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Tuesday, August 24, 2010

Respiratory arrest and asthma attack

Every day at we get lots of asthma related questions. Below are some questions I thought my readers at the RT Cave would enjoy.

Your Question: Is it appropriate to intubate a person during an asthma attack with respiratory arrest or cardiac arrest?

My humble answer: First of all, allow me to say it's very rare that a person having an asthma attack will stop breathing. However, if untreated long enough, this can happen.

By definition, respiratory arrest means cessation of breathing or breathing that is very difficult and inefficient. So, if a person goes into respiratory arrest, there is no alternative but to "artificially" breathe for that person. One way to do this is by bag and mask, although eventually the person will need to be intubated and placed on a ventilator.

The ventilator actually allows the person's lungs to completely relax, at which time bronchodilators, steroids and other medicines will be used to open up the person's lungs.

Just remember that any time an asthmatic is intubated it is usually only done as a last resort and is very temporary. Basically it allows trained medical professionals time to work their magic.
Usually an asthmatic will be intubated before he goes into respiratory arrest. If a patient looks like he is pooping out, and it appears what we are doing is not working, then the doctor may make the call to intubate.

If respiratory arrests progresses to full cardiac arrest (heart probably not getting enough oxygen), medical professionals will have no choice but to ventilate for that patient, and follow appropriate Adult Cardiac Life Support to get that patient's heart started up again.

Actually, while sometimes asthma attacks can progress rapidly, most of the time asthma shows signs that it is coming on, and this is why it's important to know your signs and symptoms of asthma, and have a good asthma management plan.

The key here is that by managing asthma right away, and knowing when it's time to get to the emergency room, respiratory arrests caused by asthma can be avoided -- and in most cases they are.

While it doesn't happen very often, I have taken care of asthmatics in this situation. Just about every one was breathing fine in a day or two.

If you have any further questions email me, or Visit's" Q&A section.

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