From the Guidelines
There is no evidence supporting manual chest compression, or squeezing the chest, as a treatment for asthma, and this technique is not recommended. The American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, as described in the 2010 study 1, do not support the use of manual chest compression in asthma management. Instead, the guidelines recommend standard ACLS techniques and consider the possible diagnosis of a tension pneumothorax in asthmatic patients with cardiac arrest.
The standard treatments for asthma exacerbations include:
- Inhaled short-acting beta-2 agonists (e.g., albuterol) via nebulizer or metered-dose inhaler with spacer
- Systemic corticosteroids (e.g., prednisone 40-60 mg orally daily for 5-7 days)
- Oxygen therapy if needed
- In severe cases, intravenous magnesium sulfate or mechanical ventilation may be required Manually compressing the chest could worsen respiratory distress by interfering with the patient's ability to breathe and potentially causing injury to the chest wall or internal organs. Asthma involves inflammation and constriction of the airways, which requires medication to relax the smooth muscles and reduce inflammation, as noted in the study 1. Physical manipulation of the chest does not address these underlying mechanisms and is not part of any recognized asthma management protocol.
In the context of cardiac arrest in patients with acute asthma, the study 1 suggests a ventilation strategy of low respiratory rate and tidal volume, and considers the brief disconnection from the bag mask or ventilator to relieve air-trapping. However, this does not involve manual chest compression as a treatment for asthma. If you encounter someone having an asthma attack, focus on helping them use their prescribed inhaler, keeping them calm, and seeking emergency medical attention if symptoms are severe or not improving with treatment.
From the Research
Manual Chest Compression in Asthma
There is limited evidence for manual chest compression in asthma, referring to squeezing the chest. The available studies discuss the technique of external chest compression, but its effectiveness and role in asthma management are not well established.
- The study by 2 discusses the history and technique of mechanical external chest compression (MECC) and presents a case report, but notes that no published trials of the technique exist.
- A preliminary study by 3 describes a method for assisted expiration using external chest compression and its potential value in the emergency treatment of asthma, but acknowledges that the technique requires further evaluation.
- Other studies, such as 4, 5, and 6, focus on the management of acute asthma, including treatment options and guidelines, but do not mention manual chest compression as a recommended technique.
Key Findings
- External chest compression has been used in asthmatic patients to assist expiration, but its effectiveness is not well established 2, 3.
- The technique of external chest compression requires further evaluation to determine its role in the resuscitation of asthmatics 3.
- Current guidelines for asthma management focus on other treatment options, such as oxygen supplementation, inhaled bronchodilators, and systemic glucocorticosteroids 4, 5, 6.