Asthma and 999

[breaded]

Hi
I’m an asthmatic who was diagnosed in adulthood. I’m still sort of getting to grips with it all. I’m on symbicort and montelukast which has been helping a lot, and anytime I have a flare up I get given steroid treatment. However there’s been a few times where I’ve had really bad attacks where I’ve almost called 999 because initially it isn’t being controlled by my inhaler, and sometimes it takes several puffs spaced out to actually get the attack under control. I was never sure when is ok to call 999- it’s terrifying during an attack and I’m always scared the attack won’t come under control, but equally I don’t want to call 999 for no good reason either. My asthma plan says to call if my inhaler doesn’t immediately work or if I’ve taken it 10+ times but I’ve had episodes where it doesn’t immediately work but then after even more puffs it does start to work so if I’d called for help at the start then it would have been a waste of the paramedics time because I was eventually ok

sorry bit of a confusing one, just wondered how other asthmatics manage this? And if you did call for help but the attack was under control by the time 999 came out, what would happen? Would you still have to go to hospital or would they just leave again? Just don’t want to be a timewaster

any help would be appreciated 🙂

If you don’t need to go they won’t take you.

I’ve had asthma all my life and have called 999 before once for an asthma attack. The paramedics came out and put me on a nebuliser for a bit in the ambulance, then left when I was breathing normally again. So no, they don’t have to take you to hospital but I would always call 999 if I’ve not been able to resolve an attack as you describe. It’s hard to recognise when to take something seriously - but asthma is definitely something to take seriously!!

If you don't need to be admitted, they will just check you over at home and make sure you are safe.

Are you on an antihistamine? Taking one every day makes a massive difference to my asthma but I only started as a colleague had been an asthma nurse. Never got mentioned in my multiple contacts at the surgery.

do you have a spacer? It’s much more effective to use ventolin with a spacer when you are having an attack. Take mine everywhere. They should prescribe one if you done have one.

Don't mess about with asthma, it's a leading cause of death among adults.

Do speak to your GP or asthma nurse for clarification about when to seek help but if you're ever in doubt, don't second-guess yourself or worry about making a fuss - just call 999.

Totally agree @Lisapillar

I just don't have, and presumably will never have, good inhaler technique. And when you are in a panic it all disappears anyway.

I have an inhaler + spacer in every handbag. It's so much more effective.

Your asthma nurse will be able to make this completely clear for you. You could book a telephone appointment with her.

Spacers are brilliant, it can be difficult take a proper breath when having an attack

Do you have a peak flow meter? That's a good way to check how bad an episode is, it varies from person to person though, so talk to your asthma nurse about what yours should be and what is too low. Mine is normally just above 400 and if it went below 300 and didn't respond to inhalers I'd head to A&E (or call 999).

As above, don’t mess around with asthma.
I take my child to a&e if the inhaler doesn’t resolve it and they put him on the nebuliser. If he were struggling to breathe and I didn’t think I could get him in quickly I’d call 999.
It doesn’t sound well managed at the moment and worth a chat with the asthma nurse re different options I think. Good luck OP

I had an assessment with an asthma nurse who gave me a chart with what to do at different stages, which is massively helpful. Needless to say, that nurses job has been axed because of cuts.

I have called 999 with asthma twice. Once they didn’t turn up and I did end up in hospital for several days and the second time they gave me a nebuliser at home. However my consultant says I should have gone into hospital that time for a few days for a variety of reasons (I have a complicated health history.) My view is to always call if you are worried, they would rather come and check you are ok than not be called. I agree it is very frightening at the time.

Register for the text service for 999 just in case you're struggling to speak

Asthma nurse here.

In an asthma attack you should take 1 puff on your blue inhaler every minute for 10 minutes (so 10 puffs in 10 minutes).
If you use an aerosol inhaler, always use a spacer with it.
If you're feeling better after the 10 puffs, great. If not, at that point call 999. Then repeat another 10 minutes. By then the ambulance should be with you. If you've improved, they will be glad and just check you over, if not they will give you additional treatment and then if needed take you to hospital.

Even those with very mild asthma are at risk of an asthma attack if they are faced with a big enough trigger.

You can request an allergy panel blood test that can check a small amount of common allergies to increase your awareness. Make sure you take your montelukast every day.

Good inhaler technique is an absolute must, these videos maybe useful to refresh yourself:

Symbicort, both device types:

Reliever inhaler, both devices:

Hope this helps

Paramedic here, just come off shift actually!

I think the advice you've got so far is on the money, especially encouraging the use of a spacer. In studies this has shown to be just as effective as a nebuliser and on several occasions this is the only treatment I've needed to provide to an asthma patient calling 999.

Essentially 999 is to be called when you're experiencing what you judge to be a life threatening emergency and you're too unwell/unable to make your own way to hospital. Tonight in my region we were responding to cat2 emergencies (which most asthma attacks would come under) in around 70minutes which is something to bare in mind should there be someone available to get you to hospital and the journey time is much less than this (I say this year I've been to 2 asthma patients who'd probably would have survived if they'd made their own way when the attack started but on those occasions response times were more like 2 hours and we were only allocated when they stopped breathing).

(I say this year I've been to 2 asthma patients who'd probably would have survived if they'd made their own way when the attack started but on those occasions response times were more like 2 hours and we were only allocated when they stopped breathing

That's awful, and terrifying.

Never a time waster with asthma. It's life threatening.
Paramedics will only take you if you need to go.