What happens in A&E?

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

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

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

  • the reliever inhaler doesn’t help
  • symptoms are getting worse
  • it’s difficult to speak, eat or sleep.

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 might 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.

While 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 30-60 seconds, up to a maximum of ten.

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.

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 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.

What will happen in A&E?

Many - but not all -  hospitals now have a separate children’s accident and emergency 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.

Registration

If you arrive by ambulance, the crew will register for you. If you arrive by yourself, you’ll be asked to register – you’ll need to answer a few questions about your personal details and your symptoms, and wait until you can be assessed in more detail.

Pre-assessment or ‘triage’

A nurse will assess your or your child’s condition to see how urgently you need treatment. This 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 is 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.

Treatments

The treatment you are given will depend on your assessment. It might include a nebuliser, or steroids in the form of liquid, tablets or (in the most urgent cases) injected into a vein. Then a healthcare professional will review you again to see how you react to the treatment and whether you can go home, or need to be admitted.

Next steps

At this point, you might 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’re doing a lot better, you might be told to go home and make an appointment with your usual GP. You might also be given a prescription for medicines you can pick up yourself.

Going to A&E is a sign that asthma isn’t as well controlled as it could be. The hospital should always let your GP know so they can follow up and suggest ways to control your asthma better, perhaps by making a change to your regular medicines.

But this doesn’t always happen, or it can be very slow, so always do contact your GP and let them know – it won’t matter if you and the hospital both give them the same information. Booking an appointment for an urgent asthma review within two working days will help you take control after a frightening experience, and reduce the risk of you having to go back to hospital again soon afterwards.

Read our advice on looking after yourself physically and emotionally after an asthma attack.

How to avoid needing A&E

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

Research shows that people who have filled in a written asthma action plan with their GP or asthma nurse are four times less likely to have to go to A&E with their asthma – which is good news for you, your GP and everyone else in the waiting room. Check out our advice on getting the best from the NHS, wherever you are treated.

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 October 2016

Next review due October 2019