According to the American Academy of Asthma, Allergy and Immunology, about 25 million people in the United States have asthma, and that number appears to be growing. Asthma is so common that some people may not realize how serious the condition can be.
When asthma symptoms develop into status asthmaticus, the situation is life-threatening. According to the Centers for Disease Control and Prevention, in 2014 over 3600 people died from an asthma attack. Deaths from asthma may occur if the severity of the situation is not recognized quickly. Delayed treatment in patients experiencing status asthmaticus increases the risk of death.
Status Asthmaticus Symptoms
Asthma often causes narrowing and inflammation of the airway and increased mucus production, which leads to difficulty breathing. The reason some people develop asthma is not entirely clear, but it appears to be a combination of environmental factors and genetics.
People with asthma may have different triggers. For example, exercise or allergens including mold or dust may trigger asthma symptoms in some people. In other instances, a respiratory infection, such as a cold, can lead to a flare-up of asthma.
Asthma symptoms may vary in frequency and severity. Some people only experience a flare-up of symptoms occasionally. In many cases, symptoms can be treated at home with fast-acting inhalers that relax the airways, which opens the breathing passages.
But in some instances, asthma symptoms are more severe. Typical asthma symptoms can include the following:
- Wheezing
- Shortness of breath
- Chest tightness
- Coughing
- Anxiety
- Increased respiratory rate
In many cases, treatment for asthma, such as bronchodilators to open the airways and steroids to decrease inflammation improve symptoms. When status asthmaticus develops, symptoms do not respond to initial treatment and often become more severe.
The reason asthma symptoms may not respond to treatment is not understood. But people who have a history of severe asthma attacks in the past that required hospitalization have a higher risk of developing status asthmaticus in the future. People who are on three or more medications for asthma also have an increased risk of developing severe asthma symptoms at some point.
Why Immediate Treatment is Critical
When someone has status asthmaticus, the inflamed and narrowed airways, make it difficult to get air in and out of the lungs efficiently. As symptoms progress, breathing is impaired. Patients with status asthmaticus often have an increased work of breathing, which means they are using accessory muscle and working hard to get air into their lungs.
If the condition is not recognized and treated quickly, respiratory failure can develop. Respiratory failure indicates the individual is not getting enough oxygen in and carbon dioxide out of the lungs. Symptoms include rapid, shallow breathing, alerted level of consciousness and bluish color of the skin. If adequate respiratory function is not restored, it can progress to respiratory arrest, which means the patient can no longer breathe on their own. Respiratory arrest often progresses to cardiac arrest.
Frequent monitoring of a patient who has status asthmaticus is essential. If a patient is not monitored as they should be, signs of impending respiratory failure can be missed.
Some patients with severe asthma symptoms may require intubation, which is the insertion of a breathing tube referred to as an endotracheal tube. An endotracheal tube allows the patient to receive positive pressure ventilation and be attached to a mechanical ventilator to assist the patient’s breathing. A breathing tube also protects the patient’s airway, keeping it open and preventing aspiration.
Inserting a breathing tube in a patient having a severe asthma attack can be difficult. But one problem associated with delaying treatment in status asthmaticus is the airway can become so swollen it makes inserting the tube difficult. The inability to place the breathing tube may prevent adequate ventilation of the patient, which can be fatal.
The exact time to insert a breathing tube is largely a clinical judgment call. But patients who fail to respond to treatment and continue to get worse need to be intubated. Once intubation is deemed necessary, it should not be delayed. Inserting a breathing tube in a semi-elective situation instead of waiting until the patient is in respiratory arrest is preferred and decreases complications.
Medical professionals need to make quick decisions to give their patients the best chance of survival. In some cases, failure to recognize and treat status asthmaticus can have serious consequences. If you or a loved one have suffered from status asthmaticus that may not have been treated promptly, we may be able to help. Please call our office at 312-698-3694 for a free consultation with one of our top-rated attorneys.
