Avoiding Code Blue

Vol. 21 •Issue 19 • Page 23
Avoiding Code Blue

What Asthma Patients Need to Know About Emergency Meds

Putting all your eggs in one basket is not a recommended strategy for your retirement funds. Neither is it smart for an asthma patient to over rely on an inhaled medication to quell an emergency or rescue situation.

While covering the emergency room one night, I was part of a team notified that a code blue was en route via ambulance. As the gurney crashed through the door and rolled toward us, I saw a woman with a metered-dose inhaler (MDI) tightly clutched in her hand. She had been found behind the wheel of her parked car. Unfortunately, she was dead on arrival, the victim of an acute asthma attack.

This was a wake-up call reminding us that people need to be educated about the reality that MDIs and other medications may be unable to rescue them from rapid-onset pulmonary


They must be well-informed of the life-threatening potential of an asthma attack and be aware of alternatives available to relieve the symptoms of a sudden event. Prevention and keeping current with the latest research remain the best policies for all individuals with asthma.

Patients with asthma also must avoid the dependency syndrome. They should not rely on others to keep track of an MDI or to make certain the MDI actually contains a drug. Self-reliance goes a long way in thwarting a major attack.

Other Thoughts

In addition to using long-term control medication, patients can take other measures to avoid a trip to the ER for a severe asthma attack.

  • Many of us depend on glasses to read and keep several pairs strategically positioned throughout the house, the car or the workplace. Stashing life-saving medications at different locations also makes sense.
  • Many new MDIs come with a counter which takes the guesswork out of knowing whether the device is nearly empty. This preventive measure eliminates the old guesswork method of placing the canister in water to see if it floats.
  • Built-in mental discipline can reduce the anxiety produced by shortness of breath, stabilize the attack and possibly reduce its severity. It may not end the attack, but it will perhaps buy some time to counteract the episode with medication or find assistance.
  • Allergies can trigger an asthma attack instantaneously if the right conditions present themselves. Some attacks are acute enough that an MDI may not work. Individuals subject to such attacks often carry an injection of racemic epinephrine for acute incidents where the airway suddenly closes due to an unforeseen reaction.

Michael Donnellan is a California practitioner.

Asthma Mortality Facts

  • Each day, 11 Americans die from asthma. More than 4,000 deaths due to asthma occur annually. In addition, asthma is indicated as a contributing factor for nearly 7,000 other deaths each year.
  • Since 1980, asthma death rates overall have increased more than 50 percent among all genders, age and ethnic groups. The death rate for children under 19 years old has increased by nearly 80 percent since 1980.
  • More females die of asthma than males, and women account for nearly 65 percent of asthma deaths overall.
  • Blacks are three times more likely to die from asthma. Black women have the highest asthma mortality rate of all groups, more than 2.5 times higher than Caucasian women.

Source: Asthma and Allergy Foundation of America

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