Fatal Asthma- Is My Child at Risk for a Fatal Asthma Attack?

Identifiying & Preventing Fatal Asthma

Fatal Asthma
Severe Asthma Symptoms. BSIP/UIG/Getty Images

Most fatal asthma attacks are preventable.

While asthma is the 35th ranked in terms of all causes of death, rates have declined after peaking in the 1990's. Over 10 years (2001-2009) the United States deaths from asthma declined from 2.1 per 10,00 patients with asthma to about 1.4 per 10,000 while the exact reasons are not totally clear.

It is essential that you understand your child's risk, educate yourself, and then take action.

If you need to do certain things better such as monitoring symptoms or developing an asthma action plan, you need to get the appropriate education and take action.

Never Ignore the Severity of a Child's Asthma Exacerbation

Determining your child's risk for a fatal asthma attack is important. Only 33% of asthma deaths occur in the hospital, meaning children with asthma who die are either not seeking care or are not being hospitalized with their worsening asthma. Asthma exacerbations can be life threatening and can occur in anyone with mild to severe asthma.

Patients at high risk of asthma-related death require intensive education and special care. Make sure you know if your child is in one of the increased risk groups discussed below.

Importantly, 80 to 85% who die from asthma develop progressive symptoms from anywhere 12 hours to several weeks before the death occurs. Only 15% to 20% die in less than 6 hours after developing symptoms.

Thus, the vast majority of children dying from asthma developed symptoms in a time frame that would have allowed them to seek appropriate medical care. These facts taken in total indicate that most patients have the ability to seek care and take action to prevent an asthma death and that there is some degree of either complacency or a lack of knowledge associated with asthma deaths.

Risk Factors for Asthma-Related Death

Unfortunately, there is a small and difficult to explain group of patients that experience a fatal or near fatal asthma exacerbation without significant symptoms previously. To date, scientists have not been able to elucidate risks for rapidly fatal asthma. These patients have a wide spectrum of disease with mild, moderate, or severe asthma. All of the following are known risk factors for asthma-related death:

  • Previous history of a near-fatal asthma event
  • Frequent and severe asthma symptoms
  • Recent poorly controlled asthma with increased shortness of breath, nocturnal awakenings, and rescue inhaler use
  • Prior severe asthma exacerbation where your child was intubated or admitted to an intensive care unit.
  • Two or more asthma-related hospital admissions or three or more visits to the emergency room for asthma
  • Using 2 or more canisters of short-acting bronchodilators like albuterol in a month
  • If you or your child has trouble identifying when asthma symptoms are worsening or your child is having an asthma attack
  • Being poor and from the inner city
  • Substance abuse
  • Significant psychiatric disease
  • Other significant medical problems like congenital heart disease and other lung diseases

    What Do I Do if My Child is at Increased Risk?

    All of the following may help you reduce your child's risk of an asthma-related death:

    • Know that your child is at risk
    • Know your child's asthma action plan and make sure any other caregivers also know it also
    • Make sure you understand your child's asthma action plan
    • Use your child's asthma action plan
    • Encourage your child to use a peak flow meter regularly
    • Do not delay seeking emergency care if your child's symptoms worsen
    • Tell your child's asthma care provider that your child is at increased risk of an asthma-related death
    • Make sure you can effectively communicate with your child's asthma care provider


      National Heart, Lung, and Blood Institute. . Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

      Identifying Patients at Risk for Fatal Asthma. UptoDate 

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