What happens in A&E?

If you ever have to go to Accident & Emergency with your asthma it’s helpful to know what to expect when you get there

Calling 999

Waiting for the ambulance

What happens in A&E

What to do after A&E

Lower your risk of another trip to A&E

 

Calling 999

Many people with asthma will never need to be treated in hospital. But if you do, it’s vital to act quickly.

People with asthma sometimes tell us they don’t want to “cause a fuss” but it’s always better to be safe than sorry.

And it’s not wasting the paramedics’ time: NHS guidelines say that 999 is “for medical emergencies, when someone is seriously ill and their life is at risk”. It’s a shocking fact that three people die from their asthma each day in the UK.

You (or someone you’re with) should call 999 for an ambulance right away if you (or your child) are struggling to breathe and:

  • your blue reliever inhaler isn’t helping (after you’ve taken one puff every 30 to 60 seconds up to 10 puffs) or you need to use it more than every four hours
  • your symptoms are getting worse at any point or you don’t feel better after 10 puffs of your reliever inhaler
  • it’s difficult to walk or talk.

Even if you feel able to get to A&E yourself, you should call 999 for an ambulance, because:

  • you can be treated on the way to stop your symptoms getting worse – or, if you are an adult, you may be treated at the scene so you don’t have to go to hospital
  • you can get to hospital more quickly
  • you can be looked after and monitored by trained healthcare professionals.

Waiting for the ambulance

Whoever is having the asthma attack should try to stay calm and sit upright – don’t lie down. If the ambulance is taking more than 15 minutes, take another puff of your reliever inhaler every 30 to 60 seconds, up to a maximum of 10.

Some people find that loosening tight clothing helps them feel more comfortable. 

Save time and get treated more quickly

If you or your child have to go to hospital, there are a few things you can take with you to help the healthcare professionals to treat you:

  • Your inhalers (and spacer, if you use one)
  • Any other medicines you take for asthma or other conditions
  • Your asthma action plan, or a photo of it on your phone, so you can pass on information about your triggers, peak flow and medicines even if you can’t speak.

You may find it useful to keep a copy of your asthma action plan with a list of all your medications in an obvious place so that you (or a paramedic or friend) can grab it in an emergency.

Local Lions Clubs also give out Message in a Bottle kits, including a sticker to tell paramedics that your medical details are stored in the fridge if you don’t have the breath to talk when they arrive.

If you’ve been diagnosed with severe asthma, you can find some tips for getting the emergency treatment you need quickly here.

People with asthma tell us it’s also a good idea to take:

  • Water or other drinks and snacks
  • Loose change for vending machines
  • Extra clothes, and books or toys for children – you may need to be there for a few hours. 

What happens in A&E?

Registration at A&E for an asthma emergency

Once you get to A&E you need to register first. If you arrive by ambulance, the crew will register for you. You’ll need to give personal details like your name and address, and tell the reception team what your symptoms are and why you're visiting A&E. 

Many – but not all – hospitals now have a separate children’s A&E department where your child will be assessed by healthcare professionals who are trained to diagnose and treat children. The series of steps you go through is the same as in a general A&E, but the waiting room and cubicles will be more child friendly.

Once you’re registered you’ll need to wait for a first or pre-assessment. 

Pre-assessment by a nurse or doctor

A nurse or a doctor will assess you or your child’s condition to see how urgently you need treatment. This is known as ‘triage’. Anyone going to A&E is assessed in this way to see how urgently they need to be seen. It makes sure that the people who are most in need (whether they arrived alone or in an ambulance) are seen first, so you may have to wait.

Most A&Es aim to triage you within 15 minutes of registration – but if you or your child feel worse in that time, tell any member of staff in the department (or ask someone who’s with you to tell them) and they will direct you to the right person.

People whose condition is not serious may be referred to a GP on site.

Asthma treatments in A&E

The treatment you’re given will depend on your assessment. It may include being given medicine through a nebuliser, or steroids in the form of liquid or tablets.

In the most urgent cases, steroids will be injected into a vein or medicines given through a cannula (a small tube inserted into a vein, usually in the back of your hand.)

You may need X-rays or scans to help the A&E team get a full and clear assessment of your condition.

Once you or your child have been treated, you’ll need to wait to see if your symptoms improve. This could be for four hours or more. Doctors will want to be sure treatments have worked and it’s safe to send you home. 

At this point a decision will be made about whether it’s OK for you to go home, or whether you need to be admitted to hospital.

If you need to stay in hospital, you may be admitted to another department, such as a ward or intensive care. Depending on your condition, you might be seen by a combination of healthcare professionals, including a respiratory specialist or physiologist.

If you can go home you’ll be asked to make an appointment with your usual GP. You may also be given a prescription for medicines you can pick up yourself.

What to do after A&E 

Read our advice about what you need to do within 48 hours of having an asthma attack.

Before you leave hospital you should be given a clear plan about what to do next and when to see your GP for a follow up.

The hospital should let your GP know what’s happened but this doesn’t always happen, or it can be very slow. So always contact your GP yourself – it won’t matter if you and the hospital both give them the same information.

Going to A&E is a sign that asthma isn’t as well controlled as it could be, so it’s really important to follow up with your GP within two working days.

Your GP can suggest ways to control your asthma better, perhaps by making a change to your regular medicines. Talking to your GP about what happened can help you take back control after a frightening experience. It also reduces the risk of you having to go back to hospital again soon afterwards.

If you’re worried about time off work because of your asthma attack we have some advice here.

Lower your risk of another trip to A&E

Although it can seem like a hassle to take your preventer medicines every day, even when you’re feeling well, it really is the best way to reduce the risk of having an asthma attack and ending up in A&E.

Everyone with asthma should have an asthma action plan. Having an action plan means you're better equipped to manage your symptoms and so less likely to be admitted to hospital for your asthma.  

For a lot of people, asthma attacks don’t come out of the blue – symptoms gradually get worse over the course of a few days. So if you or your child have been wheezing or waking more in the night, or you’re starting to struggle doing things you usually can, now’s the time to take four actions to prevent an asthma attack and stay out of hospital.

 

Last updated August 2019

Next review due August 2022