Dr Frederick A Deutch wrote ".......I have a family on my list for the past 8
years consisting of 4 asthmatics - the father, age 50, seems to have solved his
problem with his previous GP who gave him Kenacort-R,........ she stayed out
late one night fooling around with friends in the piazza (plaza)
until 1:00 AM, probably got a blast of cold mountain air, went to bed to awaken
at 3:00 AM with shortness of breath that continuously worsened and after about
an hour, she died.
Would Kenacort-R have saved her life? "
My sympathies to you. This is the sort of significant event audit that goes
over and over in ones mind.
Sadly I think the answer to your question is Yes. Prophylactic steroid would
have reduced the liklihood of this girl's sudden death.
I am struck by three things.:
1 Your preference in Italy, for giving I.M. steroids rather than inhaled.
In the UK we would be much more likely to have such a patient on a steroid
inhaler probably before the use of Salmeterol
2 Our Medical defence organisations frown on the use of Injected steroid in
Hay Fever. I think that is a great shame, but the reason they give is
Osteoporosis with annual usage. Inhaled steroids are free from this side effect.
3 My third observation is that this reminds me to emphasize to patients the
lifesaving effects of high dose salbutamol. Should all asthmatics have a
volumatic (spacing device) to use up to 50 puffs of Salbutamol (5mg) in an
emergency?
Thanks for sharing this with us
Best Wishes
John Sanfey
Alvaston Med.Centre
Derby.
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