3-13. STATUS ASTHMATICUS
Status asthmaticus is a severe, prolonged asthma attack that does not respond
to conventional methods of treatment. This condition is considered a medical
emergency. Proceed in the following manner with patients having this type of asthma
a. History. It is important to know the patient's recent medical history. Ask the
questions listed below of or about the patient. Then, record that information.
How long has the child been wheezing?
How much fluid has the child taken?
Has the child had a recent infection?
(4) What medications has the child been given? When were the
medications given, and what was the amount of each medication?
Is the child allergic to anything? If so, what?
Has the child been hospitalized recently?
b. Physical Examination. Give the child a physical examination, paying
particular attention to the following.
(1) General appearance. Is the child sitting or lying down? In how much
distress is the child? A child having a mild asthmatic attack will lie down but prefers to
sit. A child having a severe asthmatic attack appears exhausted and may be unable to
move from the position he is in.
(2) State of consciousness. Very serious signs include sleepiness, stupor,
and coma. These signs indicate the patient is experiencing severe degrees of
hypercarbia, hypoxemia, and acidosis.
A patient having an asthma attack and being very
sleepy at the same time is seriously ill.
(3) Vital signs. As the asthma attack becomes more severe, the patient's
pulse becomes weaker and faster and his blood pressure falls.