Getting to Hospital
As part of your crisis plan you should work out how to get to a hospital as nebulised reliever medication and oxygen may be required.
If your asthma is at the point where you need to get to the hospital or emergency center immediately then do not drive yourself. Get a neighbour, family member or call an ambulance. You may not be thinking clearly and taking yourself to the hospital could be dangerous. Driving will also be exhausting or your asthma may get worse on the way and you may not be able to get out of the car and walk into the emergency room. It is better to call an ambulance that will have all the necessary equipment to cope with your attack.
The Hospital Casualty Department:
On arrival, if you are not extremely ill, you will talk briefly with the receptionist, who will record vital information. You will then be seen immediately by a doctor or nurse. If you are extremely ill on arrival it may be difficult to indicate the severity of the problem to the clerical staff – simply say “severe asthma attack” with conviction.
The treatment procedure is usually as follows:
The casualty doctor will normally assess the condition with a physical examination.
A nebuliser of reliever medication is given to ease your breathing difficulties. If there is no improvement, cortisone may be given intravenously. It takes approximately 3 hours for cortisone to work.
Blood oxygen levels may be monitored and if the attack is particularly severe than an arterial blood test is taken to see how much oxygen there is the blood and how much carbon dioxide building up. According to these figures the medical team may or may not put the asthmatic straight in intensive care and assist with ventilation
Once your condition has stabilised and the doctor feels confident with your progress you are will be allowed to go home. This could be any time between one hour and two weeks depending on the severity of your attack.
What can the hospital offer?
A staff of professionals who treat attacks all the time
The ability to assess the severity of the asthma attack quickly and accurately, usually without having to resort to many tests
A wide variety of medications proven effective for acute asthma and its complications, and ways to get them to your lungs quickly and safely
Oxygen, which may be needed when asthma becomes very severe
Mechanical ventilation devices, when the work of breathing becomes too difficult
Testing for possible underlying causes of asthma attacks, such as a chest X ray for lung infections. Access to pulmonary specialists for very advanced asthma attacks
The casualty staff efficiently and effectively treat asthma so it is extremely rare to die from asthma once you reach the casualty department. Generally they are not there to review what went wrong or to suggest follow-up treatment. After a severe attack, you need to see your doctor. You should review why the attack occurred and consider adjusting the treatment plan.
Continue to take the preventer medications prescribed for you. It is especially important that you do not suddenly stop taking a course of oral cortisone.
If you are using reliever medications every day then you need to also take preventers.
It is not recommended to take reliever medication unless you actually have symptoms. Be prepared to discuss this matter with the doctor if he/she suggests that you take relievers every four hours even if you do not have asthma. Studies suggest that regular use of relievers when you do not need them can make asthma worse. It is generally accepted that reliever medication should be used on an “as needed” basis.
Drink lots of clear fluids as part of your recovery as this will help to prevent dehydration and make the excessive mucus easier remove.