Diagnose the Need for Emergency Asthma Treatment

An asthma attack is serious and can be a life-threatening situation, so it’s important to be aware of severe symptoms and know what to do in emergency cases.

A recent study found that in England and Wales, deaths from asthma rose 33% in the last decade, with over 1,400 adults and children in a year dying from asthma attacks.

In the US, figures from the National Center for Health Statistics reveal that there were 3,564 deaths from asthma in a year, which equates to 1.1 deaths per 100,000 population. There were also 1.6m emergency department visits in a year due to asthma. You can read our severe asthma death risk guide to understand more.

Keep reading this page to discover how severe asthma symptoms present themselves and what steps you should take in an emergency.

When to go to A&E or ER for asthma

If your usual asthma symptoms have worsened, perhaps due to a chest infection, or you’re having an asthma attack, getting prompt treatment could save your life.

The symptoms of severe asthma include:

  • Wheezing
  • Coughing
  • Difficulty breathing
  • A tight chest
  • Shortness of breath
  • Pain in the chest.

Warning signs that you need to go to hospital with asthma include:

  • Rapid breathing
  • Extreme shortness of breath, where you’re unable to breathe in or out fully
  • Developing a blue tint on your face, lips or fingernails
  • The inability to talk in full sentences
  • Feeling confused or agitated
  • Getting no relief from using your reliever inhaler.

If these symptoms occur, do not hesitate – go to hospital to the asthma emergency room or seek emergency help immediately.

Are you suffering a severe asthma attack?

In an emergency, you need to act fast. Here’s a list of emergency contact numbers around the world:

  • In the UK, dial 999.
  • In the US, dial 911.
  • In Canada, dial 911.
  • In Australia, dial 000.
  • In France, dial 15.
  • In Germany, dial 112.
  • In Spain, dial 112.
  • In New Zealand, dial 111.
  • In South Africa, dial 10 177.

Note that 112 also works in any European Union country and the UK.

You can find a comprehensive list of worldwide emergency contact numbers here.

What to take with you when going to hospital with asthma?

If you’re at home when you have an asthma emergency and need to go to hospital, it would ideally help if you could take a few things with you. These include:

  • Your asthma inhalers
  • Your spacer, if you use one
  • Any other medications you currently take, for your asthma and other conditions
  • A copy of your asthma action plan – this will help medics see your asthma triggers, your peak flow and other relevant

Taking these items with you will help the medics to treat you. However, they are not essential, so don’t worry if you’re not able to take them with you.

How is asthma treated in an emergency situation?

When you go to hospital with asthma, you’re likely to go through several stages of assessment and treatment.

1.  Registration at A&E or ER

When you first arrive at A&E or the emergency room at the hospital, you’ll have to register your details and inform them of why you’re there. If you were brought in by paramedics in an ambulance, then they will do this for you.

You’ll then be directed to an area to wait for a triage pre-assessment.

2. Triage pre-assessment

A medical professional, such as a doctor or specialist nurse, will see you for a triage pre-assessment. You’ll be asked in more detail about your symptoms, when they occurred and how long they’ve lasted.

If you have a copy of your asthma action plan with you and details of the medications and treatments you take, this is the time to supply them.

The triage process helps the medical professionals assess the severity of the situation, how soon you need to be seen and what treatments you’re likely to need for your asthma emergency.

Once the pre-assessment is finished, you may need to wait a bit longer to see another doctor, or they may progress immediately with urgent treatment.

3. Asthma treatments in A&E

Asthma attack treatment in hospitals is designed to meet your individual needs and requirements. The exact treatment you’ll have will depend on your symptoms and how you’ve been assessed.

If you’re suffering from severe asthma, you’re likely to be given an oxygen mask, nebuliser and steroids to try to calm the attack. Bronchodilator drugs will be given through a nebuliser to help open up your airways. The nebuliser converts the medication into a fine spray, so you can breathe it in via a mask. It’s an effective way to deliver the dose of medication that you need.

Steroids can be provided as tablets or in liquid form, or you may have a canula put into the back of your hand so that steroids can be injected directly into a vein. The steroids will help to reduce the inflammation in your lungs and airways.

4. Testing treatment effectiveness

Various tests may be performed to assess how well your asthma is responding to the treatment you’re being given. For example, your blood oxygen levels will be measured through a device placed on a finger, or you may have a peak flow test to measure how quickly you’re able to breathe out.

You may need to have more tests, such as:

  • x-rays or scans, performed to get a full picture of what’s happening with your lungs and airways
  • a spirometry test, to measure how much air you can breathe out in one second.

You’ll continue to receive treatment and be monitored until your asthma attack symptoms ease. Depending on how you are, you may be able to be sent home later the same day or be kept in for further tests and treatment.

When to take your child to ER?

It can be upsetting and worrying to see your child struggling to breathe due to asthma.

The key signs that you need to take your child to ER or call an ambulance include:

  • They are coughing and wheezing a lot
  • They are complaining that their chest hurts or feels tight; some children may also say their tummy hurts
  • They’re getting no relief from their reliever inhaler (blue)
  • They’re having difficulty breathing
  • They’re unable to walk or talk easily.

Try to keep your child as calm as possible and get them to sit up – lying down will make things worse. If you are waiting for an ambulance to take you to hospital, get your child to use their reliever inhaler (normally blue) with their spacer. Take one puff every 30 to 60 seconds, up to a total of 10 puffs.

What should I do after emergency treatment?

When you leave hospital or the emergency room, you should be given details of what medication you need to have. You will also be told of any other steps you need to take to look after yourself in the next few days.

After you’ve had emergency treatment for your asthma, you should make an urgent appointment with your doctor or asthma nurse, ideally within two days. This includes if you were taken to hospital or treated by paramedics. It’s important to keep your primary care providers in the loop with your current asthma symptoms and asthma emergency and ensure they have a record of your asthma attack.

When you’ve had a severe asthma attack that needed ER hospital treatment, your risk of this happening again is higher. It’s therefore important to discuss practical ways in which you can reduce your risk of future attacks. Even something as simple as changing the technique you use to take your inhalers could help reduce your risk of a subsequent attack.

Your doctor or asthma nurse will review all the medications you’re currently taking and look at your asthma action plan. If necessary, they will advise on any changes or adaptations you need to ensure your asthma gets fully under control. They may decide to prescribe you a short course of oral steroid tablets, such as Prednisolone, if the hospital hasn’t already. Steroids can help to reduce the inflammation in your airways after an asthma attack. It is important to discuss the potential side effects of prednisolone with your doctor.

In the long run, it’s important to have regular asthma reviews with a nurse or doctor. Ideally, this should be at least once a year. Remember to take your asthma inhalers and medications as prescribed and try to avoid any known asthma triggers as this will all help to keep your asthma under control.

Information and support

You will find a wealth of further information about allergies and asthma on our website, and we hope you will explore it. You can also get in touch with us – we would love to hear from you!