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Hospital have changed their protocol so not a happy bunny!

It appears our local hospital have changed their policy for emergency card holders. It used to be that if your child was having probs with asthma but wasn't in immediate need of medical attention you could be seen on the paediatric ambulatory care ward by a peads doctor (most of whom know the severe asthmatics and how best to treat them). This was a fantastic system as you bypassed A&E and could be seen if things were getting out of control but not quite at the emergency stage yet. This has helped my son so many times in the past as he often becomes unwell even on 40mg Pred and gets to the point that using 10 puffs with a spacer every few hours is not really effective. At this point he needs back to back nebs to bring him up for a bit. His sats don't usually drop until he is really struggling and then he needs IV's.

The hospial administrators have decided that all emergency card holders now have to present to A&E and if the doctors there can't manage they will then be referred to paeds.

This is a huge blow to us as we have had so many arguments in A&E as they don't understand Jay's asthma. He doesn't wheeze and is very rarely distressed which gives a false picture of how unwell he is. Our local won't give nebs if sats are above 92% and don't listen when you say he's been using 10 puffs every 2 hours for the past few days. They just get out a spacer, give 10 puffs of Ventolin and send you on your merry way!

I am so disappointed they have changed the system. I have to fight anyway to actually get Jay to go to hospital in the first place and he only agrees (and very reluctantly) if he feels he is tired and needs nebs. If he has to go through A&E and be treated with spacers he is just going to refuse to go. This is going to lead to a far worse attack as he won't be able to access the help he needs before he gets to this stage.

How do other peoples hospitals deal with non-emergency attacks?

5 Replies

Have you tried asking your GP if they can give nebs. I was told by the discharging doctor in hospital to visit my GP in the first instance when I next had an attack as they all have nebulisers. I double checked with the surgery and was told to phone before turning up to make sure that there would be someone there to administer the neb.

It hardly seems worth the hassle etc of going to A&E if they won't give any treatment that you couldn't have given you or your child at home.

Best Wishes


More on nebuilsers. I think someone needs to create a standard nebuilser protocol! We are hitting more and more problems and yet they treat severe asthmatics so well! Sorry have no suggestions. I have same problem a and e never helpful for me! I need to go straight to my consultant who knows me and my attacks.



Thanks for the replies.

The problem is the GP is reluctant to treat Jay as she says if he is still struggling on 40mg of Pred and regular ventolin he needs to be assessed by hospital, and GP won't give back to back nebs with Atrovent. So a catch 22!


Hey koolkat!

Sorry to hear the trouble your having, just a thought could you ask your Son's consultant for a headed letter with a protocol on for his care? even if it just says please always send X up to the peads ward for an assesment due to the severity of his asthma? Is his asthma consultant and resp team at the same hospital which you attend in an emergancy?

Just an idea and to wish you a bit of luck too,

ally x


open access

Hi, for just over 2 yrs we had to go to A&E on every attack, we had an older chest consutlant but he wouldnt grant open access to childrens ward.

we now have a new chest consultant who is marvelous, she is younger and more forward thinking and has helped our son and us trememdously. we have an open access letter all yr round to the childrens ward. we ring 999, they ring the wardand we are immediately admitted to a holding bay. urgent nebs can be given whilst being assessed and admitted / discharged as appropiate. we also have a letter to carry for when we go outside our hospital area, if he takes ill we show it to the ambulancemen and the hospital so they know whats wrong with him and what to treat him with. saves so much hassle and explanations.

ask if you can have open access if your local childrens ward have that policy. it may help bypass the red tape of A&E.

you can only go to our local A&E now in an ambulance. no ambulance means you go to minor injuries dept and wait to be assessed.

Whatever the situation just shout long and loud until someone helps your child. better safe than sorry.


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