HDU - Little bit of advice?

I think I've possibly had the wake up call which I've needed. Ended up getting ambulance out last night because of chest tightness/feeling wheezy/really unwell, I got told that my chest wasn't too wheezy, but my oxygen levels were all over, they were going from 95%, - 86% - 98% - 85% within 30 seconds at the most, paramedic checked monitors to make sure they weren't dodgy or anything else & were fine. Most of my attacks hit criteria for severe attacks, & oxygen levels have hit 92% at the lowest during an attack.They have hit 83% before when I had a really nasty cough & couldn't breathe because of it. I had the nurse who I had last time I got admitted keeping a really close eye on my resp rate, pulse, BP, oxygen levels, ect, every 5 minutes, doctor who discharged me this morning after been stable for a couple of hours with BP 117/84, pulse of 102, resp rate back to a normal 15 breaths a minute, said to me I was lucky not to be seriously ill from it, & if I'd left it any longer, I woulda been really ill from how my oxygen levels were, I also got told that if it wasn't for the nurse who I had last time I got admitted, checking my obs every 5 minutes or so & took my oxygen levels down slowly, instead of taking me straight off it, I'd have ended up in HDU to keep a close eye on my oxygen levels & everything else. I didn't feel -too- ill with it, drowsy as hell, yes [I consider being tired/drowsy at midnight/1am normal?], tight in chest, yes, nothing any worse than ""normal"" though, didn't feel any wheezier than I normally do either. Blah. I've been admitted, been on back to back nebulisers, been on oxygen for hours, I've been on IV's [nothing drug related, BP drops a lot, end up on saline to bring it back up], had loads [meaning 6-7] of ABG's done, hospital treatment no longer bothers me, too used to it, A&E is like my 2nd home recently. How do u deal with a situation like last night though? When you're not feeling too bad for all your oxygen levels, BP, heart rate, resp rate & everything else to be completely off? Sorry if this is completely rambly, I've been awake 24hrs & got given codeine for the pain I'm in, in A&E before I got discharged.. Is it normal to have a male paramedic do an [full] ECG because of fast heart rate, & low BP? Had loads of ECG's done before & its always been a female nurse to do them. Little bit confused. Sorry to add -another- question, but can u request which nebs u get put on? I've been on both salbutamol and terbutaline, & find the terbutaline works better/need less of it than I do with salbutamol.

6 Replies

  • Hi emma

    It sounds like you had a bit of a rough night hope you are feeling better.

    When reading your post I was sort of surprised that you weren't kept in on a medical resp ward...I know that is my sats had been that low I don't think i would have been allowed home even if they had bounced back...you were lucky ;)

    I have had male and female nurses, paramedics, techs do full ecg's I think if there is concern about your condition like it sounds like there was last night the health care people don't worry so much about their gender, I think they want to amke sure you are okay and nothing major is happening.

    I have ended up on HDU/ ITU a few times now and I know that there they wean the drugs including oxygen instead of just whipping them straight of you. Hopefully this gives your body a bit more time to recuperate from the attack and get back to as normal as possible.

    As for the question about terbutaline v salbutamol I am not sure, I have to have terbutaline becasue I am very allergic to something in salbutamol and atrovent but I really feel that the salbutamol is more affective, I find I need more nebs to make a difference but once it has made the difference it lasts longer so as I say I am not sure. Have you ever had atrovent? It seems to last longer than salbutamol and i know that before I developed the allergy problem a combination of atrovent and ventolin nebs was most affective with me.

    I hope you get some answers soon and someone can start to make an impact on your unruly asthma.

  • I have been given ECG's done by both genders. The male ones ask if i mind. I am in resus unable to talk and just want to breathe. My eyes open up in utter amazement.

    I did feel put out once when my bag was left on the floor while many, many medical personnel attended me and they just stepped over it numerous times.

    Finally someone picked it up when I was stabilised and explained in the scheme of things they concentrate on saving my life but they are sure i might want it.

    Unfortunately i couldn't laugh as i was being admitted again.


  • I -think- I may have had atrovent before, but it made me feel really sick & lost my appetite, to the point where I wasn't drinking at all & I always get told I over drink in hospital/by GP. Found most of the time when I'm in A&E with my chest, I'm on salbutamol, for 10-15 mins, oxygen, back to salbutamol, blah blah blah, think you're gonna guess which way it goes. I can be on nebs & oxygen for anything between half hour & about an hour & half. My oxygen levels seem to drop a lot once I get off nebs even if they weren't bad before I got put on them. My obs stay set [normally] once they've been stabilized, its just the job of stabilizing them first, which can prove to be difficult. They'd managed to get my oxygen levels to 96/97% earlier on, & it'd stayed like that for about 2hours, & wasn't dropping at all, if anything, hit 98% a few times. Slower they brought me off the oxygen, better my levels were staying on their own & was off it longer. I'm not doing too bad, I suppose, a massive emotional wreck, I can deal with nasty attacks, when I'm actually pretty symptomatic.. but when its barely any symptoms like it was last night, it seems to get to me more. I have a really really sore throat, which I assume is from nebs & stuff, & really sleepy, managed to fall asleep in A&E a few times when I was on nebs, nurse was nice enough not to wake me up to check obs as I was kept wired up to everything. The first time I got admitted, the nurse on the ward said that males don't usually do ECG's on young lasses, which is what caused the confusion about it. I got told if my peak flow changes at all, back I go, as it was already low due to been in pain as painkillers hadn't kicked in at that point, or if I start feeling really spaced out & weird like I was doing last night, or if my nails change colour any more than they already are, doesn't -really- say a lot, I don't notice nails/fingers/whatever changing colour unless they're really obviously off-coloured. Hopefully I'll get in to see the consultant soon, my mum rang up the other day, & apparently I'm under someone, I just need to wait for a date to see them, one step in the right direction I suppose? Need to nip to the chemist to get my prescription sorted for montelukast, & keep putting it off & making excuses why I'm not gonna go round to get it. I was bad for leaving my house after I had first attack when I wasn't at home, is it normal to be a similar thing with an attack of the similar level, even when I was at home? Feeling kinda pathetic about it, cause its not first attack I've had, & I very much doubt its gonna be the last one I'm gonna have..

  • Sorry for the length of the replies, didn't realise just how much I can, & do witter on. I bet I'll look over the replies when I've had some proper sleep & be like, whoa, what? is this meant to make any sense?

  • The switching between salbutamol and oxygen can't be helping. If the need for oxygen is indicated, pretty sure you should be given oxygen driven nebs? Might be wrong though - that's what I've always had. :S

  • They are oxygen driven nebs, I think reasoning [or at least what I've been told before, not sure if same goes for every time I'm in], my heart rate can be 130+ without any sort of nebuliser stuff, so they use nebs & oxygen, then straight oxygen, back to nebs & oxygen again to stop my heart rate getting too fast because of the salbutamol or whatever else is in it, or to try bring it back to a normal-ish level.

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