How to obtain disability for bronchial asthma as an adult. What is needed for registration

Bronchial asthma is a very serious disease that can lead to disability. Children, unfortunately, also have to deal with the severe course of this disease.

When can bronchial asthma cause disability in children?

The severity of most diseases of the lungs and bronchi is determined based on the presence or absence of respiratory failure. It is this factor that is most often decisive for medical experts when determining the severity of the disease for granting disability to a child or adult.

Currently, there are 4 degrees of respiratory failure:

The absence of respiratory failure, as well as mild shortness of breath, is not an indication for disability.

As for indicators DN2 and DN3, their presence in asthma most often indicates that the child actually has limitations in his life.

In addition to this determining factor, there are several additional ones that also influence the expert decision when establishing a disability group.

The main ones among them are the following:

  1. Frequency of bronchial asthma attacks.
  2. Severity of attacks.
  3. Level of control over the course of the disease.

Each of these factors is assessed not from the words of patients, but on the basis of established and officially documented facts.

If attacks of suffocation bother a small patient no more than several times a week, then the child is unlikely to be recognized as disabled. This indicator will be significant only if he has to use an inhaler almost every day to improve bronchial patency.

Mild shortness of breath, which can be relieved by using conventional basic medications, is not a sign of disability. This indicator leads to limitation of life activity, if an ambulance has to be called to stop the attack medical care. In this case, not only the number of calls is assessed, but also their quality.

If doctors manage to relieve a child’s attack with regular inhalers, then this is also not a sign of disability. A fact indicating possible availability disability is the use medical workers hormonal drugs or Eufillina for.

To confirm the severity of the disease, along with the documents sent to the medical expert commission, the attending physician must include the results of spirography with a special sample. Within the framework of such a study, it is possible to clarify how well the simple ones used in Everyday life asthma, medications.

The next factor influencing the commission’s decision can be considered the level of control over the course of the disease. This indicator has many similarities with the previous two.

It indicates how long the patient is not bothered by attacks of bronchial asthma. With a controlled and partially controlled course of this disease, the disability group in most cases is not established.

Entitled benefits and procedure for obtaining disability

Many parents are interested in whether any benefits are given to minor patients with bronchial asthma. If there are limitations in life activity caused by this disease, the patient may be provided with the following benefits:

In the case where a child with bronchial asthma has serious limitations in his or her ability to live, the attending physician must independently invite his parents to collect documents for a medical expert commission. In this case you will have to perform the following steps:


Based on all documentation, including extracts from the hospital, emergency medical care call records, and advisory opinions, specialists from the medical expert commission will determine whether or not to assign a disability group to the patient. In addition to deciding whether there are indications for disability, this commission provides recommendations for the child’s further education (at school or at home).

Once a disability is established, the child will have to periodically undergo re-examination by a medical expert commission. At the age of 14-15, he needs to visit specialists to further determine a safe work orientation for him.

This will allow the minor to clarify what work he will be suitable for in the future. Upon reaching 18 years of age, such a patient is again sent to a medical expert commission. If a patient is determined to be incapacitated, he is issued an appropriate certificate. Disabled people without significant disabilities expert commission recommends doing certain types works At the same time, the length of the working day is often limited.

Thus, you can claim the following benefits:

  • Get free medicines
  • Housing benefits
  • Opportunity to go to a sanatorium for treatment and rest
  • Preferential travel for disabled children and their parents

Free medicines are provided in mandatory everyone who is registered with this disease. Asthma disability groups There are three categories:

  • Mild degree, when attacks occur two to three times a year and can end on their own without requiring additional treatment medications
  • Moderate, attacks occur more than three times a year and cough relief is necessary
  • Severe, frequent shortness of breath, inability to breathe, constant need for medications and supportive medications

At the first symptoms of suffocation and poor health, you must go to the clinic and register.

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After receiving all documents from the clinic, those wishing to apply for benefits should register at their place of residence with the Bureau of Medical social expertise. You will be given a day to come for a medical examination.
You should take the documents listed above with you. The commission's experts will analyze your medical history and ask about your well-being during bronchial asthma, characteristics of work and life.

Important

According to the results of the ITU, the patient will be assigned a group or denied it. You can challenge the results of the examination at the Main Regional Bureau.

If it is not possible to obtain benefits there, they go to court. Features For mild and moderate bronchial asthma in children, disability is not prescribed.

IN early age there is a high probability that the disease will go away on its own. Therefore, benefits are prescribed if the disease is severe.

Is there any disability for bronchial asthma? how to get disability?

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Breathing problems occur even with little physical activity.

  • Heart problems arise.
  • IN peripheral circulation violations are noted.
  • Hormonal medications may affect the development of diabetes and organ disorders endocrine system.
  • Self-care and independent movement are severely limited.
  • Performing work tasks becomes impossible.
  • Work activity is possible only in special conditions, including at home.

First group Despite the medications used and hormone therapy, the disease does not stop progressing. Such disability is given in severe stage bronchial asthma.

Is disability granted for bronchial asthma and how to apply for it

Bronchial asthma is very common, severe, incurable disease, which affects millions of people on Earth. The diagnosis, made in childhood or in adulthood, is imprinted on the entire subsequent life of the patient.
He needs to cope with attacks of suffocation and shortness of breath, and protect himself from the factors that provoke them. environment, lifelong use of serious medications, including hormonal ones, take extra care of yourself from common colds, avoid physical activity. Can such a life be called fulfilling? Does bronchial asthma affect a person’s ability to work? Are they entitled to disability with such a diagnosis? Content

  • 1 Asthma and work ability
  • 2 What is needed to obtain a disability group?
  • 3 Which group can be given to an asthmatic?
  • 4 Video: Program “Live Healthy”, topic: “Bronchial asthma.

Disability due to asthma

Adults can be transferred to abbreviated work time or easier working conditions. They should work in well-ventilated areas, avoid dust, fumes chemical substances, others unfavorable conditions labor.

  • Second group.

The second disability group is given to patients whose asthma is complicated by pulmonary, endocrine, cardiovascular, digestive systems body.

Due to the constant deterioration of well-being and decreased physical activity, these people have a reduced level of self-care. Such patients need special conditions work, periodic inpatient and sanatorium treatment.


An asthmatic child with disability group 2 often cannot attend kindergarten, and at school he is transferred to home schooling.

Get compensation and benefits

He will enter the necessary information into outpatient card and will issue a referral to the ITU. In case of disagreement with the patient, the doctor will write the basis for the examination - “At the request of the patient.”


Attention

Make an appointment with the Bureau medical and social examination at the place of residence. On the appointed day you will need to appear for a medical examination.


Take your passport with you, mandatory insurance health insurance, medical certificates, referral to the commission. ITU experts will study the information you provide, ask you about your health, living conditions, features of work, etc. Based on the results of the examination, you will be assigned a disability group or denied it. You can challenge the results of the ITU in the Main Bureau of the region, and then in court.

How to get disability due to bronchial asthma

    First group.

The first disability group can be registered in patients with asthma whose bodies have undergone irreversible changes due to this disease. Often the main diagnosis is accompanied by such as “pulmonary emphysema”, “ ischemic disease hearts" and others.

The patient has difficulty caring for himself and has difficulty moving. He also has shortness of breath at rest. He is not capable of work or training at all. Patients with bronchial asthma often complain that it is almost impossible for them to become disabled.

They think net worth unsatisfactory and even difficult. Despite this ITU experts they come to the conclusion that such people are quite capable of caring for themselves, working and communicating in society, and on this basis they are denied the disability group. There is no need to blame the bureaucracy for everything. Registration of a group with asthma is a complex and sometimes lengthy procedure.

How to apply for disability due to asthma?

Not only the severity of the disease, but also the quality of life of the patient, the characteristics of his specialty and the work he performs are subject to expert assessment. professional features, his working conditions. Based on this, they decide whether to give the patient a disability or not. Which group can be given to an asthmatic? For bronchial asthma, one of three disability groups is given.

  • Third group.

To receive disability of the third group, you need the diagnosis of “asthma” and confirmation of the average severity of the disease. Prolonged attacks of suffocation stop fairly quickly, but sometimes a person needs hospitalization to stabilize the condition and prevent a new exacerbation of the disease. For children, this group means limited ability to work and limited abilities to learning. Physical activity is contraindicated for them.

Rules for obtaining disability for bronchial asthma

What is needed to register your status? To register for disability and receive benefits, you will need a number of documents:

  • passport;
  • compulsory health insurance policy;
  • document directing to medical examination;
  • hospital card or other documents describing the patient's medical condition and medications.

Before applying for disability, you should analyze your well-being and the development of the disease. You should consult your doctor about the worsening of the disease and difficulties in your life.
The doctor may discourage you from registering for a group by offering other treatment options, but by law he is obliged to give you a referral for a medical examination. Even if the disease is diagnosed in children, patients are registered at the clinic. Over time, the condition of asthmatics improves or worsens.

Is there any disability for asthma? This is a fairly common question to which not all patients know the exact answer. Bronchial asthma is a long-term, almost incurable disease, which sometimes leads to quite serious complications.

Typically, the process starts with mild degree, attacks in which occur very rarely, and outside of exacerbation, the disease does not make itself felt in any way. Over time, the course of the disease worsens, the frequency of attacks increases. Even without an exacerbation, patients complain of a significant decrease in performance, constant feeling lack of air, poor health.

Sometimes the disease progresses and with the right treatment, even hormonal drugs can be included in the therapeutic complex. If the course of the disease worsens every year and the patient is unable to perform his usual work, one should consider filing for disability.

Third disability group

This group can be established for patients with bronchial asthma mild course and moderate severity. In this case, the patient can receive hormonal therapy. The criteria for establishing the third disability group are the following:

  • Development of respiratory failure. Its symptoms appear already during habitual physical labor.
  • Exclusion of the opportunity to engage in usual work activities.
  • Limitation of opportunities for self-care and independent movement.
  • The need to change activities, downskill or reduce the usual amount of work.

Disability of the second group

The second group is given to patients with the second and third severity of bronchial asthma, with a pronounced deterioration in general health. Criteria:

  • Expressed respiratory failure, the manifestation of its symptoms with little physical activity.
  • Addition of heart failure.
  • Severe disturbance of peripheral circulation.
  • Accompanying illnesses - diabetes, disruption endocrine organs(adrenal glands) as a result of hormonal therapy.
  • Sharp limitation of physical activity and self-care.
  • Inability to perform professional tasks.
  • Patients require special conditions to work; it is possible to continue their professional activities at home.

First disability group

Registration of the first group is indicated for patients with a severe form of bronchial asthma, persistently progressing despite treatment therapeutic measures. The criteria for group registration are the following states:

  • Bronchial asthma does not respond to therapy and its course is constantly getting worse.
  • Respiratory failure is pronounced, patients suffer from shortness of breath at rest, and pulmonary emphysema is noted.
  • Severe heart failure.
  • Development of severe complications from internal organs.
  • Complete limitation of self-care and independent movement, need for outside care.
  • Complete loss of the ability to carry out any labor activity.

Bronchial asthma does not necessarily lead to severe complications in which the patient’s life activity is significantly limited. The disability group is issued individually in each clinical case. In this case, the basis is the severity of the underlying disease and accompanying pathologies, severity of complications (including those caused by taking hormonal drugs). Impaired functioning of the respiratory system and the ability to perform usual work also play an important role. The patient’s qualifications, nature and working conditions are also taken into account.

Bronchial asthma - serious illness. Disability, bronchial asthma, if present, depends on the form of the disease, the severity and nature of its course. In some cases, disability due to bronchial asthma may occur.

What is bronchial asthma

Bronchial asthma is a type of chronic inflammatory disease that occurs in the respiratory tract. T lymphocytes, eosinophils and mast cells are involved in this disease. The disease leads to shortness of breath and wheezing, coughing and a feeling of heaviness in the chest. This manifests itself most strongly in the early morning or in the second half of the night.

Obstruction is also observed in this disease bronchial tree. In general, it is partially or completely reversible (spontaneously or with treatment). In some cases, without timely and appropriate treatment, the disease leads to dangerous complications.

Exists a large number of factors provoking the onset of the disease. Among them are the following:

  1. Hereditary (genetic factors). If one of the parents is sick, the probability of the child getting sick will reach 30%, if both are sick - 75%.
  2. Presence of prolonged contact with allergenic substances.
  3. Chronic infection lungs.
  4. Serious stress or other prolonged psycho-emotional stress.
  5. Availability increased tone in the parasympathetic division of the ANS.
  6. Presence of endocrine disorders.
  7. Some features of child development.

Increased levels of immunoglobulin E, food and drug allergies, frequent illness ORZ, passive smoking also contribute to the occurrence of asthma.

There is a division of bronchial asthma into several types:

  • immunological (exogenous, atopic);
  • non-immunological (endogenous);
  • mixed.

In addition, the disease is classified according to severity:

  • light form;
  • moderate severity;
  • severe form.

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Disability due to bronchial asthma

Bronchial asthma is a disease that lasts a long time and is often completely incurable. IN severe forms asthma can lead to extremely serious complications, which can affect the quality and rhythm of a person’s life as a whole, making it impossible for him to work in a number of areas, and necessitate the need for constant specific treatment or even care.

Often mild degree the process is almost invisible. Attacks are extremely rare, and between exacerbations the disease does not manifest itself in any way. Gradually, the frequency of attacks becomes greater, the condition worsens, and performance decreases even during periods between exacerbations. All this does topical issue about disability.

There are three groups of disability (depending on the person’s condition):

  • the first group is heavy;
  • second group - average;
  • the third is easy.

Each group is given if the course of the disease meets certain criteria.

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Assignment of disability group

A patient with bronchial asthma can receive disability group III if he has mild or average degree course of the disease. In such cases, the patient often receives hormonal therapy.

Usually to establish of this type groups are guided by the following characteristics:

  • inability for a person to engage in usual work activities;
  • respiratory failure (its symptoms appear during normal physical activity);
  • restrictions on the ability to move independently and self-service;
  • forced change of activity, reduction in work volumes.

For disability group II, a person must suffer from the second or third degree of severity of the disease, and there must be a pronounced deterioration in general well-being.

For its appointment, we are guided by the following criteria:

  • development of heart failure;
  • the presence of severe respiratory failure (its symptoms appear even with little physical activity);
  • severe disturbance of peripheral circulation;
  • serious limitation of self-care and physical activity in general;
  • the presence of other diseases (malfunctions of the endocrine system due to hormone therapy, which leads to the development of diabetes mellitus, etc.);
  • inability to perform professional tasks;
  • need to continue professional activity at home.

Patients suffering from a progressive severe form of the disease can receive Group I disability. When making appointments, they are guided by the following indicators:

  • development of severe complications of internal organs;
  • severe heart failure;
  • pronounced respiratory failure (patients suffer from shortness of breath even at rest, and pulmonary emphysema is observed);
  • ineffectiveness of treatment for the disease, asthma progresses with constant worsening;
  • self-care and movement without assistance is limited, the person requires outside care;
  • inability to carry out work activities.
Members of the ITU (medical and social examination) take into account many criteria when assigning disability for bronchial asthma. Disability, quality of life and features of the organization of medical and social examination of patients with bronchial asthma and medical and social aspects of disability and rehabilitation of disabled people due to bronchial asthma

Bronchial asthma(BA) - chronic inflammatory disease respiratory tract, in which mast cells, eosinophils and T-lymphocytes take part. In susceptible individuals, this inflammation leads to repeated episodes of wheezing, shortness of breath, chest tightness and cough, especially at night and/or in the early morning. These symptoms are accompanied by widespread but variable obstruction of the bronchial tree, which, but at least, partially reversible, spontaneously or under the influence of treatment. Inflammation also causes a concomitant increase in the response of the airways to various stimuli.
Epidemiology. According to research, from 4 to 10% of adults and 10-15% child population globe suffer from asthma. Etiology and pathogenesis. In the etiology of the disease, there are 5 groups of factors that, under certain conditions, lead to the progression of congenital and/or acquired biological defects of the bronchi, lungs, immune, endocrine and nervous systems. Such factors include infectious allergens (pollen, dust, industrial, medicinal, allergens of mites, insects, animals, etc.); infectious agents(viruses, bacteria, fungi, etc.); mechanical and chemical irritants (metal, wood, silicate, cotton dust, vapors of acids, alkalis, fumes, etc.); physical and meteorological factors (changes in temperature and air humidity, fluctuations in barometric pressure, etc.); neuropsychic stress effects.
Chronic inflammatory processes play a major role in the pathogenesis of asthma. There is a clear connection between inflammatory changes in the mucous membrane of the respiratory tract with bronchial hyperreactivity and the degree of bronchial obstruction. Implementation hypersensitivity tracheobronchial tree is manifested by a characteristic triad - bronchospasm, mucosal edema and hypersecretion, and can be caused by both immunological and non-immunological mechanisms.

Risk factors for the onset and progression of the disease:

1. Heredity (if one of the parents is sick, the probability of the disease occurring in children is 20-30%, if the parents are sick with asthma - 75%).
2. Prolonged contact with household and professional allergens
(house dust, allergens indoor plants, animals, mushrooms, food products); Occupational asthma is characterized by a dependence of the onset of the disease on the duration and intensity of exposure to the causative factor (absence of previous respiratory symptom, development of symptoms no later than 24 hours after contact with causative factor in production, elimination effect; dominance in clinical picture cough, wheezing and shortness of breath).
3. Chronic lung infection.
4. The presence of prolonged or intense psycho-emotional stress.
5. Increased tone of the parasympathetic division of the autonomic nervous system.
6. Endocrine disorders(hyperthyroidism, fibroids, adrenal insufficiency).
7. Features of children's development: high level immunoglobulin E, early artificial feeding, gastrointestinal dysfunction, nutritional and drug allergy, frequent acute respiratory infections, passive smoking.

Classification.

According to the international nomenclature, there are following forms BA:

1. Immunological (exogenous, atopic).

2. Non-immunological (endogenous).

3. Mixed.

IN clinical practice classification of asthma according to severity is used:
light, medium and heavy.

Clinical picture and diagnosis.

Main clinical manifestations BAs are paroxysmal cough,
feeling of suffocation or difficulty breathing; hard breathing; whistling wheezing wheezing, the end of the attack with the release of viscous sputum, after which breathing becomes more free and dry wheezing gradually disappears.

Laboratory data: eosinophilia in the blood, changes in sputum (Courshman spirals, eosinophils, Charcot-Leyden crystals); positive results allergy tests and increased content immunoglobulin E (in the immunological form); determination of indicators of the activity of the inflammatory process (for non-immunological asthma).


Function study external respiration: 1) spirography with assessment of FEV1, FVC,
as well as peak expiratory flow (PEF). An important diagnostic criterion is an increase in FEV1 (more than 12%) and PEF (more than 15%) after inhalation (3r-agonists short acting. 2) peak flow metry - daily variability, depending on the severity of the disease, is more than 15%.

Course and prognosis. For mild intermittent (episodic) asthma
exacerbations of the disease occur 1-2 times a year; attacks of suffocation are mild, short-term, less than once a week, at night - less than 2 times a month, they can be stopped independently or with the use of inhalers. In the interictal period there are no signs of bronchospasm, external respiratory function is within normal limits: FEV1, PEF >80%, daily variability (daily fluctuations of PEF) -15-20%. In most cases, this is atopic asthma.
In mild persistent asthma, asthma attacks occur once a week or more often, but less than once a day; night attacks occur more often than twice a month; exacerbations of the disease can interfere with activity and sleep; PSV more than 80%, daily variability 20-30%.
With moderate asthma, attacks of suffocation can be daily, night attacks - more than once a week; symptoms interfere with activity and sleep; daily use of short-acting b2-agonists is necessary; FEV1 and PEF are within 80-60%, daily fluctuations in PEF are more than 30%.
Severe asthma is characterized persistent symptoms during the day, frequent exacerbations with severe attacks of suffocation, frequent attacks at night; physical activity and quality of life are significantly reduced; FEV1 and PEF less than 60%, daily fluctuations in PEF more than 30%.

The prognosis of the disease, in addition to the severity of the course, is determined by the severity
complications: 1) pulmonary complications: status asthmaticus, pulmonary emphysema, respiratory failure, atelectasis, pneumothorax, thromboembolism of the pulmonary artery and its branches; 2) extrapulmonary complications: chronic cor pulmonale, heart failure, hypoxic ulcers, etc.; 3) complications of BA treatment: steroid diabetes, steroid ulcers, osteoporosis, steroid obesity, secondary adrenal insufficiency, etc.

Principles of treatment. In the treatment of asthma, a “stepwise” approach is currently used.
an approach in which the intensity of therapy is increased (step up) if the asthma worsens, and decreased (step down) if the asthma responds well to treatment. The least severity of asthma is presented in stage 1, the greatest - in stage 4.
Preventive drugs for long-term use - basic therapy: inhaled corticosteroids (beclomethasone dipropionag, budesonide, fluticasone propionate, aldecine, beclocort, etc.); non-steroidal anti-inflammatory drugs (sodium cromoglicate and nedocromil - effective in preventing bronchospasm provoked by allergens, physical activity and cold air); b2-long-acting adrenergic receptor agonists (salmeterol, formoterol); long-acting theophyllines; leukotriene receptor antagonists (zafirlukast, montelukast - improve respiratory function, reduce the need for (short-acting b2-agonists, effective in preventing bronchospasm provoked by allergens, physical activity); systemic corticosteroids. Emergency medications: (short-acting b2-adrenergic receptor agonists actions (salbutamol, fenoterol, terbutaline, etc.); anticholinergic drugs (ipratropium bromide, berodual); systemic corticosteroids (prednisolone, etc.);

VUT criteria. During the period of exacerbation of asthma, patients are temporarily unable to work. At
non-immunological, mixed forms BA treatment periods are determined by the nature and severity of the infectious exacerbation, the effectiveness of treatment, and the severity of complications (DN, decompensation of chronic pulmonary heart disease): mild course - up to 3 weeks; moderate severity - 4-6 weeks; severe course - more than 6 weeks.
With immunological lung asthma duration of temporary disability is 5-7 days, moderate severity - 10-18 days, severe course-over 35 days. (depending on complications, effectiveness of therapy).

Criteria for mild asthma:
attacks no more than once a month, mild, quickly stopped (with bronchodilators or independently); there are no night attacks or they are rare and do not affect the child’s sleep and physical activity; outside of an attack there are no signs of bronchial obstruction, remission lasts up to 3 months or more, physical development the child does not suffer; forced expiratory volume and average daily bronchial patency - 80% and above, average daily bronchial lability - below 20%; Basic treatment is either not carried out or is carried out with drugs from the Intal group.

Criteria for moderate asthma:
moderate attacks of suffocation, with impaired external respiration function, 3-4 times a month; night attacks up to 2-3 times a week; the child’s physical activity is reduced, sleep is disturbed, physical development does not suffer; outside of an attack, clinical and functional remission is incomplete, its duration is less than 3 months, relief of an attack is possible with the use of inhaled bronchodilators or parenteral corticosteroids, the average daily bronchial patency is 60-80%, the average daily bronchial lability is 20-30%; basic treatment is carried out with drugs of the intal group, and if they are ineffective
inhaled corticosteroids in moderate doses.

Criteria for severe bronchial asthma: attacks of suffocation almost every day and almost every night, which disrupts physical activity, sleep and physical development of the child; in the interictal period, the phenomena of bronchial obstruction with signs of acute respiratory failure persist, the duration of incomplete remission is no more than 1-2 months; To stop attacks, hospitalization is required (to a pulmonology hospital and an intensive care unit); average daily bronchial patency - less than 60%, average daily bronchial lability - more than 30%; Basic treatment is high doses of inhaled corticosteroids.

Contraindicated types and working conditions: hard physical labor, work,
associated with severe neuropsychic stress, exposure to allergens that cause bronchospasm, unfavorable microclimatic factors (temperature changes, pressure, high humidity, etc.), conditions of dust, gas contamination; types of work activities, the sudden cessation of which due to an attack of suffocation can cause harm to the patient and others (air traffic controllers, vehicle drivers, work associated with staying at heights, servicing moving mechanisms, on a conveyor belt, etc.); long business trips. With the development of stage II DN. work associated with moderate physical stress and significant speech load during the working day is contraindicated.

Indications for referral to the ITU Bureau: the presence of contraindications in the conditions and nature of work and the impossibility of finding employment in an accessible profession without reducing qualifications or significantly reducing the volume of production activities; unfavorable clinical and work prognosis (severe, complicated course, ineffective treatment, etc.).

Minimum required examinations when referred to the ITU Bureau: clinical tests blood and urine; biochemical blood test - sialic acid content, C-reactive protein, total protein and fractions, sugar, electrolytes; general analysis sputum (for non-immunological BA - culture for flora and sensitivity to antibiotics, for BK); CBS and blood gases; ECG; X-ray chest; spirography (if necessary, testing with anticholinergics, b2-adrenergic receptor agonists); peak flowmetry; rheography pulmonary artery or Doppler echocardiography (to detect pulmonary hypertension).

Additional laboratory and instrumental methods studies are carried out depending on the indications. For example, with constant use of corticosteroids per os (more than 1 year), it is necessary to study the function of the adrenal cortex, exclude steroid ulcers and diabetes, osteoporosis (if there are corresponding complaints and objective data), etc.

Disability criteria. When assessing disability, take into account
the form and severity of asthma, the severity of complications, including those caused by therapy, the effectiveness of treatment, the severity of concomitant diseases; education, profession, qualifications, nature and working conditions, labor orientation.

Disability Group III installed in patients with mild to moderate asthma
course, including hormone-dependent, DN I and II stages. with limited ability to work, self-service, movement - Art. I, working in contraindicated types and conditions of work and in need of rational employment (reduction of qualifications or reduction in the volume of production activities).

Disability group II installed in patients with moderate to severe asthma
course with persistent severe impairment of respiratory and circulatory function (DN II-III stage and CH IIА stage), as well as dysfunction of the endocrine system (diabetes mellitus, adrenal insufficiency) caused by steroid therapy, with limited ability to self-care, movement, learning II Art. In some cases, patients can work in specially created conditions, in particular at home, taking into account professional skills.
Disability I groups are established for severe progressive flow BA,
refractoriness to treatment, development of stage III DN, stage IIB-III heart failure, other irreversible complications, with limited ability for self-care, movement, and work activity stage III.

Prevention and rehabilitation. Primary rehabilitation must be carried out practically healthy people if they have biological defects that pose a threat to the development of asthma: exclusion of all trigger mechanisms (allergens; upper respiratory tract infections, including viral ones, especially in children; provoking drugs; psychotraumatic factors; physical overload; gastroesophageal reflux), as well as early and long-term carrying out anti-inflammatory therapy.

Secondary prevention of asthma should include removal from the environment
unfavorable factors (allergens, irritants, etc.), organization of life regimen, activities physical culture, rational employment arrangement, timely training and retraining, organization of the work of asthma schools and asthma clubs; preparation of printed, video, audio and educational products, creation of an association of patients. It is necessary to carry out individual work patients, including communication with psychologists.
basis secondary prevention is timely and adequate treatment at all stages (outpatient, inpatient, sanatorium); compilation and control over the completeness and quality, timeliness of implementation individual program rehabilitation of a disabled person.
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