1) Patient still breathing and inhalers no longer providing any relief
Place your hands on the side of the chest over the lowest ribs with the thumbs
towards the mid line and force the ribs inwards at the end of their inspiration
(breath in) helping the patient to breathe out. This should be a short sharp
movement initially as breathing will be rapid. You should remember that the
ribs have been forced higher and higher and you are trying to get them back
to their normal resting position. This can only be achieved over the next few
breaths (timing your compressions to coincide with the patient’s breathing
out.) As soon as it is achieved the patient will be able to take a full inspiration
with great relief.
2) Patient stopped breathing and unconscious
There can be a problem with using mouth to mouth resuscitation in these patients
as the lungs are already overdistended so trying to force more air in just won’t
work until the lungs have been emptied.
Roll the patient to face down on the floor with the head turned to one side.
Kneel at the patient’s side, place your hands over the lower ribs with
your thumbs pointing towards the mid line and lean forwards so that the weight
of your body compresses the lower chest against the floor and if possible at
the same time push the lower ribs inwards. Because the ribs are fully raised
there is a rush of air from the chest. Release the pressure to enable the elasticity
in the rib cage to take air into the lungs and repeat until the patient starts
to breath normally. This is Schafer’s method of artificial respiration.
The advantage of the prone position is that the abdomen and therefore the diaphragm
is supported by the floor when pressure is applied. If there is no response
after 5 satisfactory compressions roll the patient back and follow usual
methods of resuscitation.
This simple safe procedure described above can be performed by anyone without any training and should be widely known and discussed by relatives and friends of all asthmatics because death can occur in Asphyxic Asthma before medical help let alone getting to a hospital is possible.
Chest compression can also relieve the panic of not being able to breathe in
children or adults with severe asthma.
In less severe asthma the patient can even easily perform the compression themselves
with the thumbs behind and the fingers spread over the lower ribs
Any one wishing to learn more about this method and its background should see other pages on this site and http://pdm.medicine.wisc.edu/Fischer.pdf