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Tuesday, March 10, 2015

Status asthmaticus (severe asthma attack)

Status asthmaticus is another name for a severe asthma attack. 

On TV shows or in movies, they may show someone having an asthma attack. The actress or actor  just take a puff of their inhaler and presto! They are just fine - just like that!

For those of us that live with asthma, you may know that it isn't that easy. 

It takes time for an inhaler to work and to help you breathe.

In some cases, it doesn't seem to work AT ALL.

All three of my kids have asthma (yes, they can blame me for that....)

When Son #2 was younger, he had severe asthma. He didn't respond like most patients when it came time to treat his asthma. When he would get sick, I would panic! We would use a nebulizer and give him a breathing treatment, but it didn't seem to help. So we would call Asthma Doc. Asthma Doc would listen to his lungs and start him on prednisone (a steroid liquid/pill.) Asthma Doc would also give him a steroid shot (decadron.) It's a stronger dose of steroid that can work quickly. 

I would watch him VERY closely, even staying up all night to monitor his symptoms, and Son #2 would get still get worse. So we would head to the emergency room. 

.WebMd has a list of severe asthma symptoms:

What Are The Symptoms of a Severe Asthma Attack?

The symptoms of a severe asthma attack may include:
  • Persistent shortness of breath
  • The inability to speak in full sentences 
  • Breathlessness even while lying down
  • Chest that feels closed
  • Bluish tint to your lips
  • Agitation, confusion, or an inability to concentrate
  • Hunched shoulders and strained abdominal and neck muscles
  • A need to sit or stand up to breathe more easily
These are signs of an impending respiratory system failure and require immediate medical attention.

You may not have more wheezing and coughing with a severe asthma attack. In fact, the presence of wheezing or coughing is not a reliable standard for judging the severity of an asthma attack. Very severe asthma attacks may affect airways so much that the lack of air in and out of your lungs does not cause a wheezing sound or coughing.

This happened to our son many times. It's even scarier when you know they are NOT moving any air through their lungs!

The next page of the WebMd website states:

If you have an asthma attack that does not respond to your usual bronchodilator inhaler, this is considered to be a medical emergency. These severe attacks require immediate emergency care.

With severe asthma, they can go from bad to worse VERY QUICKLY. Make sure you understand when your doctor wants you to go to the emergency room or call an ambulance.

Severe asthma attacks may be rare, but they can and do happen. 

Make sure you know what to do.


  1. My doctor told me, that these situations were very common in my country in 1980's, when there were almost no medicines for asthmatics. We had of course Polish equivalent of Ventolin, but during the martial law all shops became empty.

    In those times only people, who had near connections with communist party or had foreign currencies (like US dollars) could get medicines for asthma. Other people had to try very complicated works to get them, for example sister of my doctor sold medicines from her pharmacy (not only for asthma) for... Meat!

    Today stathus asthmaticus is rare in Polish hospitals. I've never had that (or I don't remember) - and I wish everyone not having!

    Greetings from gray city in south Poland - pollen season is just started!

    1. Wow! I'm so glad things aren't like that now! What a story!

  2. I love your blog - I am going back on a journey of allergy shots - for my horrendous allergies and asthma. Unfortunately, not many people blog about this issue at all! Crazy to me.
    I had shots when I was a young adult 17-19 during 2006-2008 but stopped because I moved away for college and didn't find it of any importance. Now, settled at 26, I am certainly realizing - I can't keep living on Claratin, pseudoephedrine, and flonase for the rest of my days.
    I look forward to more of your blogs!

    1. Gina, I understand! All of our kids have had 5 years worth of allergy shots.

      We are considering starting our daughter back on allergy shots (poor kid!) It is depressing to think that she needs so much allergy medicine after enduring shots for 5 years :(

      The allergy shots were supposed to stop her allergies from being so severe.

      Good luck with your new round of allergy shots!

  3. It is scary to hear about someone dying from asthma complications. If Albuterol has always worked for my son so far, does that mean he is at a lesser risk for a life- threatening asthma attack, or is one still possible? He needs prednisolone once or twice a year. Are severe asthma attacks always preceded by respiratory infections? Thanks for your help!

    1. Noelle,

      9-11 people die in the U.S. each day from an asthma attack. Read the link below.

      I think the key to preventing that is to understand the signs and symptoms of an asthma attack, and to seek medical help immediately if he gets worse.

      I would print out the Webmd signs of a severe asthma attack from the blog and keep it handy.

      If there is ANY question that your son is getting worse, head to the after hours or the ER. I always trusted my mother's intuition when I felt that "something wasn't right" I knew the doctors would send us home if my son was okay - but they never did. He was always admitted to the pediatric ward of the hospital.

      His episodes always started out with a cold, but he would usually end up with pneumonia.

      I hope that answers your question. I asked my doctor what he wanted me to watch for, and when to call the after hours doctor or when he wanted me to go to the ER. Have your doctor write it down for you. Your son should have an asthma action (plan where the explains what to do when your son is in the red/yellow/green zone.

      This link has different asthma action plans that you can download and have your doctor fill out.

      Good luck!

  4. Thank you Andrea for taking the time to answer my questions.

    1. So sorry you have to go through this too. But our family mantra is "Things Can Always Be Worse!"

      My kids have had a lot of healthy times too. But when their asthma flares up, it can get really scary.

      I have my asthma doc's number programmed in my cell. I also know where ALL of the after hour pediatrician clinics are, as well as the fastest route to the ER.

      Trust your mom's instinct. I have had my daughter at the after hours clinic at 8:30 one night (they said she had an ear infection), only to drive her to the ER at 10:00 that night. She had pneumonia and was admitted to the hospital.

      Kids with asthma can get SICKER than healthy kids and they get sick QUICKER. Keep on your toes.

      I also use an oximeter (finger tip oxygen monitor) Most drug stores sell them from about $40 and up

      You can find them on Ebay too.

      Have a great conversation with your doctor about what to look for and how to treat his asthma. We felt like our Asthma Doctor was a best friend! We called often!