Asthma care in the ambulance

If your asthma means you have to go to A&E in an ambulance, this is what you can expect

No one wants to think about themselves or someone they love having asthma symptoms so bad that they have to be rushed to hospital in an ambulance. But knowing what might happen when you call an ambulance and during the journey to hospital can help you feel a bit more prepared and in control. 

Calling 999 for an ambulance

When you (or someone with you) calls 999 for an ambulance, you’ll be asked:

  • Where you are, including the postcode. It can be helpful to have your address and postcode written down somewhere handy in case someone is making the call for you and you’re finding it hard to speak. People may not know your full address, and even if they do it’s easy to forget things in an emergency situation. 
  • What’s happening, and why you need an ambulance. Make sure friends and family know that if you can’t breathe and your reliever inhaler isn’t working you’re having an asthma attack.
  • The number you’re calling from. Make sure this is readily accessible so the person calling on your behalf can give it easily. Again, it’s easy to go blank in a crisis – even if you’re making the call yourself you might forget your own number.

If you or your child has asthma make sure you know the signs of an asthma attack and when you might need to call an ambulance.

“If you’re having asthma attack and finding it hard to breathe, call 999. We’d rather you call an ambulance, even if it turns out you don’t need it, than not call an ambulance and wish you had.” Dr Andy Whittamore, Asthma UK’s in-house GP.

Who will answer the call?

The person taking your call is known as the Emergency Medical Dispatcher or EMD. They decide how urgently you need help and make the decision about sending out an ambulance if necessary. They use a computerised system to make sure that people who need the most urgent care are seen first, and send out the nearest suitable vehicle - an ambulance, if you need to be taken to hospital, or a rapid response vehicle like a motorbike so you can get quick treatment from a paramedic first.

They may also give you advice on things that you can do while waiting for help such as continuing to take your reliever inhaler, and noting any symptom changes. It’s important to stay on the line until the EMD says it’s alright to hang up, and to call back if symptoms change.

Try not to get frustrated if you are being asked a lot of questions – an ambulance will already be on its way if there is one available, so the EMD isn’t delaying your treatment by continuing to ask questions. 

The EMD may also ask you to:

  • open the front door and turn on lights if it’s dark, so it’s easy to find you
  • collect any medicines or medical details (such as an asthma action plan or GP’s name). This can be helpful for both the ambulance staff and staff in A&E
  • make sure any pets are shut in another room.

When the ambulance arrives

When you need to go to hospital in an ambulance, it can be reassuring to know how the ambulance crew will look after you. Here, Liam Twomey, a member of the ambulance crew, answers your questions.

Q. Who will arrive to treat me?

A. The first person to arrive may not be the ambulance itself. Asthma is a high priority and if a solo responder – a paramedic on a car, bicycle or motorbike - is closer then they may get to you first, so we can start treatment that much sooner.

There’s very rarely anyone in the ambulance who’s there just to drive – everyone will be medically trained. Ambulances are not just for getting you to hospital as quickly as possible – the healthcare professionals on board are trained to treat your asthma symptoms, assess whether you actually need to be taken to hospital  and run tests or refer you to other services. They might include emergency care assistants, paramedics and specialist or senior paramedics.

Q. What treatment will I get when the ambulance crew first arrives?

A. The first thing we do when we arrive is assess you. This will include listening to your lung sounds, measuring oxygen levels and if possible, taking a peak flow reading. If you’re wheezing or having other symptoms suggesting an asthma attack we’ll start treating with a nebuliser, which you hold over your nose and mouth.

Q. What will the crew have been told about my condition?

A. We’ll know just what we’ve been told by the EMD. So the more information you can give the EMD the better we can help you.

Q. How will you decide if I need to be moved into the ambulance?

A. It depends on how bad your asthma attack is. If we’re able to control your symptoms easily we may treat you where you are and leave you at home with a GP referral, but this is less frequent. Most people who call 999 for asthma will need to go in the ambulance to hospital.

We will start treatment immediately, and whether we leave quickly to get you to A &E or take a little more time depends on how responsive you are to treatment. If we decide that you need to go to hospital and you are too unwell to walk to the ambulance, we will use a type of chair to carry you. It can be unnerving to be carried up or down stairs, but it is perfectly safe.

"If the paramedics don’t take you to hospital, make sure you get a follow-up with your GP or asthma nurse as soon as possible. If you have had a flare-up of your asthma, you’re at risk of it happening again without the right treatment.” Dr Andy Whittamore, Asthma UK’s in-house GP.

Q. What medicines might be used?

A. Our first line treatment will be a salbutamol nebuliser. This opens up the airways. If this doesn't work, we will use ipratropium bromide in the nebuliser, which further opens the airways and can help to reduce mucus. We may use this earlier for children, as it works particularly well for them.

We would also consider putting a steroid called hydrocortisone into your veins, which reduces the swelling around the airways.

In the most severe attacks we inject adrenaline into a muscle. This opens the airways even more.

Q. How will I be transported in the ambulance?

A. In the ambulance we’ll usually have you sitting upright as this is best for your breathing. This could be either in a chair or a bed. We’ll ask you to wear a seatbelt for the journey. Depending on how bad your attack is, we may use the lights and sirens to help us get you to hospital more quickly. If we do need to get to hospital quickly, we’ll pre-alert the A&E department that we’re coming so they are ready to see you on our arrival.

Q. Will someone else be able to come with me?

A. We can usually take one friend or relative with you, but that may change if we already have a student paramedic with us. It’s a good idea to ask the crew when they arrive.

Q. Can the ambulance crew contact my family or next of kin?

A. This depends on the situation. The ambulance crew’s priority is to get you to hospital. Once you’re there, hospital staff will help you contact anyone you need to.

Q. What happens if I’m in charge of children or pets when the attack happens?

A. If it’s possible, we will help you find a suitable adult to care for the children while you go to hospital. If no other option is available then we will take the children with us in the ambulance.

Sometimes people are worried about leaving pets too, so we do what we can to make sure any pets are safe and looked after too.

Q. Will the ambulance crew leave my house secure?

A. Yes, we will lock up as we leave, and you can usually watch us do this for your own peace of mind.

Arriving at A&E

Once you get to hospital, your care will be transferred from the ambulance crew to the A&E department. Everyone is assessed in the same way, whether they arrive on their own or by ambulance, to make sure that people who need the most urgent care are seen first.

Read more about what you can expect if you have to go to A & E with your asthma, and if your condition means you have to be admitted into hospital for a bit longer.

Last updated October 2016

Next review due October 2019