Advice on when to go to A&E

I was diagnosed with late onset Asthma 3 years ago, but even now I still don't know when it's bad enough to call A&E. I'm the old school where you ""just get on with it"" and tend not to like to bother people. Have an Asthma plan by the way, but stilll can't tell!!!

I have a lot of episodes of very bad wheezing and I will take my rescue inhaler, then another puff if it carries on etc but at times I can be wheezy all day then the next day it's as if nothing has happened. Two weeks ago I went down out surgery, couldn't get to see the Asthma nurse, she was ill, anyway one of the other nurses checked me and my Sats were 93 (ok I think) and my chest was clear but the wheeze was so bad she put me on Pred. Sorry for the ramble but can anyone tell me if I should have gone to A&E when I was just as described. When do you call the emerency, what do you do, do you wait till you get worse than me? I am exhausted most of the time.

8 Replies

  • Your action plan should tell you when to go to the doctor/A&E. If not then I'd get it written down ASAP. I made my first one last week, after having 1st attack.

    Basically if you use a peak flow meter, and you enter the yellow zone (or cough,wheeze, tight chest, or short of breath, wake at night, restriction of usual activities), use your quick relief mes 2 puffs every 20min for 1 hour if not better then go to the doctor, else keep taking the QR meds every 4 hours for a couple of days, and double the inhaled steroids if you use them, but not the combined meds (see doctor)

    If you are in the red zone (very short of breath, QR meds don't help, can't do usual activities, or symptoms stay the same or get worse), then doc or A&E, no if's or buts.

    I'd say if you keep getting attacks, then you really need to get the medication you take sorted, you should hardly ever need the reliever meds and rarely have any symptoms, make an appointment with the asthma nurse and get it sorted, I know though, I'm like you, don't wish to make a fuss, but it's your health and possibly life so go.

  • Hello,

    I have copied this from the main AUK web site.

    Recommended steps

    'Take your reliever inhaler (usually blue), immediately

    Sit down and ensure that any tight clothing is loosened. Do not lie down

    If no immediate improvement during an attack, continue to take one puff of your reliever inhaler every minute for five minutes or until symptoms improve

    If your symptoms do not improve in five minutes – or you are in doubt – call 999 or a doctor urgently

    Continue to take one puff of your reliever inhaler every minute until help arrives

    You are having an asthma attack if any of the following happen:

    Your reliever does not help symptoms

    Your symptoms are getting worse (cough, breathlessness, wheeze or tight chest)

    You are too breathless to speak, eat or sleep

    Do not be afraid of causing a fuss, even at night. '

    Also, we can't really advise on the symptoms that you describe as people interpret symptoms differently. We can't see you and it would be dangerous to advise in an emergency.

    As Woody states Please follow your asthma plan. check your peak flows.

    If your meds don't work within five minuted please get help! eg 999.

    A wheezy asthmatic has more rights to an ambulance & a&e than the drunk scraped off the streets on a friday night. You are not making a fuss if you go.

    Sats of 93 are a little below normal for the average asthmatic, your nurse should have done something about that apart from prednisolone which takes a few hours to work.


  • Thank you, both, for your quick replys. I do understand that you can't advise on symptoms as such but just wondered how long you left it before you got help. Yes, I do have an asthma plan and I do contact the Asthma nurse when I am wheezy, between us we are always putting my medication up or down (brown one) or I'll do it on my quite often. She can't quite ""fine tune"" my medications, it's not her fault she is very good but it's just my Asthma is so unpredictable. I can be really bad one day Book an appointment to see the nurse/doc for the next and it's gone, not a wheeze in site!!!

  • This is for me personally what i find works.

    (possibly my asthma plan not sure tho as no peak flow involved.)

    Just a little back ground first my asthma is not the norm! Reliever inhalers do not work for me, so i have my nebuilser as my reliever but everything else about my asthma works the same. ie when i get symptoms i use my reliever it is just in form of nebuilser not inhaler so it is less convient thats all really.

    I know there are two main symptoms for me personally for having an attack.

    Coughing and Tight Chest.

    I know the severity of my attack by which symptom i get.

    Most of the time when i get the coughing symptom i can get rid of this one by taking deep breaths and occassionally using my reliever but when i cannot stop coughing and i keep at it despite using my reliever once, i use my reliever a second time and get prepared to parcel my self to a and e if i have not stopped coughing after the second one.

    Now when i get the tight chest symptom i again try deep breaths first to see if it settles it down, then if not i try my reliever and then if not i try reliever second time and get ready to go to a and e if this does not work but i know with this symptom i have to get to a and e fast if a second releiver hasnt worked because i nearly always end up in resus with this symptom if my releiver does not work as my airways for some reason just will not respond. No clue to why.

    I think it is you learning your asthma and knowing which symptoms you have and how you respond to the different ones. For me I know if i got a tight chest it is pertenshally life threathening where as the cough is more annoying than anything else and is more often than not just a minor hurdle and can be sorted in minutes.

    For me following the recommended guidelines does not work as some of what they say are an attack i get daily so it would mean i would be sat in a and e pernmantly, so i really think use them as guidelines but learn your own asthma.

    Another tip if you are going to have an attack it will more than likely be in the middle of the night or at a weekend, so dont worry about creating a fuss another asthmatic will have done it before you so dont worry about it, just concentrating on getting yourself the treatment your body needs forget anything else.

    A and E have always told me they prefer to see me when i well and after all i didnt need them than too late.

    Hope that helps a little and dont worry if you dont follow guidelines!

    Some asthmatics like to be awkward or maybe that just me ;)

  • Plummie, you could be talking about me, that is exactly like me except I get the coughing and wheezing more than the tightness although I do get it often, but the rest is just the same. Sometimes, for me too the reliever doesn't work or if it does work it doesn't last for long, that's why I asked the question.

    Mind you I know I am not helping myself because I have three Chihuahua's, I did have five but I rehomed two. I couldn't bear to get rid of my last three, they are my favourites and to be honest life is hard enough living with Asthma and if I lost them too life wouldn't be worth living (metaphorically speaking).

    Thank you for the tips though, it certainly takes a long time to learn about this here condition!!

  • how long before you go to get help is a personal thing, and I'm still working this out as a new asthma sufferer.

    Try and work out using symptoms and/or peak flow when you have been really bad and needed help, then memorise this, and go before you actually get to that stage, so any serious potential problems can be prevented, which is easier to do than cure them.

  • hi hope all the advice helps you but remember if your scared or dont feel right in any way just go to a and e getting sent home again is better then not going home at all!! everybody is differant and react in diff ways so only you now how you feel..

    take care roxy

  • Thank you for your sound advice Roxy and once again thank you to everybody else, I feel a lot more positive now.

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