A Mom’s Worst Nightmare: Asthma Attack at the Grove Park Inn as a Toddler
I will never forget the day. I was at a North Carolina Society of Anesthesiologist meeting in Asheville, North Carolina, when suddenly, at 6am, I realized that my child was on the brink of death from an asthma attack. atI was attending a scheduled conference that included a group of the most highly skilled expert airway management physicians in the state, or should I say, in the world; I was one of them.
Like many working moms during the early years of their careers, I found that sometimes the only way to spend any time with my child was bring him along to meetings even though it is taxing, and at times, added to work exhaustion. My husband, of course, was a great dad, but at times as a physician mom, it was hard to get that quality time– or any time– to bond, resulting in anxiety and guilt. To help with the stress, I brought a sitter with us to tend to my son during the conference. my son, was around 4 years old…not yet yet in elementary school and was sleeping right beside me.. HHe woke up in distress, in distress, banging on my chest to get my attention. I jumped up to sit up in the double bed and he softly uttered, “I want milk.” my son was no longer being breastfed and never requested milk in the morning. “Never,” I discovered, was horrifically wrong.
I tried to calm him down and requested he talk. HE COULD NOT. In layman’s terms he had gone into a full asthmatic arrest. I yelled at the sitter to bring me his inhaler. All sitters of asthma children know or SHOULD KNOW to store the rescue inhaler and epi pen, if prescribed, at all times. However this time, my reliable and “seasoned” sitter was awkwardly fumbling with the inhaler. Why? The pharmacist had given us a metered inhaler unbeknownst to myself and the sitter. In the hospital, we never use metered inhalers so I had to quickly play with it myself. Afterwards, I think I gave my son more than 10 puffs because it appeared nothing was working. At the same time I informed the sitter to call “911” and give them our room number. She did. WWithin less than 3 minutes, we heard a knock on the hotel door. We thought it was the 911 ambulance crew or Emergency Medical Team. Instead, it was the hotel staff asking Instead, it was the hotel staff asking if we had called “911,” which caused more anxiety because I knew it was delaying the EMTs from being able to treat my child. The sitter and I stayed laser focused on my son and ignored their questions but urgently asked them to locate the “911” team and coordinate/guide them to our hotel room ASAP. They obliged probably because of my directness and confidence.even though I think I heard “buckling” murmuring under their breaths.
“The best way to keep my child alive was to be direct, not humble.”
-Charlene Green, MD
When the “911” team arrived and informed them succinctly about the situation and my expertise as an anesthesiologist, they questioned my expert judgment as a board certified anesthesiologist (They knew what that meant!). The EMT’s were dismissive, judgemental, rude and lackadaisical in treatment of my son. I then ushered out directives. The first was “put a pulse on him.” The second was, “he needs oxygen immediately” because at this time my son was moving some air and had some chest rising but still NOT talking. When the EMT’s saw how low the pulse oximetry reading was they began to panic. I never panicked. We will on another blog discuss the clinically significant racial and ethnic disparities in pulse oximetry readings that medical companies were well aware of for decades that caused harm to black and brown communities. The readings looked “normal” for black and brown patients, underestimating their low blood oxygen levels and putting them at risk, underestimating their low blood oxygen levels and putting them at risk. So the EMT’s were panicking over what they thought were dire readings readings for my son but little did we know how his blood oxygen levels were even lower than the device indicated! True decades of disparities in healthcare!
They rushed my son to Mission Hospital in Asheville, and luckily, it was a tertiary hospital, which is a hospital that provides care from specialists; the only one within miles in that county. In the news recently, this particular hospital has been cited by our state officials recently as one of the worst in the state for healthcare and safety ….harming that community that deserves better. Of note ambulance patient handoffs were reportedly one of the concerns cited to be harmful to patients and abysmal policy practices.
At the hospital, I determined the best way to keep my child alive was to be direct, not humble but always respectful to staff. I informed the team that my son needed to see the pediatric emergency room attending to address his clinical needs. My soon need to be treated with oxygen by mask inhalation, an immediate albuterol breathing treatment, intravenous steroids, and portable chest x-ray and –in that order! For parents seeking ways to advocate for your children with asthma, I encourage you to check these tips from the Mayo Clinic
my son got the treatment he needed because I advocated for him that day. He stayed there for hours and was eventually released from the emergency room that afternoon.
Needless to say, my son, the sitter and I were traumatized but we were so grateful he survived. Many don’t. It is important for all parents to know what to do if your child experiences an asthma attack because they are scary for all those involved.
Decisive and evidence-based medical care is mandatory to handle an emergency asthma attack outside a hospital setting, such as at home or school. See below for some additional scholarly and newspaper articles to provide a well-rounded understanding of the topic.
Understanding Asthma in Children
Before diving into the steps, it's important to understand what asthma is. Asthma is a chronic lung disease that inflames and narrows the airways, causing difficulty in breathing. Symptoms can include coughing, wheezing, shortness of breath, and chest tightness.
10 Tips to Handle an Asthma Attack at Home or School
Stay Calm: Your calmness can help soothe the child.
Sit the Child Up: Do not lay them down. Sitting upright helps open the airways.
Administer First Line of Medical Defense: Use the prescribed inhaler (usually a short-acting beta-agonist like albuterol). Follow the "two puffs" rule, with one minute between puffs.
Use a Spacer: If available, use a spacer with the inhaler for more effective medication delivery.
Reassess the Child: After administering medication, wait 4-5 minutes. If there's no improvement, administer another round of medication.
Avoid Triggers: Keep the child away from known asthma triggers like dust, smoke, or pets.
Seek Emergency Help AND Call 911: If symptoms persist after the second round of medication or you feel the child is not moving any air significantly
Identify Symptoms Early: Recognize signs of an asthma attack such as wheezing, coughing, or difficulty speaking.
Do Not Give Food or Drink: This can make breathing more difficult.
Keep the Child Warm and Comfortable: Cold air can worsen symptoms.
