"Status Asthmaticus"

I remember so well that time when I was still a medical senior in UST, I saw a 27 year old male who died because of asthma. His story is still fresh in my memory.

It was late in the afternoon, I was on duty as a rotator at the department of Internal Medicine. He came in all alone with difficulty of breathing. When I saw him dyspneic, I immediately listened to his lungs, it was very tight and with too many wheezes. But his words were comprehensible so after getting the PEFR I did nebulization while informing my intern and the resident on duty. They saw the patient and told me to continue nebulizing every 20-30 minutes and check fo his vitals. After the first neb, he was able to talk to me in phrases and managed to tell me that at that same moment his wife was giving birth to their first son at Fabella Hospital, a 20 minute ride to UST. He became very excited that he began to feel he was having an asthma attack. He forgot his Salbutamol inhaler so he ran to Fabella's ER only to be told to wait because there were too many patients. After 20 minutes waiting, he decided to go to UST Hospital. He was smiling with joy in his eyes as he looked at me.

After the second nebulization, he started to feel dyspneic again. I did my auscultation and heard more wheezes and the PEFR became worse. I told my intern, who decided to give him an IV steroids. After another 15 minutes, he was becoming more dyspneic and his lips became bluish green. I knew we had to do intubation. And so we did. He was intubated and was subsequently admitted to the ICU.

I felt very sad as I thought of his newborn child and his wife. I was really praying hard for his recovery. It sent shivers to my spine to think of a new life in exchange of another life. After two hours, the hospital was in CODE and we rushed to the ICU. My patient was now being resuscitated. After 10 minutes, he succumbed to death...

There may be factors contributing to his death but ever since that time, I make sure I have my inhaler at hand. When I laugh hard I always try to control myself. Asthma may be reversible but only God knows when it's not.