personnel et professionnel. Elle nécessite une prise en charge du patient dans sa globalité tout en travaillant en étroite collaboration avec les professionnels de santé, les écoles, l'environnement familial et professionnel



3- Fiches Techniques

Utilisation des sprays

Utilisation de la chambre d'inhalation

Utilisation du débitmètre de pointe

1 Agiter le spray doseur

2 Enlever le capuchon protecteur du spray

3 Expirer à fond

4 Mettre l'embout dans la bouche en serrant les lèvres autour, le fond de la cartouche doit être vers le haut

5 Appuyer une seule fois sur la cartouche en inspirant lentement et profondément par la bouche

6 Bloquer 10 secondes la respiration puis expirer lentement

7 Recommencer en fonction du nombre de bouffées prescrites

8 Faire toujours les broncodilatateurs ( ex: ventoline ) avant les corticoides ( ex: bécotide )

9 Se rincer la bouche après la prise des corticoides.

Si mauvaise utilisation : prendre chambre inhalation

 

 

1 Monter la chambre d'inhalation si besoin

2 Agiter le spray

3 Enlever le capuchon protecteur du spray

4 Emboîter le spray à la chambre d'inhalation, le fond de la cartouche doit être vers le haut

5 Ne pas mélanger les produits. Déclencher 1 bouffée du produit prescrit

6 Inspirer et expirer normalement dans la chambre d'inhalation au moins 4 à 5 fois ( on doit entendre l'ouverture et la fermeture de la valve )

7 Renouveler l'opération pour chaque bouffée

8 Faire toujours les broncodilatateurs avant les corticoides

9 Se rincer la bouche après la prise des corticoides

10 Ne pas oublier de nettoyer régulièrement la chambre

Objectif pédagogique :

Le patient doit maîtriser l'utilisation d'un débitmètre de pointe et savoir interpréter les résultats

Matériel :

Débitmètre de pointe, embout cartonné blanc à usage unique pendant la durée d'hospitalisation

Technique

- Se mettre debout si possible sinon position assise ( les différentes mesures doivent toujours se fairent dans la même position )

- Fixer l'embout buccal sur le débitmètre de pointe

- Placer le curseur sur le zéro de l'échelle graduée

- Tenir le débitmètre de pointe entre les doigts en laissant libre le trajet du curseur

- Inspirer à fond et bloquer la respiration

- Porter l'appareil à la bouche horizontalement

- Souffler par la bouche le plus fort et le plus vite possible en maintenant bien les lèvres serrées autour de l'embout sans gonfler les joues

- Il est recommandé de réaliser 3 fois successivement et de noter que la meilleur mesure

4 votes. Moyenne 4.00 sur 5.

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