The Safety Net



Consumer Respiratory Conditions

Overview

The respiratory system serves the human body’s need for breathing. Breathing is the process by which oxygen in the air is brought into the lungs and into close contact with the blood, which absorbs it and carries it to all parts of the body. Waste matter (carbon dioxide) from the blood is carried out of the lungs when we breathe out. Some people, including many people with developmental disabilities, develop conditions that compromise the healthy functioning of this system. This article provides information on some of the respiratory conditions that can complicate the lives of consumers and the staff who provide services and supports.

Asthma

Asthma is a condition in which the airways are narrowed due to a sensitivity to inflammatory 'triggers'. These may include pollen, pet dander, tobacco smoke, and air pollution, as well as respiratory infections such as colds and flu. The severity and frequency of asthma episodes (attacks) can vary greatly; some people experience mild symptoms occasionally whereas others have significant distress on a regular basis.

Common symptoms of asthma include, but are not limited to, the following:

  • wheezing (a whistling or hissing sound when you breathe out);
  • shortness of breath;
  • tightness in the chest; and
  • a cough that lasts for more than a week.

An asthma attack can cause severe shortness of breath. You may notice the person becoming anxious and sweating. The person may lean forward, using neck and chest muscles to help breathe. In a serious episode, a consumer who is verbal would not be able to say more than a few words at a time before stopping for a breath. A person who vocalizes instead of speaking may also be limited in their production of sounds. If the person’s oxygen supply becomes very limited, he or she can become drowsy and confused, and skin color can look blue. When this happens, you must seek emergency help.

Health care treatment for asthma allows most people to lead normal lives. Medications (including those administered with inhalers) and strategies for limiting exposure to known triggers can help to prevent episodes and manage those that do occur.

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is the persistent obstruction of the airways caused by emphysema and/or chronic bronchitis. Emphysema results from a breakdown of the walls of the tiny lung air sacs (alveoli) which then causes over-inflation and decrease in lung function. Chronic bronchitis is inflammation and scarring of the lining of the bronchial tubes. These two conditions are frequently found together causing the obstruction of air flow through the lungs. This develops gradually over many years.

Between 80% and 90% of cases of COPD are caused by smoking. The most important way to prevent COPD is to avoid smoking. Never starting to smoke or quitting are critical to prevention. Physicians can assist people with COPD to live more comfortably with this condition for many years. Short of lung transplants, however, there currently is no cure.

Pneumonia

Pneumonia is a serious infection or inflammation of one or both lungs. Most cases of pneumonia are caused by viruses or bacteria. In pneumonia, the air sacs in the lung fill with fluid making it difficult for oxygen to reach the bloodstream. Pneumonia typically starts when a person inhales air particles that are infected and can develop when someone has a cold or flu. Viral pneumonia symptoms develop gradually and are frequently less obvious and severe than symptoms of bacterial pneumonia. Viral pneumonia may go unnoticed due to the limited degree of symptoms. Bacterial pneumonia symptoms usually come on suddenly and include the following:

  • productive cough, with discolored mucus (sputum);
  • fever with chills;
  • rapid shallow breathing and/or shortness of breath;
  • chest pain, often worse when coughing or inhaling;
  • rapid heart beat; and
  • fatigue or weakness.

People who are at risk for serious complications of bacterial pneumonia can reduce their chances of infection by receiving the pneumococcal vaccine (Pneumovax). The pneumococcal vaccine provides protection against almost all types of bacteria that cause pneumococcal infections. It is not effective in preventing other types of pneumonia. As with flu vaccines, the pneumococcal vaccine cannot give you pneumonia. Individuals’physicians can provide guidance regarding the appropriateness and frequency of this type of vaccination.

Aspiration Pneumonia

Pneumonia can develop when a person aspirates (inhales) food, vomit, or mucus into the lungs. This is referred to as Aspiration Pneumonia. Many individuals with developmental disabilities are considered at high risk for aspiration and aspiration pneumonia. This risk increases when the person aspirates frequently, the aspirated matter is large, acidic (such as stomach contents), or infected (such as matter from periodontal disease). Risk factors for aspiration pneumonia include the following:

  • history of recurrent pneumonia or other respiratory infections;
  • dysphagia (difficulties with swallowing)
  • GERD (gastro-esophageal reflux disease)
  • enteral (tube) feeding
  • scoliosis
  • spasticity
  • seizure activity
  • inability to feed oneself

Service providers should share their observations with health care personnel involved in the personís services and supports and be alert to the following symptoms:

  • coughing
  • wheezing
  • intermittent fevers (typically low grade)
  • weight loss
  • dehydration
  • rumination

Influenza

Influenza, the flu, is caused by a virus that infects the respiratory system. It is spread when an infected person coughs, sneezes, and talks, sending the virus into the air where others can inhale it. People may also become infected by touching surfaces such as doorknobs or telephones, where the virus is present and then by touching their nose or mouth. The flu is highly contagious. To help prevent the spread of the virus, people should use sanitary practices including consistent hand washing and keeping their hands away from their nose and mouth.

The Centers for Disease Control and Prevention (CDC) estimates that 10% to 20% of U.S. residents will get the flu each year. The CDC also estimates that 114,000 people will be hospitalized and 36,000 will die as a result of influenza. According to the National Center for Health Statistics, approximately 192 million days will be spent in bed due to people having the flu. Most people recover from the flu within a week or two. Some people who become ill with the flu are at greater risk for developing pneumonia and other serious complications.

This year the CDC is recommending that everyone (with the few exceptions noted below) receive a flu vaccine. It has been reported nationally that the virus expected to hit the U.S. this season is very potent. There is plenty of vaccine to go around and people are urged to take advantage of it. The following people, however, SHOULD NOT receive flu shots:

  • persons who have a severe allergy to eggs;
  • persons who have had a severe reaction to a flu shot in the past; and
  • persons who have developed Guillain-Barre' Syndrome during the 6-week period following a flu shot.

One myth about influenza is that flu shots cause the virus. This is not true. The flu vaccine used in the United States is made from inactivated (killed) flu viruses. This vaccine cannot cause the flu. There is also a new form of the vaccine available that is administered in a nasal spray. Physicians’recommendations should be followed regarding the most appropriate means of protection against the flu virus.

There are a variety of things that can alleviate flu symptoms. Resting and drinking plenty of fluids are both very helpful. Avoiding alcohol and tobacco is also recommended. Some over-the-counter medications may be used to lessen the symptoms, as long as physicians approve their use. Children and teenagers should not take aspirin due to possibly developing Reye Syndrome, a rare but serious illness.

Resources

The following websites contain a wealth of information for anyone interested in conditions that impact respiratory health.


American Lung Association
www.lungusa.org

Centers for Disease Control and Prevention
www.cdc.gov

NIH/National Heart, Lung and Blood Institute Information Center
[email protected]

University of New Mexico Continuum of Care
www.unmcoc.org

 

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