HOW LONG IS TO LONG

Right when were having an asthma attack whens it time to say enough is enough i need to go to hospital. In the past and present i have thought to myself i can deal with this and ended up in hospital anyway but other times i can fight it sort of living on my nebs for hours back to back. Because as we all know hospital ughh My family and friends say to me i need to go to A and E but i always think i can do what they do Back to Back nebs and steroids. Im always thinking to myself i should go but i will leave it a bit longer see if i can help myself. It has worked and even my DR has said ive done everything A and E would do but sometimes I think enough is enough i cant do this any more im always thinking am i wasteing an ambulance cause we all know how precious they are. Ive been told off for this by the hospital and by my GP they said if i think i need a ambulance then i probably do need an ambulance does anyone else think like me ive been in hospital a few times and left it so long ive ended up in ITU but it still plauges me how long is to long before you ask for help strange question i know xxxxxxx

[Hidden]

Hi kerry-anne,

The question of 'how long is too long' is a very difficult one, something which I suspect that all of us who have regular hospital admissions struggle with, and something which I'm sure many of us have misjudged one way or the other in the past. There is no real right answer - it is different for every person and for every attack.

It is not true to say that the hospital cannot do anything for you that you can't do yourself at home. They can assess you much more thoroughly than you can yourself or even than your GP can, with blood tests, blood gases and X rays. They have much more powerful drugs available - IV aminophylline, salbutamol, magnesium, adrenaline, hydrocortisone, as well as antibiotics if you need them. Most importantly, if you are having a very severe attack and stop breathing, or are in danger of stopping breathing, or are not breathing adequately, then they can of course intubate you and put you on a ventilator to breathe for you. I'm sure I don't have to point out the potential consequences if you stopped breathing and needed intubation and ventilation and were at home rather than in hospital.

One of the dangers of having a nebuliser at home, and one of the reasons why consultants usually only recommend home nebs with caution and after a lot of thought, is that it is too easy for people to sit at home having back-to-back nebs for hours when they should be getting themselves in. By the time you get to the stage where back-to-back nebs aren't helping, you are in the middle of a very severe attack and need to be in hospital as quickly as possible. Most people who have home nebs have guidance from their consultant about how many nebs they should have back-to-back or how frequently they should have a neb before they come in - has your consultant not given you this guidance? If not, then you could ask at your next appointment, explaining that you are having difficulty judging when to come in. A clear management plan, that you can have x number of nebs back-to-back, or hourly nebs for y number of hours, before coming in, should make things clearer for you.

Please don't worry about 'wasting' an ambulance - it will not be considered a waste, and it shouldn't be. Acute severe asthma is one of very few genuine medical emergencies, and timely admission and treatment can be life-saving. The Ambulance Service is there for people like us who can become very unwell very rapidly. Please don't try to risk getting in to hospital on your own or in someone's car, either - if you deteriorate en route to the hospital, you will not get appropriate treatment unless you are in an ambulance.

The fact that you have had multiple hospital admissions and have ended up in ICU means that you are high risk for future severe attacks. It sounds from what you have said that you have misjudged it a little in the past and have ended up being in ICU when perhaps you could have avoided that by getting earlier treatment. Asthma can kill, and over-reliance on home nebs and leaving it too late is one of the ways that it kills. Please don't put your life at risk by letting this happen again - get some clear guidance from your consultant and stick to it.

Hope this helps

Take care

Em H