when do you need hospitalised ?

Hi everyone , I have had Asthma as an Adult for about 6 years. During that time I've been taken to hospital by ambulance twice and have attended A&E to be nebulised my self about 20 times.

I take Symbicourt and Monteklast daily and have a Ventolin reliever . I also take antihistamine every day which has helped me a lot.

My questions is , a lot of you on here say you've been kept in hospital for several days following an attack - I never seem to be kept in - I generally respond well to nebuliser so I get nebulised and then sent home within a couple of hours with a prescription for steroids. Sometimes I have repeat attacks that go on for days and use my blue inhaler about 20 times a day- but I don't want to keep going back to the hospital .

- so I guess my question is- what is your experience of an attack that required you to be admitted to hospital ? I'm sacred I will go home too soon and have a really bad one some day, thanks for any advice x

15 Replies

  • The one time I was kept in it was because there was more to it than just a severe asthma exacerbation. On that occasion my asthma had been triggered by an infection which went to pneumonia, so I required antiobiotics via IV line as well as medication to bring the asthma back under control. It was as a result of this attack that I was given my first peak flow metre (almost thirty years ago). I can remember having to use one in the hospital - I was down at 150 when admitted. Once I got my own PFM and used it regularly I realised that what was normal for me at that time was around 450.

  • Thank you 😀

  • Maybe you could ask your doctor/nurse if you should have a nebuliser to use at home? I believe these days you have to buy your own, but if your medical professional agrees they will supply the meds. x

  • Thank you , I did ask for a nebuliser at home but they said they would rather I was seen at hospital if I was bad enough to need nebulised , im worried because I just dont know how bad it should get before I go back My peak flow is normally about 400 but when Im bad it can be as low as 50 .

    Other times i can struggle along for days coughing and hardly making it upstairs at about 150-200

  • Hospitalisation depends on several things. I've been kept in twice and sent home the same day once. My first time I was very poorly, oxygen sats down in the 80's, heart rate up to nearly 200, multiple nebs, intravenous steroids etc with minimal effect for several hours. I was seen by a fab respirtory consultant who I am still under review with. Second time was less than two weeks after the above event. Again was slow to respond but it did settle with the extra nebs and oxygen assistance. Third time I was told I was making it all up, was deliberately making myself poorly and was only having a panic attack, completely ignoring the two days prior that I hadn't been well. Despite this they gave me steroids and I agreed to go home because I was so frustrated and upset it was more harmful to stay in hospital. Steroids helped but still took me a little while to recover so obviously wasn't simply a panic attack

    Usually they will keep you in to monitor you if you have been slow to respond to the medications or the sats and blood tests show you need monitoring, but they will likely send you home after a couple of hours if you have responded well.

    Unfortunately however there have been cases of asthmatics being sent home too early and without the proper follow up and medications needed resulting in them returning because of more asthma flare ups. It has created a distrust but the fact is you know your body best.

    Are you under the care of a respiratory consultant? If you have a lot of flareups you may require alternative medications.

  • That's awful Beth! Even if it was 'just' a panic attack ask them if they wouldn't panic if they couldn't breathe either! x

  • Thank you, I usually respond well to the nebuliser so maybe that's why x

  • Hi, you seem to have a good case..last time they wanted to keep me in for 48 hours under observation but I didn't see it would make any change, so I went home..the time I really needed them to keep me in with pleurisy they sent me home with a pack of antibiotics... you know your own body, if you feel you need to stay in and you cannot cope at home you must tell them.

    take care xx

  • Thank you

  • Thank you

  • Tulamben

    My worry is that you seem to have exacerbations quite often. Are you fully controlled between these? How often do you take your reliever each week?

    If you are taking your blue more than 3 times a week then you are not fully controlled!! I've spent year being not fully controlled - I've now been referred to a lovely consultant who is determined to get my asthma under control.

    You need to keep pestering....

    The answer is not a home nebuliser but to get rid of the need for one. My consultant has suggested I have a home nebuliser but is still determined to get me better controlled!! There are lots of other medications that you could try in order to be more controlled!!

    Ask your GP to make a referral or keep going back until they do!

    Good Luck!

  • I had many years of being sent home after nebulisation and then recently 5 admissions to ward. For me the difference was when admitted my asthma hadn't responded well enough to nebulisation - I was still wheezy and struggling for breath. Also when they take Arterial Blood Gases the results there were poor and showed I was struggling and my peak flow hadn't picked up enough.

    Also I believe how you are treated in A and E? When I've been in resus I'm always admitted. If I've needed IV treatment also I'm admitted. I'd also say if you need to return then return! Even if they sent you home.

  • If you struggle against, even the same day, even just an hour later, go back. Many of us here have had the nasty experience of being fobbed off at A&E. Many of us are suffering with poorly controlled asthma which is giving us symptoms all the time.

    As vrchad said using a lot of blue inhaler means you are not under control. A home nebuliser is not the answer, better control of your symptoms is.

    You need to start making a nuisance of yourself. Start with the GP. Ask for a complete review of your medications and a referral to a consultant. Anyone who is admitted to hospital triggers a referral to chest clinic so if there is a next time soon, just explain how many times lately there have been, say you feel really ill and scared and ask if they'll keep you.

  • Hi! Others have said similar things to what I will say, but I thought I would add my straw to the stack.

    I was hospitalised in June, for four days. For about 5 days before I had struggled acutely, got prednisolone from an out of hours gp, a second visit to gp led to changed meds, and not just my asthma meds, and a third visit, when my peakflow was still going down, albeit slower with prednisolone, I was sent to hospital, to a medical assessment unit, which is a step locally here between casualty and a ward. My attack wasn't as bad as some people's, but stubborn. I was nebulised regularly for about 48 hours, then they kept me another 24 to make sure I didn't deteriorate without nebs (this seems part of a protocol) and then as my pf was slow to improve they kept me for another 12-15 hours. Then I was allowed home, late on a Sunday night (could have stayed the night as it was so late, but preferred to get home).

    I think it seems I was slow to respond, to steroids as well. A cold triggered it all - though things hadn't been good for some time and my asthma was 'uncontrolled', though I didn't realise it, nor was it picked up in reviews. Since then I have been fine, albeit anxious about what could land me in this situation again - and I am now on meds that work far better for me. And I am working on getting more aware when I have a problem, not just dismiss it as my general whimpishness.

  • Thanks everyone I really appreciate the advice and will ask for a medication review x

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