The asthma crisis is also classified as follows:
- The intermittent asthma, which is arbitrarily defined as the occurrence to a maximum of two brief seizures per week and / or two nightly episodes per month, and PEF greater than 80%.
- The persistent asthma is defined when there are more than two episodes per week and / or more than two nocturnal episodes per month, with impact on daily activities. It can be mild, moderate or severe.
- The severe asthma that involves life-threatening. It requires urgent treatment in hospital (for example, in France about 2 000 people a year die from asthma, or 3.2 cases per 100 000 population) Clinically, there is at least one of the following signs:
- unusual feeling of crisis;
- difficulty speaking (spoke a word at a time)
- increased heart rate (tachycardia CF> 120/min)
- disorders of consciousness (confusion, coma)
- "Auscultatory silence" (absence of breath sounds on auscultation);
- a decrease of PEF (peak expiratory flow or Peak Flow) halved compared with the best score of the patient, or its theoretical value, the DEP is the only objective way to evaluate the intensity of asthma
- resistance to treatment of the crisis (bronchodilator fast action);
- a respiratory rate 25/mn adults, 30/mn in children over 5 years 50/mn among children 2 to 5 years, even with low breathing pauses in breathing
- a hypotension
It is advisable to separate the''asthma infants, defined by the appearance of at least three episodes of wheezing before the age of three. Asthma in infants disappears usually before age five.
Recent Expansion of asthma
There has been a rapid expansion of disease for 40 years in developed countries It occurs mainly in countries with heavy industrialization, and industrialization in developing fast, there is such little known in sub-Saharan Africa. In 1999 researchers at the International Study of Asthma and Allergies in Childhood has quantified some data on asthma by measuring the percentage of asthma and allergies among 13-14 years in different countries:
- Sweden and Finland between 10% and 20%;
- Albania, Romania, Russia, Georgia and Uzbekistan:
- United Kingdom:> 30% (asthma is the second leading cause of death)
- Examinations of lung function or spirometry;
- Test reactivity to a bronchodilator (expiratory flow before and after salbutamol);
- Bronchial provocation test.
- Measurement of exhaled NO (diagnostic aid but also evaluating the effectiveness of treatment)