From the Guidelines
There is no evidence supporting manually compressing or squeezing the chest as a treatment for asthma, and this technique is not recommended. The study by 1 discusses cardiac arrest in special situations, including asthma, and does not support the use of manual chest compression as a treatment for asthma. Instead, it focuses on standard ACLS guidelines and ventilation strategies to manage cardiac arrest in asthmatic patients.
Asthma should be managed with established treatments, including:
- Inhaled short-acting beta-agonists (e.g., albuterol) for quick relief
- Inhaled corticosteroids (e.g., fluticasone, budesonide) for long-term control
- Oral corticosteroids (e.g., prednisone) for severe exacerbations
- Proper inhaler technique and spacer use Manually compressing the chest could worsen breathing difficulties by restricting lung expansion and air movement, and may also cause physical injury. Asthma involves airway inflammation and constriction, which are best addressed through medication and proper breathing techniques, not external pressure.
If experiencing an asthma attack, focus on using prescribed inhalers, sitting upright, and practicing pursed-lip breathing. Seek immediate medical attention if symptoms worsen or don't improve with medication. The study by 1 highlights the importance of considering a possible diagnosis of tension pneumothorax in asthmatic patients with cardiac arrest, and treating it accordingly. However, this does not support the use of manual chest compression as a treatment for asthma.
From the Research
Manual Chest Compression in Asthma
There is evidence to suggest that manual chest compression, referring to squeezing the chest, may be a useful technique in the management of acute severe asthma.
- The technique of external chest compression to assist expiration has been used in asthmatic patients for some years, although it has not been widely described in the medical literature 2.
- A study published in 2010 demonstrated the importance of including external chest compression as a method of resuscitation in first aid for cases of life-threatening asphyxic asthma, with three patients successfully treated using this method 3.
- Another study published in 2001 discussed the history and technique of mechanical external chest compression (MECC) and illustrated its potential benefits with a case report, although the authors noted that no published trials of the technique exist 4.
Effectiveness of Manual Chest Compression
The effectiveness of manual chest compression in asthma is still a topic of debate, with some studies suggesting that it may be beneficial in certain situations.
- A study published in 1998 found that manual expiratory rib cage compression had limited effects on cardiorespiratory parameters in mechanically ventilated patients recovering from acute severe asthma, although the authors noted that the technique may still be useful in emergency situations where ventilation cannot be achieved by positive-pressure ventilation 5.
- In contrast, the 2010 study suggested that chest compression may be the only way to avoid death in patients with life-threatening asphyxic asthma, particularly when the chest wall does not deflate spontaneously and mouth-to-mouth resuscitation is ineffective 3.
Comparison with Other Techniques
Manual chest compression has been compared to other techniques, such as mechanical ventilation, in the management of acute severe asthma.
- A study published in 2015 discussed the use of mechanical ventilation in severe asthma, including the importance of avoiding ventilator-related complications and the potential benefits of noninvasive ventilation 6.
- In contrast, the 2001 study suggested that MECC may have its greatest impact when initiated in the prehospital setting for patients suffering from severe, sudden-onset, asphyxic asthma 4.