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Asthma, Panic Attacks & Adrenal Insufficiency

Ok, I have a confusing one here and don't know what to make of it!

My son has severe asthma and is on all sorts of meds including long term Pred. I have been advised that during bouts of increased stress/illness he should take additional Hydrocortisone. Recently he has had a few asthma attacks that have come on suddenly and don't respond very well to ventolin with a spacer. It was suggested a few weeks ago that these might be panik attacks brought on by an initial asthma attack. I am not so sure about this as he often needs to use about 3/4 x10 puffs to control an attack and his pulse and resp rate were pretty normal and he was using his accessory muscles.

Now here's my problem. Last weekend when he was staying with a friend he got his fingers trapped in a door and broke the bone just beneath his nail. He was shouting and jumping up and down for a few minutes then felt as though he was going to collapse, felt sick and couldn't breath. He had to go outside to get some air and lay down on the ground so he wouldn't pass out. His friend called an ambulance because he couldn't breathe and they gave him a neb because his sats were 88%.

He was much better by the time he got to the hospital and after they handed him over no one did any obs, listened to his chest or did a peak flow. The nursing notes just said he was asthmatic and had been given a neb because he was distressed. It also said he wasn't on any medication! After he had an xray as an after thought it seems the doctor listened to his chest and said he wasn't wheezy so was good to go. Still no obs or peak flow, and my son told the doctor he doesn't wheeze.

I heard about all of this later that day when it was too late to do anything about it, and it seems my son thinks it was a panik attack and they gave him a neb to calm him down. Do your sats drop with a panik attack or is just C02 that increases? Also could he have felt so ill as his body couldn't cope with the situation due to adrenal suppression or was this his response to the pain?

Hoping someone can help so I know how to deal with this type of situation should it arise again. I am so cross with the doctor saying J has been having panik attacks because he didn't use his inhaler because he thought it wouldn't help. He is really confused now and is putting anything sudden down to panik now.

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