Episode Transcript
Interviewer: What should you do if someone you know has a very severe asthma attack? We're going to find out next on The Scope.
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Interviewer: Dr. Madsen, I want to do a scenario here. If somebody has a very severe asthma attack, and I'm there, what should I do? I would imagine that that person knew they had asthma, and I'd hoped they had an inhaler. Would that be the first place I'd start?
Dr. Madsen: Probably so, but you also have to think, is this someone you just need to call 911 for and get them to the ER. And in my mind, the way I really judge the severity of an asthma attack is, first of all, can the person talk to me? If a person cannot breathe well enough, where they can't really get out more than say a one word answer, that's really severe. And in that situation, before I go looking for their inhaler, I'd say call 911. Get the ambulance there, get them to the ER, because even if they take a couple of puffs of their inhaler, it's probably not going to do much in that situation.
Interviewer: All right, so super severe like that, don't even mess around with it, don't hesitate, call 911, get the professionals there.
Dr. Madsen: I would.
Interviewer: And if they're not quite that severe, they're able to get some sentences out, they're able to talk to you, what would you do at that point?
Dr. Madsen: Usually in that situation, if they have asthma, they have an inhaler somewhere, and so they might say "Hey, can you go grab my inhaler for me?" Maybe they're feeling kind of winded, they just want to sit down, try and relax a little bit. But they're talking to you, they're not breathing so fast they just can't get anything out. You look at them, they look like they're working a little bit to breathe, but it's not like when they breathe you see all of their neck kind of sucking in because they're trying to get air in. So it's not a real severe case, so certainly I think an inhaler is going to help there.
Even in those situations, if it's that bad they might take a couple of puffs of their inhaler, they might feel a little bit better. But I often find even in those scenarios, they may need some more treatments in the ER, including possibly steroids which are going to help out as well, which typically they don't have at home.
Interviewer: All right, one of the ABCs is breathing. And any time that somebody is having trouble breathing, that is one of the rules that you use that you should go to the ER. So it's crucially important. What should you do at that point, while you're waiting for help to arrive, whether it's the inhaler didn't work, maybe they didn't have one, they ran out, they are struggling breathing. Is there anything you can do to help them at that point?
Dr. Madsen: Really the best thing you can do is whatever you can do to just keep them calm, because if someone is having trouble breathing, that's going to make you feel anxious. You can just imagine that drive you have to breathe, and when you're struggling with that you're going to feel incredibly anxious. The problem with asthma is that anxiety is going to make it even more difficult to breathe, it's just going to compound the problem.
So realistically, the only thing you can do there besides say having them take some puffs of their inhaler, would be to do whatever you can do to help them calm down. Turn on the TV, turn on some music, something just to help them relax a little bit, while you're waiting for the ambulance. Reassure them they're going to be fine, tell them you're breathing okay, you're talking to me, this is great, ambulance should be there hopefully within 5 to 10 minutes. And at that point, they're going to get them on some continuous breathing treatments and get them where they need to be.
Interviewer: So in summer, it sounds like if somebody is having a severe attack like that, just call 911 because there are things that you can do in the emergency room to help them, and just a breathing problem is not something you want to mess with.
Dr. Madsen: That's exactly right. Like you said, we talk about the ABCs, that's what B stands for. Once you talk about breathing, you've got to address it, and usually you're not going to be successful at home. Keep in mind that asthma is a very serious disease. It kills thousands of people every year, so you have to take it seriously to get them the help they need.
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