planned admission

Does anyone ever have planned admissions when their asthma deteriorates but they can get in before they end up in a+e?

I saw my nurse earlier and she has suggested we get this arranged as pfs and sats have dropped and have had to up nebs as am having a couple of attacks a day.

I just wondered in what way it differs from an emergency admission?

Do you just get assessed on the ward and then treatment goes from there or what?

the nearest i have got to this was earlier this yr when i was due to go in but ended up as an emergency the night before.

If i don't improve on upped meds or end in via a+e first this is what they want to do?

Thanks

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Hi,

I have had a couple of planned admissions when things have started to go wrong.

After mutliple severe attacks the team that looks after me asked me to contact one of the Respiratory Nurse Specialists of things aren't so good. This works particularly well for me because I'm usually very well controlled the rest of the time so ANY symptoms mean things are going very wrong.

Both times they've sorted a bed for me on the medical assesment unit and then I've been seen and assesed by the Respiratory team that looks after me, which is great because they know me really well. They've then started regular nebs/ hydrocortisone/antibiotics (I dont have home nebs/maintenance steroids)

I have to admit that I still had the 3am nosedrive both times requiring nebs/magnesium etc but I didn't end up on HDU/ITU which is unsual for me so it clearly did work to some extent. If I'm honest I think just forcing me to rest for a few hours helped!

I hope this helps,

SX

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hi there im sorry this is brief did hav a lengthy reply 4 u but my mobile just made it vanish n i havnt got the energy 2 write it all again!

We hav 2 systems at my local hospital as it doesnt hav an a+e!

1st is planned admission 4 medical tests or gettin ur condition stabilised n then gradually reducin therapy to a level that can b managed at home. And

2ndly blue card system. A system which u can get an emergency admission on to the unit if u are taken poorly- u can b rather poorly wen phoneing them but need 2 allow them a few hrs generally 2 get beds organised etc. Anythin required any quicker is a dash 2 a+e wit a nee nor!!

Hope this helps. If u feel poorly b4 u can get anythin clarified by planned in ur case dont let it stop u gettin ur butt to a+e if u gotta go u gotta go. Dont let things get 2 bad b4 gettin help. Sorry 2 hear ur not well. Get better soon n gud luck i'll try n post another better reply later if i can. Xx

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When I lived elsewhere in the country they had an open access chest ward. You had a traffic light protocol and when you reached point where were needing regular nebs or were exhausted but things not drastic enough to go to A and E you rang them up. (By the way most people shouldn't leave attending A+E until things get drastic- hence really strict protocol of how long to leave things!)

They had a resp nurse on call at all times and she would sort out a bed within a couple of hours or direct you to pitch up at A+E who would be expecting you.

On arrival at hospital you always went to A+E first and someone would come down from resp team to assess you if during usual hours or a medic if out of hours. It bypassed the whole 4 hours waiting in A+E to see if needed to be admitted.

The assumption was that if you felt you were bad enough to be there then you needed to be admitted regardless.

Going in through A+E meant if you were really quite poorly you could be stabalised in a place where there were lots of staff to help but you knew you were going to end up on resp ward not medical assessment gynae or wherever happened to have a bed!

It worked really well as a system, they used it for COPD patients as well as asthma and other chest conditions and it prevented me deteriorating on several occasions - but you have to be sensible and be prepared to follow the protocol to the letter no should i ring should i not or you just end up in resus.

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At my local they have a clinic staffed by consultants on week day mornings which GPs can refer to if you're classed as 'threatening admission'(or when they run out of ideas!!!). The consultants then review the case and decide the best course of action to stabilise you before things get too bad. In my case this meant IV amino and hydrocort and regular nebs to bring things back under control before they got worse. This means that they are able to admit straight on to the respiratory ward rather than sat in admissions got hours!!

Although I suppose this has had to be imposed as someone had the bright idea of closing one of the local AnE's; so for me to be admitted through AnE would leave me the wrong side of town without access to my respiratory team!!

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Thanks guys, its amazing how different hospitals have such different protocols.

My local wont do direct admissions unless authorized by one of the 2 resp cons not even the resp nurses can sort it out.

Im trying to hold out and hoping that i can cope on increased nebs and and horrid amounts of pred, i have so much going on at the mo i really do need to avoid admission if it can be helped!!

My community nurse rang me this eve to see how i was coping and is going to call again first thing so depending on what goes on overnight will shape what happens from then on .im just hoping tonight will be better than last!! She has also informed a+e and spoken to the medic in charge of resus about my protocol so if i do go in hopefully they will have the mag sulph ready and have read that me and amino dont get on!!!

right im going to try and get some kip and im really worn out.