Asthma in intensive care

Support and advice if you, or someone close to you, has to stay in intensive care for asthma

Health advice > Asthma care in the NHS > Emergency asthma care

What is intensive care?

The intensive care unit (ICU) is a specialist hospital ward for treating people who are the most critically ill. It’s sometimes called the critical care unit (CCU) or intensive therapy unit (ITU). 

In ICU, the team of doctors and nurses are trained to look after patients who are very unwell. There’s usually one nurse for every one or two patients so they can monitor you closely.

If you’re having severe asthma symptoms but don’t need one-to-one care, you might go to the high dependency unit (HDU) instead. Here, each nurse may be looking after two or three patients.

Being admitted to ICU or HDU can feel scary. But you’re in the right place to get the best treatment to bring your asthma back under control. And the staff are focused on giving you the best care.

When you might need intensive care for your asthma

You may need to be admitted to intensive care (ICU) if:

  • you’re having a severe or life-threatening asthma attack that isn’t responding to treatment
  • you’re showing signs of being exhausted, drowsy or confused
  • your oxygen levels are too low and the level of carbon dioxide in your body is increasing
  • there’s a risk that you could stop breathing, or are struggling to breathe on your own.

If you go to A&E with these symptoms, you may go to ICU after being stabilised.

How will your asthma be treated in intensive care?

In ICU, the team is focused on giving you lifesaving medicines and helping you breathe.

You’ll probably be connected to machines with lots of tubes and wires. And you may have lots of hospital staff working around you at the same time.

These include:

  • Intravenous (IV) lines. These give you fluids and medicines straight into your bloodstream, so they work faster to support your whole body, and treat your asthma symptoms. You’ll have a cannula (a tube) put into a vein; this is connected to a narrow tube called an IV line.
  • A face mask. This goes over your nose and mouth and gives you air and oxygen to help your breathing.
  • A ventilator. This is a machine that helps your breathing. You might be put on a ventilator if doctors are very worried about your breathing or the oxygen and carbon dioxide levels in your blood, or if you’re unconscious. The doctors will put a tube through your nose or mouth into your airways. You’ll be given medicines to relax and sedate you first, so you’re more comfortable.
  • Monitoring and measuring equipment. These machines keep an eye on important body functions like your heart rate, blood pressure and oxygen levels.
  • A catheter. This is a tube going into your bladder to drain urine.

You might need other treatments in ICU, like physiotherapy, or suction through a mouth or nose tube to help clear mucus and fluid from your lungs.

The doctors can give you painkillers or sedatives (medicines that calm you down) to help you cope with uncomfortable procedures.

Are visitors allowed in ICU?

Visitors are allowed, and visiting hours are often more flexible in ICU than on general wards. But check with the unit first. 

How long do you need to stay in intensive care for your asthma?

Some people are in intensive care for a few days, but some will be in for shorter periods, and some for longer.

Once you’re improving, the ICU team will gradually reduce the amount of help you’re getting from the machines supporting you.

Then, when you’re well enough, you’ll be moved either to the high dependency unit (HDU) or straight to a general ward.

If you’re moved into the HDU, it’s because your doctors think you still need closer monitoring than you’d get on a general ward. 

If you go to a general ward, the staff will be given a written plan from the ICU team, so you get the care you need.

Whether you’re in HDU or on a general ward, your care team will continue to give you the treatment you need to get your asthma back under control, and monitor you to see how well you’re recovering.

Find out more about what to expect if you’re staying in hospital.

Being discharged from hospital after being in ICU

Once you’re well enough, you’ll be discharged from hospital and can go home.

You should be referred to a specialist consultant or a specialist asthma care centre for a follow-up appointment to help you manage your asthma going forward. Find out what to expect from specialist asthma care.

Before you leave hospital make sure:

  • you have a written asthma action plan to take away with you
  • you see someone in the specialist respiratory team to review your treatment plan and explain anything you need to know
  • you understand any medicines you need to take and how to use them, and have collected them from the hospital pharmacy
  • the hospital has told your GP about your asthma attack and you have a follow-up appointment booked as soon as possible, and certainly within two days of leaving hospital
  • you know when you’ll need a follow-up with a specialist consultant or at an asthma care centre

Coming to terms with your experience in ICU

Being unwell enough to need treatment in intensive care can be a traumatic experience. You might feel:

  • weak, tired and lacking in energy, possibly with no appetite
  • stiff from being in bed for a long time
  • like you can’t think clearly or are forgetful
  • depressed or anxious

It’s normal to need some time to recover and come to terms with what’s happened.

Be realistic about your recovery time and set some small, achievable goals. For example, you could contact friends on the phone or by message if you’re not up to socialising, do small bits of housework, or go for gentle walks.

If you’re going back to work, you might be able to build up your hours gradually. Talk to your employer about how they can help you, and read our advice for managing asthma at work.

If you’re struggling with your recovery, speak to your GP or asthma nurse. They can help you get the support and treatment you need.

Some ICU departments allow patients to come back for a look around the unit, as a way for them to come to terms with their experience. If you think you’d benefit from doing this, call first to see if it’s possible or not. And think carefully about if and when you’re ready to do this.

You can also speak to our asthma nurses on 0300 222 5800 (Mon-Fri 9am-5pm) or you can WhatsApp them on 07378 606 728.

Friends and family may need time to come to terms with it too

Remember that this may have been a scary experience for close friends and family, and they might be struggling to come to terms with it too.

Talking about what happened might help them as well as you. Remember that they can contact our asthma nurses for support, too.

How can I avoid going to intensive care for my asthma again?

There are things you can do to reduce the risk of needing more emergency care for your asthma, so you’re less likely to end up in ICU again.

  • Make sure you have a review with a trained member of staff before you leave hospital.
  • Make sure you have a written asthma action plan: you’re much less likely to need hospital treatment if you’re using one.
  • Keep taking your medicines as prescribed and using your peak flow meter if you have one.
  • Go to all your follow-up appointments.
  • Keep a symptom diary to help you notice if your asthma is getting worse. Most asthma attacks that need hospital treatment develop slowly, so you have a ‘window of opportunity’ to get on top of your symptoms before they develop into an asthma attack.
  • Put your health first – don’t struggle on because of work or home commitments, or delay seeking help if you need it.
  • Try not to feel worried or embarrassed about calling an ambulance if you’re not able to deal with symptoms yourself.

Last updated January 2020

Next review due January 2023

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