Understanding Status Asthmaticus


What Is Status Asthmaticus?
Status asthmaticus happens when an asthma attack comes on quickly and doesn't respond to treatment. This can lead to respiratory failure, which is life-threatening. To stay safe, it's important to know the signs and when to get medical help.

What Causes It?
Doctors don't know the exact reason why some people get severe asthma attacks. But it's more likely if your asthma isn't under good control. It can also happen if you come in contact with your asthma triggers, which may include things you're allergic to, or don't take your medication correctly.

What Are the Symptoms?
You may have status asthmaticus if you experience severe shortness of breath, an inability to speak in full sentences, chest tightness, and bluish lips. You may also feel irritated or have difficulty concentrating.

How Is It Diagnosed?
Your doctor will diagnose this condition by checking your breathing and symptoms. They'll want to know if you have any fatigue or if you wheeze when you breathe in and out. They'll check your pulse rate. You may also have tests to check some things, such as your peak expiratory flow and oxygen saturation.

Emergency Treatments
If you have a severe asthma attack, go to the hospital immediately. If it is status asthmaticus, you may receive treatments such as continuous nebulization, epinephrine, corticosteroids, and, sometimes, mechanical ventilation.

Preventing Attacks
Monitoring your asthma with peak flow meters and having regular follow-ups with your doctor can help you prevent attacks. You should also try to avoid asthma triggers and take your medication as directed by your care team.
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SOURCES:
Smolley, L. and Bruce, D. Breathe Right Now, New York, Random House, 1998.
American Family Physician.
American Academy of Family Physicians: "The Crashing Asthmatic," "Expert Panel report 2: guidelines for the diagnosis and management of asthma."
National Heart, Lung, and Blood Institute.
Circulation: "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 8: advanced challenges in resuscitation: section 3: special challenges in ECC. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation."
UpToDate: "Management of asthma exacerbations: Emergency department and hospital-based care," "Theophylline poisoning."
Medscape: "Status Asthmaticus."
Critical Care: "Clinical review: Severe asthma."
American Family Physician: "The 'Crashing Asthmatic.'"
Cleveland Clinic: "Hypoxemia: Management and Treatment."
Merck Manual: "Respiratory Alkalosis."
Mayo Clinic: "Hyperinflated lungs: What does it mean?" "Pneumothorax."
Journal of Thoracic Disease: "Pneumomediastinum."