What happens if I have to go to hospital because of my asthma?
A small percentage of people with asthma will need to attend a hospital for asthma each year. Usually it all starts with registering at the front desk so the hospital staff can get your details and/or a triage nurse will briefly assess you to decide if you need treatment immediately or could wait in a queue. If your attack is severe you will be immediately taken into the treatment area.
Depending on the assessment, some or all of the following things will then happen:
- You will be allocated a bed, connected to a monitor and given a reliever medication via puffer and spacer (occasionally a nebuliser will be used instead).
- If your asthma symptoms are moderate to severe it is likely that you will need to start a short course of oral prednisone (steroid tablets) or sometimes the intra-venous (through a drip) steroid called hydrocortisone.
- You may be given oxygen by mask or sometimes nasal prongs (small tubes sitting in your nose).
- The monitor records your heart rate, blood pressure and breathing rate.
- You will also be connected to a pulse oximeter (a peg on your finger or maybe your earlobe) which estimates the level of oxygen in your blood.
- A blood sample might be taken (from your arm) to accurately measure your oxygen and carbon dioxide level.
- A cannula (small tube) is usually placed in a vein in your arm so that the doctors and nurses can give you drugs and fluids directly into your blood stream as needed.
Note: For severe symptoms of asthma it is common for reliever medication to be given almost continually until there is evidence of a satisfactory improvement. This means that either a puffer and spacer or a nebuliser will be used until your asthma attack appears to be responding.
How soon can I leave hospital?
At some stage you will be asked to blow into a peak flow meter or spirometer to measure your lung function and this test will be repeated a few times. This breathing test will help the doctors and nurses assess if you are well enough to go home or if you need to be further assessed for possible admission.
- If reliever medication settles your symptoms quickly and shows that the reliever can significantly reduce your symptoms for at least 4 hours then you may be allowed home.
- If you respond well to treatment in the emergency department you may be allowed to go home with increased medications, which generally includes a course of oral steroids.
- You will be given advice about maintaining this medication over the next 5 – 10 days (depending on whether you are a child or adult) and urged to see your doctor as soon as possible so you can discuss changes to prevent an attack like this in the future.
- Other preventer medication may be prescribed in hospital and started at the same time but this should continue when the other medications are ceased. You should see your doctor as soon as possible after an incident like this to make sure you both understand which medications you are taking.
If I don’t improve do I have to stay in hospital long? 
More than half the people who come to hospital with an asthma attack are treated and sent home from the emergency department. However if you do not respond particularly well to the treatment in the emergency department and your symptoms are still occurring or your lung function or oxygen levels remain low, you will be admitted to hospital.
If you are critically ill and need more assistance with your breathing you may be admitted to intensive care. The decision to send you home will be made by the doctor based on your improvement in symptoms, oxygen levels and lung function.
Staying out of hospital
Most people find that asthma attacks are the result of gradual worsening of symptoms over a few days. If your asthma symptoms are getting worse do not ignore them.
Follow your personal Asthma Action Plan. This will tell you what to do when your symptoms get worse.
The longer you wait to get treatment, the harder it is to control.
Never hesitate to call an ambulance (Dial 000) for an asthma attack if you don’t know what to do or if your symptoms don’t improve once you’ve started Asthma First Aid.
To find out when, why and how to call an ambulance and how the ambulance paramedics can help treat your asthma attack see www.ambulancesforasthma.net.au.