“I’m off to work now, Dad,” Alicia* called as she raced for the front door. “Don’t wait up for me.”

Her dad called from the living room, “Okay. Have a good night. Hey! You got your inhaler?”

“Don’t need it. I’m okay now. Gotta go.”

Her dad called out again, “Alicia, take your inhaler with you.”

Hearing the door slam shut, he smiled and muttered to himself, “She’ll call in an hour and ask me to bring it down for her.”

But Alicia didn’t call. In an hour, the 19-year-old waitress would be dead.

Fifteen minutes later, Alicia was sitting with the DJ in the bar where she worked on-call, a nice change of pace from her part-time day job at a fast food counter. And she really liked the DJ. Tonight, their pre-shift chat perked her up, but it couldn’t distract her from the tightening in her chest. Alicia just couldn’t catch her breath. Finally, she excused herself and headed for the bar.

It wasn’t a long walk – about 25 feet. And the room wasn’t that smoky tonight, either. Still, Alicia’s chest began to hurt and she felt the familiar sense of fear that came with her asthma attacks.

“Michelle,” Alicia whispered to the bar manager at the counter, “I’ve got to get out of here. I need to get to the hospital. I wish I had my puffer with me.”

As Michelle guided her toward the back door, Alicia collapsed on the dance floor. From the patrons, Michelle found an inhaler, but Alicia couldn’t use it properly, the mist spraying into her face. Michelle panicked. Unsure of what to do, she called the bar owner. Then she called 911.

When the ambulance arrived five minutes later, Alicia was unresponsive, without a pulse. She stopped breathing. By the time she reached the hospital, Alicia was dead.

COULD THIS DEATH HAVE BEEN PREVENTED?

The bar might not have been overly smoky during Alicia’s final shift, but secondhand smoke (also known as environmental tobacco smoke or ETS) is a known asthma trigger.

Even though the bar had a “smoke eater” installed – a ventilation system that draws air from the bar area – it only reduces the odor. Ventilation systems do not guard against ETS health dangers. There’s only one sure way to do that: ban indoor smoking entirely.

During the investigation, it was also learned that the bar did not have an emergency response plan in place. The bar manager, in her panic, did not call 911 first. Instead, she phoned the bar’s owner, losing valuable time.

It is important that business owners develop an emergency action plan that identifies all possible threats and hazards and spells out what employees should do during an emergency. It is equally important that employees familiarize themselves with this plan. Had the bar manager called 911 first, the emergency response team would have had more time to provide Alicia with treatment. And, of course, Alicia should have had her inhaler with her.

*Not her true name.