Chest
Clinical InvestigationsPrevention of Fatal Asthma
Section snippets
METHODS
The study involved two parts. A retrospective study was performed to analyze data from asthma deaths in our unit and to enable comparison with the prospective part of the study. Moreover, in order to confirm or show up the weakness of our assumption that patients who called our unit actually had a severe attack of asthma, peak-flow was systematically measured in asthmatic patients who called our unit.
RESULTS
Retrospective Study
Some 980 emergency calls from asthmatic patients were recorded during the study period. A total of 216 (22 percent) of these patients were taken to the hospital with an emergency care ambulance and none of them died.
Ninety (9.2 percent) asthmatic patients who called died; 36 asthmatic deaths occurred in 1983; 31 in 1984; and 23 from January to August 1985. A total of 21 (23 percent) patients were found in respiratory or cardiorespiratory arrest by their relatives or a
DISCUSSION
The results of our study suggest that the mortality rate of asthma was dramatically decreased, and that most asthma deaths are preventable. Nevertheless, we must admit that the patients who died and never called anybody were not counted in our study and that four patients died in spite of our scheme. Nevertheless, during a six-month period, 17 patients in circulatory or respiratory arrest were successfully resuscitated and were discharged alive from the hospital without sequellae.
The question
CONCLUSIONS
A better recognition of asthma, because failure to diagnose precludes effective treatment, education of asthmatic patients and all professionals likely to come into contact with asthma, and the development of self-referral admission services for asthmatic patients are probably necessary. But development of prehospital emergency care schemes are of paramount importance and may prevent some unnecessary deaths. Emergency calls from asthmatic patients must be considered as related to a severe
ACKNOWLEDGMENT
We wish to thank the staff of the Fire Brigade of Paris for their continuous help in this study. We are particularly indebted to Colonel René Noto, M.D., who controls the Emergency Medical Service of the Fire brigade of Paris and helped develop the prehospital scheme for asthmatic patients. We are indebted to Pr. Francois Clergue, M.D., and to Michel Aubier, M.D., for reviewing the manuscript and for their valuable advices. We are indebted to Françoise Neukirch for her assistance in statistical
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Manuscript received October 9; revision accepted February 26.