[medicerik]

Status asthmaticus is actually a little more than an acute exacerbation. We don't consider a patient to be in status unless they don't respond to the initial run of meds to try and open up the airways.

A prolonged asthma attack can most definitely cause a cardiac arrest. It can occur from prolonged hypoxia (not enough oxygen) or can also occur from a pneumothorax. The cardiac arrests from asthma that I've managed have been results of big bilateral pneumothoracies. One was in a 14 year old who's parents sat on her for four days of an acute exacerbation because they didn't have insurance. The other was in a 68 year old male. We found his inhaler laying next to him on the ground. Once the pt's chest was needle decompressed, I got pulses back. The pneumothoracies in these patients can occur for a couple of reasons. These patients develop weak outpouchings of the pleura called blebs. The blebs can rupture causing the pneumothorax.

Fully understand the not wanting to certify asthmatics to dive. The last thing you need is someone 60 feet underwater who suddenly starts wheezing, panics, and bolts for the surface. It's not like you can just pull your regulator out of your mouth for a minute, take a couple of puffs off your albuterol inhaler, and then go straight back to strenuous physical activity.

Erik