What To Expect In The Emergency Room
When you get to the emergency room, the staff will evaluate your symptoms and risk factors. This gives them information about the likelihood of a life-threatening situation. Risk factors can help them in this process even if you appear stable.
The strongest risk factor for a potentially fatal asthma attack is having been admitted to the hospital for an asthma attack in the past. You will need extremely close monitoring in this case. Other risk factors include having a history of poorly controlled asthma or recently needing oral corticosteroids to manage your disease.
Adult asthma emergencies require aggressive treatment. This will include supplemental oxygen and inhaled medicines to relax and open your airways. The staff may give you medicines through a nebulizer or with an inhaler. The inhaler doses will be very frequent, sometimes every 30 seconds. They will continue until you improve or cant tolerate the side effects. You will also get corticosteroids either by mouth or through an IV line. These medicines will help stop the asthma attack. A nurse will remain with you and monitor your condition until you show signs of improvement. Monitoring will include continuously measuring your oxygen levels and checking peak flow rates periodically.
Are You Suffering A Severe Asthma Attack
In an emergency, you need to act fast. Heres a list of emergency contact numbers around the world:
- In the UK, dial 999.
- In the US, dial 911.
- In Canada, dial 911.
- In New Zealand, dial 111.
- In South Africa, dial 10 177.
Note that 112 also works in any European Union country and the UK.
You can find a comprehensive list of worldwide emergency contact numbers here.
Can Asthma Be Prevented
Asthma cant be prevented entirely, but there are some practical ways to reduce the risk of an asthma attack and live well with asthma.
- Get vaccinated for influenza: flu and other respiratory viruses are common triggers for asthma.
- Manage any allergies: asthma and allergies are closely linked, so treating allergic rhinitis and avoiding or managing any allergy triggers will help with your asthma.
- Live smoke-free: quit smoking if you smoke, and avoid any second-hand smoke .
- Eat well: a balanced diet helps you to maintain a healthy weight. Being overweight or obese makes asthma harder to manage.
- Care for yourself: mental health and asthma are linked, so let a trusted friend or your doctor know if you have been feeling sad or anxious, or dont enjoy things as much as before.
- See your doctor regularly: asthma needs to be regularly assessed and managed, and your medication needs may change over time. Ensure your asthma action plan is up to date by checking in with your doctor regularly.
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What To Expect When You Go Home
Doctors may send you home if your peak flow rates and symptoms improve with treatment in the emergency room. Or, you may go home after a hospital stay. Before you leave, the staff will spend some time with you to make sure you have the tools you need to stay healthy. This includes explaining the criteria for asthma control and what it looks like when the disease is under control:
- Being able to do all normal activities
- Having a peak flow rate greater than or equal to 80% of your best rate
- Having no more than one asthma attack per year that requires oral corticosteroids
- Having symptoms no more than twice a week
- Using rescue medicines no more than twice a week
- Waking from sleep due to symptoms no more than twice a month
You will likely leave with prescriptions for both inhaled corticosteroids and a course of oral corticosteroids. The staff will review the purpose of each of your asthma medicines and how to properly use your inhalers. If you struggle to use inhalers, ask the staff about nebulizer treatments.If you didnt have an asthma action plan when you arrived, the staff will give you one before you leave. They may update your plan if you had one. The plan will cover how to avoid asthma triggers and check peak flow rates. Most importantly, it will spell out what medicines and actions to take in each asthma zone. Some general guidelines for asthma zones are as follows:
Everyones Threshold Is Different
I was once treated in practice where I needed to come in immediately even if I had even slight changes. I was then managed in a practice that used different criteria, where there was data that needed to be tracked and then a call with an RT or nurse. I have even had the false positive, a common cold that was mostly viral that I thought was exacerbating my asthma but it turned out to just be viral.
What are your thresholds? What parameters have you determined with your care team? Do you use other indicators to tell you when you need to see your asthma doctor? I would love to hear about your experiences in the comments below.
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When To Get A Cough Checked Out
A person should seek medical attention for a subacute or chronic cough.
Different types of cough vary in how long they last. For example:
- acute coughs last less than 3 weeks
- subacute coughs last 38 weeks
- chronic coughs last over 8 weeks
Each cough can have a different cause, and some may require medical attention. Most acute coughs have less serious causes, such as a cold. It is not necessary to see a doctor in these cases.
However, subacute and chronic coughs could be a sign of something more serious that may require medical attention.
It is also important to see a doctor if the cough occurs with other, more serious symptoms, such as:
- coughing up blood
- unexplained weight loss
If You Develop New Symptoms
You should have a good idea of what is typical for you when it comes to asthma. If your asthma is under control, youre likely aware of potential triggers and following a treatment plan. Common early warning signs of an impending panic attack are fatigue, irritability, feeling breathless when exercising, and feeling on edge.
Many individuals with asthma know their early warning signs and have a plan to act promptly to reduce the severity of the attack. But sometimes new symptoms may emerge and take you by surprise. If new symptoms crop up, its a good idea to come see us.
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How Do You Monitor Asthma Symptoms
Monitoring your asthma symptoms is an essential piece of managing the disease. Your healthcare provider may have you use a peak flow meter. This device measures how fast you can blow air out of your lungs. It can help your provider make adjustments to your medication. It also tells you if your symptoms are getting worse.
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Symptoms Of An Asthma Attack
Signs that you may be having an asthma attack include:
- your symptoms are getting worse
- your reliever inhaler is not helping
- you’re too breathless to speak, eat or sleep
- your breathing is getting faster and it feels like you cannot catch your breath
- your peak flow score is lower than normal
- children may also complain of a tummy or chest ache
The symptoms will not necessarily occur suddenly. In fact, they often come on slowly over a few hours or days.
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How Can We Avoid A Trip To The Er
Well-managed asthma is rarely life-threatening. Taking asthma medicines as prescribed can help prevent severe asthma flare-ups and the need for emergency care.
Be sure to schedule and keep follow-up visits with your doctor and to track your child’s asthma.
It’s important to monitor your child’s asthma using the written asthma action plan your doctor helps you create. This plan will outline day-to-day treatment, symptoms to watch for, and step-by-step instructions to follow during a flare-up.
Taking asthma seriously and working to manage it can make it less likely that your child will need to go to the ER.
Advice For Friends And Family
It’s important that your friends and family know how to help in an emergency.
It can be useful to make copies of your personal asthma action plan and share it with others who may need to know what to do when you have an attack.
You can photocopy your existing plan, or you could download a blank personal asthma action plan from Asthma UK and fill it in for anyone who might need a copy.
Or you could take a photo of your action plan on your phone, so you can show or send it to others easily.
Page last reviewed: 19 April 2021 Next review due: 19 April 2024
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Acute Versus Chronic Coughing
Its one thing if you cough here or there. But if you have an acute or chronic cough, its time to look for answers.
Acute coughs typically last less than three weeks. However, this type of cough can linger for up to eight weeks, especially if you recently had a respiratory infection. Acute coughs usually occur in response to factors like:
- Allergens, ranging from pollen and mold to pet dander
- Environmental irritants, like dust or smoke
- Upper or lower respiratory infections
- Serious underlying conditions, like pulmonary embolism
In most cases, having chronic respiratory conditions like asthma can exacerbate an acute cough.
Unlike an acute cough, chronic coughs last longer than eight weeks and often occur because of health problems or chronic respiratory conditions. For example, sleep apnea, gastroesophageal reflux disease , asthma, heart disease, and lung cancer can all cause a chronic cough. You can even develop a chronic cough from taking certain medications.
When To Call 999
youre having an asthma attack and your symptoms dont improve after ten puffs of your blue reliever inhaler.
An asthma attack is a medical emergency and its vital to treat it quickly. Because asthma is a high priority, you may be sent a rapid response paramedic ahead of the ambulance. This means you can start to be treated sooner.
Don’t ask for a lift or call a taxi. Call 999 for an ambulance so the paramedics can start treating you immediately and take you to the most appropriate A& E.
- your GP surgery is closed
- your symptoms are getting in the way of your everyday activities
- your symptoms are waking you up at night
- youre using your reliever inhaler three or more times a week.
The NHS 111 service is for medical problems that are urgent, but not life-threatening, and youre not sure what to do when your GP surgery is closed. The NHS 111 service is available 24 hours a day, seven days a week.
When you call 111, be ready to answer questions about your symptoms. This is so the caller can give you the right advice about what to do, and where to go for further help.
They might suggest you go to A& E, a walk-in centre, or get an urgent same day appointment at your GP surgery/out of hours centre.
If you’re using the NHS 111 website, remember that it isn’t for children under 5.
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What Are Common Asthma Attack Triggers
An asthma attack happens when someone comes in contact with substances that irritate them. Healthcare providers call these substances triggers. Knowing what triggers your asthma makes it easier to avoid asthma attacks.
For some people, a trigger can bring on an attack right away. Sometimes, an attack may start hours or days later.
Triggers can be different for each person. But some common triggers include:
- Air pollution: Many things outside can cause an asthma attack. Air pollution includes factory emissions, car exhaust, wildfire smoke and more.
- Dust mites: You cant see these bugs, but they are in many homes. If you have a dust mite allergy, they can cause an asthma attack.
- Exercise: For some people, exercising can cause an attack.
- Mold: Damp places can spawn mold. It can cause problems for people with asthma. You dont even have to be allergic to mold to have an attack.
- Pests: Cockroaches, mice and other household pests can cause asthma attacks.
- Pets: Your pets can cause asthma attacks. If youre allergic to pet dander , breathing in the dander can irritate your airways.
- Tobacco smoke: If you or someone in your home smokes, you have a higher risk of developing asthma. The best solution is to quit smoking.
- Strong chemicals or smells.
With asthma, you may not have all of these symptoms. You may have different signs at different times. And symptoms can change between asthma attacks.
Recognizing Serious Cough Symptoms
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When To See Your Gp Or Asthma Nurse
Ask for an urgent appointment with your GP or asthma nurse if:
- your symptoms are coming back
- youre waking up at night because of your asthma
- your symptoms are getting in the way of your day-to-day routine
- you’re having symptoms, and using your reliever inhaler, three or more times a week.
These are all warning signs that you may be at risk of an asthma attack. Talk to your GP or asthma nurse about your asthma medicines. They can check you’re taking them in the correct way.
Getting help now means you can cut your risk of what could be a life-threatening asthma attack.
If your GP or nurse has given you a specific phone number to call when youre concerned about your asthma, continue to use that number.
But if you’re finding it hard to breathe, or your reliever inhaler isnt helping, call 999.
Book a routine appointment with your GP or asthma nurse if:
- you’re due an annual asthma review
- youre worried about the side effects of your medicines, or medicines not working as well
- you need health advice – for example, information about giving up smoking
- you’ve just come out of hospital after an asthma attack book an appointment within two days.
Always remember to take your written asthma action plan with you. If you haven’t got one, fill one out with your GP or asthma nurse at your next appointment.
Next review due September 2023
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What Causes Asthma Symptoms To Flare Up
Your asthma can flare up for different reasons. If you’re allergic to dust mites, pollens or molds, they can make your asthma symptoms get worse. Cold air, exercise, fumes from chemicals or perfume, tobacco or wood smoke, and weather changes can also make asthma symptoms worse. So can common colds and sinus infections. Gastroesophageal reflux can also cause flare-ups. You can help yourself by paying attention to the way these things affect your asthma. Your doctor might test you to find out if you’re allergic to something. Then your doctor can help you avoid the things that bother your asthma.
Some Asthma Symptoms Are Only Present During An Asthma Attack
An asthma attack is when a persons asthma symptoms become worse or more noticeable. During an attack, the muscles around the airways tighten more than usual, and the airways produce an overabundance of mucus.
The typical signs of an asthma attack can include any of the following:
Wheezing This refers to a whistling or squeaky, almost musical sound during breathing.
Shortness of Breath This simply means feeling like you can’t get enough air into your lungs.
Rapid Breathing In response to not getting enough air in each breath, your body may speed up your rate of breathing.
Coughing A cough during an asthma attack may contain phlegm.
Chest Tightness This can take the form of pain, pressure, or feeling like something is squeezing or sitting on your chest.
Not everyone with asthma experiences symptoms the same way, and asthma symptoms can differ between attacks. Asthma attacks require immediate treatment with a rescue or quick-relief inhaler or other medication recommended by your doctor.
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