Asthma – When to Call 911
- Tuesday, September 15, 2009, 12:34
- Asthma
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- Gina:
- When should a parent call 911?
- Dr. Redding:
- Parents should have as part of their asthma management plan contingencies for what works and what doesn’t when asthma becomes severe suddenly. Part of that plan should include calling 911. Much of that decision is based on how children have deteriorated in the past. If a child has a history of having suddenly bad asthma — we call that labile asthma — their care plan may have a 911 call much earlier in the decision tree than someone who gradually gets worse over several days where a parent has time to intervene in many different ways before they call 911. So, it depends a little bit on the history of how suddenly children worsen, how severely ill they become when acute asthma begins, and how much time a parent has to actually administer rescue drugs such as albuterol, to see if there’s a response that will slow down that acute asthma attack.
- Gina:
- It’s very frightening when a child is frightened that they’re having so much trouble breathing. I’m trying to think of the right way to phrase this. To have a young child have an asthma attack that’s very serious scares the child. It also scares the parent. What can the parent do while they’re waiting for help? You mentioned trying to use albuterol. What else?
- Dr. Redding:
- I think there’s very little that works effectively other than albuterol. It’s helpful to calm an individual down if you think that the stress of being short of breath is aggravating the situation. However, realistically, if you can’t breathe, you’re probably going to be agitated. In that circumstance, ideally you know how to give albuterol. You know how to give it in the most effective way. Some children are on metered dose inhalers or puffers when they’re well. Particularly young children may get by with that, but when they become ill suddenly, that may not be the best way to give thealbuterol. Oral syrups don’t work very well, particularly with acute asthma events, and nebulized albuterol may be the best way to give the drug. It’s important for parents to know the best way to give a symptom reliever such as albuterol when their child has an acute asthma attack.
- Gina:
- Because the child probably can’t take care of themselves at that point to do it. Is that right?
- Dr. Redding:
- I don’t think parents should ever assume that during an acute asthma event that a child knows how to take care of themselves. It’s incumbent on the child if they can speak that they alert the family to things going badly. It’s also, I think, the parents’ responsibility to ensure that the child’s care is administered when the child is certainly sick enough with acute asthma to be in distress.
- Gina:
- Is this really a life and death situation? Do people really stop breathing?
- Dr. Redding:
- People really do die of asthma. They die of asthma before they get to the hospital. Most of the asthma deaths that we know can be prevented, can be prevented if you recognize asthma early and have a plan of care to treat it at an early stage. You need to keep yourself alive before your 911 personnel arrive, and that’s certainly part of the overall management of asthma.
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