Anaphylaxis and Deadly Asthma Attacks: What You Need to Know

If you have asthma, it's important to recognize that it could kill you. This is true whether you have mild intermittent asthma like me or severe, poorly-controlled asthma. In fact, in the U.S., 10 people every day die from asthma. Many of these deaths could have been avoided with proper treatment and care. In adults, who are 4 times more likely to die from asthma than kids, women and African-Americans are most at risk for dying.

These are some pretty sobering statistics, aren't they?

But the good news is, there are actions you can take to prevent such deadly asthma attacks or to treat them effectively when prevention isn't possible. In this post, we'll look at both acute and more chronic episodes that can result in a deadly asthma attack.

Understanding Anaphylaxis

Anaphylaxis is a life-threatening allergic reaction. Prompt recognition and treatment are essential to preventing complications and death, which can occur within minutes. Epinephrine is the only way to stop the reaction. You can not just "ride out" an anaphylactic reaction.

The most common symptoms are:

• Hives
• Swelling of the mouth and nasal passages
• Wheezing

Anyone can develop a severe allergic reaction like this, even if they do not have asthma. But because most people with asthma do have allergies, they are at more risk. Common allergens that can trigger such a severe allergic reaction as anaphylaxis are:

• Certain types of foods, such as tree nuts or shellfish
• Medications, such as antibiotics
• Insect stings

If you have ever had any kind of reaction to those types of allergens in the past, even if it wasn't severe, you are at risk. If you have a sensitivity to these allergens, with each exposure, the likelihood of anaphylaxis increases.

Dealing With Anaphylaxis-Related Attacks

Prevention is the best approach if you know that you have a severe sensitivity that might result in anaphylaxis. If food is your allergen:

• Remove it from your diet
• Learn to read food labels carefully
• Ask about ingredients and preparation methods when eating away from home

If stinging insects are what you're sensitive to:

• Avoid places where they might be
• Wear protective clothing when outdoors, including shoes rather than sandals and hats
• Never drink from an open container outdoors that might have attracted a stinging insect

If you're allergic to medication, then be sure to learn both the generic name and any and all brand names for it. It's also a great idea to wear a medical alert bracelet, no matter what you're allergic to.

If prevention doesn't work and anaphylaxis occurs, it must be treated as an emergency. Follow these steps:

1. Ask someone to call for emergency help, if possible.*
2. Remove the allergen from the area, if you can do so quickly.*
3. Administer an epinephrine autoinjection, if available (Epipen or Auvi-Q).

* If you are the only one around the ill person, then first administer the epinephrine, followed by the other steps.

If the person is able to rest comfortably lying down, have them lie on their back with their feet slightly elevated. Monitor their pulse and breathing. Be prepared to give CPR if necessary. Anyone who has had an anaphylactic reaction should go to the hospital afterwards, even if they appear to recover.

Understanding Slow-Building Severe Asthma Attacks

Most asthma deaths do not occur in the hospital. This suggests that the severity of the person's respiratory health status was not recognized in time to get needed treatment. This is sad, because it's a fact that most asthma-related deaths could be prevented if risk factors were recognized and addressed early on.

With this type of severe asthma attack, symptoms and severity can build slowly over a period of hours or even weeks. So there is generally plenty of time to seek treatment that would reverse the course of the attack.

You are at risk for death from asthma if you:

• Have had a previous severe asthma attack that required admission to a hospital for intubation or intensive care
• Were hospitalized 2 or more times or made 3 or more ER visits this past year for asthma
• Use 2 or more canisters of your rescue inhaler per month
• Have a hard time recognizing when your asthma symptoms are getting worse or when you're having an asthma attack
• Are poor or live in the inner city
• Have a substance abuse problem or other coping issues
• Suffer from other health conditions, such as heart disease, other lung diseases or mental illness

Typical symptoms of a slow-building asthma attack that should be treated quickly include:

• Marked breathlessness
• Inability to speak more than short phrases
• Use of accessory muscles
• Drowsiness

Preventing & Treating Severe Asthma Attacks

Prevention is best achieved when you are knowledgeable about your asthma and how it affects you. A written Asthma Action Plan can also help guide you in recognizing when control is slipping and what to do about it. Be sure any caregivers also know about your action plan.

Knowing and accepting that you are at risk of dying from uncontrolled asthma is the first step in dealing with it. Use your peak flow meter regularly to monitor your asthma control. This is important because the peak flow meter can often pick up changes in your lung status before you notice any symptoms. Also, trust your gut and any feelings that things are not right, if you have them.

When you so realize control is slipping, follow your Asthma Action Plan and use your rescue inhaler and/or increase the dose of your preventer medicine, as directed. If your symptoms do not get any better or continue to worsen, then don't wait to seek emergency care. Your quick action may be the difference between life and death.

In Summary

The prospect of dying from asthma can be frightening. However, it's important to understand that most asthma deaths are completely preventable. Know your risks and then take steps to lower them. And, if all else fails, be prepared to take quick action!