Casualty

Hey Peeps,

Was just wondering if anyone saw Casualty last night and if so what did they think of the potrayal of someone with asthma?

I'm not brittle but thought it all happened very fast - although i'm guessing for someone who is brittle that could be realistic.

In a good way when i wnet to work today a few of my collegues had watched it and were talking to me about it, explaining that they never realised how serious it could be and how sudden it could happen (a lot of the time they react bu saying you were fine an hour ago but obviously asthma is sudden. etc in that way i think it was good as it has probably educated a few people.

laurenjayne x

32 Replies

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  • I saw it and got typical reaction from my mum that am getting loads at mo in that she keeps telling me that if I wrap up warm and keep well I won't have any problems. Think thing that struck me is that they said she was brittle but were only told she was on ventolin and steroids and that her parents had nagged her to manage it better. Good topic to cover but think they could have used topic further?

  • I agree with that with the medication she was on - I'm on a lot more than that and i'm not brittle and i did find that bizzare as i have a few different types of inhalors and tablets.

  • Just watched it (not normally a fan as the inaccuracies annoy me - picky, I know!)

    Bit near the knuckle - not particularly easy to watch, and I'm quite hardened!

    I thought on the whole it was a good portrayal of brittle asthma. The speed of onset of the attack certainly wasn't particularly unrealistic - I've had brittle attacks that have come on that quickly. I'm not sure that someone with brittle asthma would have just two puffs of salbutamol before declaring that the medication wasn't working, though!

    The medication issue didn't quite sit right - but you could put it down to her father being in a stressful situation and not really knowing what she was on. I think if you asked my mum what I was on for my asthma she'd probably say 'salbutamol and steroids and some other stuff'! The thing about the parents nagging her was probably realistic for a lot of young people (who hasn't been a bit gung ho with it as a teenager?) but was a little annoying - we don't really need people to be given the impression that poor compliance is the only factor in brittle asthma.

    The paramedic treatment seemed basically accurate, but just a few issues - I think most Ambulance Services' protocols would have said to give adrenaline much earlier on, as soon as it was clear that the nebs weren't working. Certainly in my area, paramedics can't give IV hydrocort, although that may vary in other areas. And the bag and mask ventilation, and then the ventilation after she was intubated, was a bit patchy - there were quite long periods when the damn thing was sticking out of her mouth but no-one was breathing for her! The bag and mask ventilation technique was a bit crap, too - I'm not surprised he wasn't getting any air into her!

    Overall, though, I thought it was a reasonably realistic portrayal of brittle asthma, and, as laurenjayne said, an important effort in trying to get the public to have a better understanding of asthma and how serious it can be.

    Em

  • Kids watched it and I have since seen it too. Kids reaction was pretty laid back ""that is what you did at football the other week"" type thing. They did wonder why did she not have her own neb with her and they did ask "" you do take your meds don't you"" there was a short and rather sobering debate about what could happen if I did not have neb or take my meds.

    Actually I don't remember much about the sudden ones what I do remember is fragmented with huge gaps in it. Anyway down here they carry and give IV hydro-cort, 200mg they also give adrenalin although my protocol says not to, it does not help or at least I don't think it does.

    As to the suddeness yes it can happen just like that in no time at all and sometimes for no good reason. Thankfully the sudden dramatic ones are few and far between and I know if neb number 2 on a B2B is not hitting the spot then I am big trouble.

    On the whole I think it is good that people realise asthma does really kill, I think sometimes they think it only kills if you get something else with it like a chest infection. If it opens up debate and informs then its a good thing, but I hope it does not scare people too much. Going off like that is very very rare most people who are likely to do it are aware they do and all those I know who really go off that fast are compliant with meds cos not being is not an option.

    Bex

  • A slight variation on this topic. I always carry a listing of my various conditions, my GP and Consultants details and a list of all my meds and dosages and I always carry a Steroid card in my wallet. The details, I carry in my wallet and, also in a large locket around my neck.

  • hey,

    Can i ask what hydrocort is? Sorry never heard of it and being nosy!

    I also carry a list of my med's and dosages as there is nothing worse than someone asking you and you trying to say when you are obviousy struggling and don't want to talk!

    I think on Casualty maybe some of it was done to dramatise and make it a bit more effective on the telly - eg just using to puffs then saying not working. I agree with you as well Bex and hadn't thought of the fact she never had a neb or spacer etc.

    L x

  • Haven't watched casualty for ages as i too (sorry) get frustrated by a lot on inconsistency and 'incorrectness'

    However, despite this i am quite intruiged by this episode...is it repeated? or is there any way i can see it?

    Laurenjayne hydrocort is hydrocortisone, a corticosteroid (like prednisolone).

  • I have to agree with Em, patchy with the treatment and I was yelling, give her adrenaline!

    Attacks like that in normal people are rare, but in Brittles it can come on that quick. I have adrenaline for if 2 nebs don't work and adrenaline seems to help me hold my own till I get expert help.

    It was a good lesson in making sure you keep on top of your asthma & taking the meds, as her Paramedic Dad said, 'she said it wasn't cool' -relating to taking meds etc.

    Also good to introduce the concept of brittle asthma to the general public as many people don't understand how difficult or life threatening asthma can be.

    (I have to explain it to a med student last week!)

    I hope people here weren't too allarmed by it though, please!

    Kate

  • As Bex, says, going off like that is rare - but sadly the people most at risk (outside of the brittle group) are those who completely underestimate their asthma, and don't comply with the treatment they are given to take.

    Sobering indeed.

  • With thanks to Gorn Fishing, who has posted this link on another thread - for catch-up TV for preceding 7 days, go to bbc.co.uk/iplayerbeta/ where you can download programmes free, upon registration.

  • Thanks for answering that EmH - I was just curious as i'd never heard of it!

    It was a really interesting episode, I think Asthma is never really covered on the telly so for it to be a main storyline and potrayed fairly well for a television show.

    My attacks personally are a lot different form them - eg i do not go off as quick and I am a lot noisier etc but i'm not brittle etc.

    I'm glad they done the storyline and i have a feeling a few of us will be going and watching it on the BBC Site!

    L x

  • I think we broke the download thing. I was trying to put it onto my lap top for future reference you can't get at it! I wonder if it has something to do with too many people trying to access it?

    Bex

  • I downloaded it earlier but it took ages, even with broadband running full pelt.

    Agree with most of the comments made on here.

    Uncomfortable memories of a recent similar experience with the ambulance service for me. Sadly I think this is happening all too frequently.

  • Have to say the ambulance not coming and the poor First Responder guy being on his own for so long was probably the most scary bit for me. The other issues like compliance with meds, carrying a neb and a medical history card, and, errm, not climbing scalfoldings are all things I can control to keep myself safer, but the speed of response of the paras is not.

    I've never even remotely had problems like that - being four miles from the hospital, quarter of a mile from the Ambulance Station and having my name flagged there helps - but the idea is quite anxiety-provoking.

    I've also been in the situation, as a junior doctor, of looking after someone and knowing that I was out of my depth, or simply not managing them effectively because there was only one of me, and frantically waiting for backup and senior support that took an age to arrive. It's one of the most frightening situations to be in in medicine - thankfully, it doesn't happen very much any more - and I can vividly remember the feeling of powerlessness, especially in cases where I knew what should be done, but didn't have the skills or experience to do it.

    So, yes... pretty scary.

  • Forgot to add that if I looked like *that* whilst on steroids I would not be at all annoyed!

  • EmH, I want some of those steroids too. I was a size 12 and at 5 11"" was underweight until my 1st encounter with long term pred!

    I am lucky in that even SHO's have gone ""oh my gods bleep the reg and ITU"" when I appear the most they do is hang around get ABG's, try to get a line in (ha ha) and catch up writing the drugs once the fuss is over. Having said that there have been times when others with me have had to ask for someone who knows what they are doing, I am glad I was not aware of those times.

    Bex

    ps is the downlaod working for anyone esle?

  • Being in the situation where someone is going off with a big style asthma attack, there is a junior SHO trying their best to manage it, and you are sitting in the next bed listening in thinking 'I know they shoudn't be doing that' is not very comfortable, either. I always want to get up and help them!

    Thankfully, as a national tread and certainly at my local, Acute Medicine is becoming increasingly a consultant and registrar led specialty. I think if you are a regular at your local with sudden onset attacks, it's usually better as well - the nurses in Resus at my local know to call the reg or consultant if I am on my way. I must admit having my own personal doctor husband who is quite happy to say if things aren't being done the way they should be does help quite a lot too!

    Em

  • I had trouble getting it to download but my boyf went on and it worked - i'm starting to think computers don't like me!!!

    I'd def not get away with taking that small a bag around with me - I always need a large bag for the inhalors, spacer and extra's!

    I know what you mean as well about looking like that on steriods!

    It was scary to think the ambulance took so long to turn up and the fast responser was left alone - luckily that has never happened to be, i'd say at most a solo person has been with me minutes before others turn up but i suppose it is probably something that does happen.

    I just hope some people have watched it and leanred from it!

    L x

  • I was just very distracted by Luke (the very erm nice first responder guy) hee hee

  • Err, I think you mean Gorgeous Greg, the Ausie!

    Kate

  • has anyone had people quizzing them on the episode? I found since it was on i have had a number of people(esp mums at school) asking me about it,is that what happenes to me etc.

    I dont have an issue with talking about my asthma but it is bugging me when mums i hardly know start cross examining me.

    Im glad i didnt let my girls watch the episode as they are already too aware of asthma's potential to kill but even they have been questioned in school.

    I do rather like Greg -wouldnt mind him as my R R paramedic!!

  • I do quite like Greg too!! I think its the australian accent!!! I used to love him in home and away and it was funny when he changed to Casualty!!

    I've had a few people quiz me about the episode but more along the lines of - "" I didn't realise how serious asthma could be."" etc etc

  • I have had a couple of friends ask me about the episode, strangely enough friends who have well-controlled asthma questioning the speed at which the girl went off - 'that's not very realistic, is it?'

    It has provided a good opportunity to say, well, actually, that's pretty much how it can happen in my rapid onset 'brittle' type attacks, and I think it has given them a little more insight into why I tend to be cautious about going away, carry Epipens and oxygen with me everywhere, and so on. Strange how they can hear me, a doctor and brittle asthma sufferer, tell them about it and not really take it in, but when they see it on Casualty they believe it!

  • OMG what am I thinking of? I meant Greg - I said Luke because he used to be my fave in the lasy series!!! Greg is more yummy!

  • I missed this episode because I was in hospital at the time. I wish I'd seen it though. Mind you, this thread is the first I'd heard of the episode, not having been asked about it by any of my friends, but then my friends have witnessed rapid onset attacks in me so maybe they don't have so many questions. It would've been interesting to see how it was portrayed on TV though.

  • Hi Emily H - Its just more real on TV isn't it! Perhaps its uncomfortable for them to think that your asthma is serious. Maybe they don't want to think of you as unstable with your asthma or acknowledge the impact this has on your daily life. There is a old indian proverb about not knowing what someone elses life is like until you have walked a day in their shoes or something. Although friends know we get ill from time to time and 'drop out' of our usual activities I think it is difficult for them to appreciate the real impact asthma has.

    I didn't know there was such a thing as brittle asthma until a few years ago - someone's child was diagnosed. I guess we only know what we have to know. There are a lot of ostritch asthmatics.

    An odd thing - When you see or hear someone's breathing in difficulty does anyone else find they are speeding up their breathing too? I find I do this mostly when I am ill myself. When my daughter was a baby and suffered with very chesty coughs I couldn't comfort her at night time because her breathing would make mine worse too . How suggestible does that make me???

    Take care.

    Sandi X

  • Sandi, I'm with you on the suggestibility thing - how strange is this? - I get wheezy watching people smoke on television!

    <blush>

    Can't believe I just admitted to that!

  • Hi Emily H, Huge LOL. I now blame my blushes on Pre Menopause less embarrassing maybe!?

    I have this reaction to smoking and pets - especially when people are stroking and fussing with them or if the dogs are jumping around. I get a wierd sort of chest tightening and I have to get a grip of myself and mentally tell myself to breathe properly. Perhaps its all suggestibility and in reality we are all well with normal untwitchy lungs (off to fantasy land again - blame the 1 tab of pred I took today)

    Yes I have taken my last one and am glad, however I keep avoiding doing my peak flow to make sure that things are back to normal. I have ordered a peak flow chart and will try and make myself do it daily to try and keep a check on things.

    I am hoping to go back to my gym next week. This week I've done all my usual things housework, walking around the village and in towncentre. Exciting stuff I know. But how good it feels.

    I am just hoping that when I get out there next week I dont encounter any more viruses.

    Hope you are well and keeping nice and cosy. Ooh just remembered I left the lid up on my propagator - will ask husband to go and put it down.

    Sandi X

  • brittle asthma

    the episode of casualty is only to true to me it happens sometimes so fast i havent got time to think i now have a warden control alarm for when i comes on so sudden as they get me the help i need and fast any one with such bad asthma should consider (espically if living alone like me) getting a warden alarm from your local social services or local council its only 4 pound a week and if your on benifits it costs nothing it could save someones life. best wishes xxx

  • I have a community care alarm too and the reassurance it provides (as well as the servive, of course) is great. I also have a key safe outside my front door (again provided by social services) so that a warden, social services, paramedics, police etc can get in if they get no answer from me either when I've called them or if they're expecting me to be in (eg when my carer is due). Definitely things to consider if you live alone/spend much of your day on your own and you have brittle asthma.

    Becky.

  • Hi, I am brittle too living independently.

    I have though about the key safe but my flat front is very open and I would be worried that someone would break into it. ( I don't trust my neighbour from hell!!) Also, not gone down the road of call care as I have neighbours who are key holders and I think would get to the door faster than call care as my local White taxi service is just down the road and then not busy are here within 3-4 minutes. I will consider it when (If!!) I move.

    Kate

  • I have brittle asthma and spend much of my day alone (apart from carer visits) as my husband works (more than) full-time as a junior doctor. I have a 'Lifeline' community care alarm which I pay about £4 a month for - well worth it, as when I have a severe attack I can become very unwell very rapidly. The local Ambulance Control also know to treat any call from my address (even a silent or hung up call) as a Cat A call, and they have a copy of my protocol.

    I do have a keysafe outside my house for my carers (or the paramedics) to let themselves in. The security aspects do worry me - there have been a few occasions when we've felt that the keysafe has been fiddled with. We don't leave a key in unless I'm in the house alone and awake (I'm not on my own at night, as a rule, anyway). I certainly wouldn't leave a key in there when the house was empty. I still worry, as I wouldn't be a lot of use at fighting off a burglar! - but I could at least press my Lifeline, I suppose! Anyway, it's the lesser of two evils, as I wouldn't be able to get to the door in an acute attack and I don't have neighbours that I know well enough to hold a key for me.

    I would certainly suggest that anyone who has severe attacks and is alone looks into these options.

    Em H

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