Asthma ... Help, docs or a&e?

[lollipoppi]

Brief background, DS is 22mo, diagnosed with asthma early at 14mo after lots of hospital admissions and family history. he is on brown inhalers daily and blue as required
I'm used to dealing with his asthma with the help from the asthma nurses and his plan but today in just in two minds what to do.

He started with a cough 2 days ago (started his blue inhalers) it's gradually got worse, last night he was very wheezy but not struggling too much, 8 puffs on blue then went to bed and seemed less wheezy.

He has woke up around 8 times in the night just crying, (really unusual for DS as normally sleeps through) so done inhalers through the night.
He is breathing very fast this morn and tugging on his neck and ribs, and coughing a lot.
Before I gave him his inhalers he was taking 64 breaths per min which is very high, although has calmed down a bit now since inhalers

Do I wait for the docs to open at 9, or go to a&e!??? Help!

A&E.

A and E without a doubt.

Thought so thank you.
I have just timed his breathing again it's come down to 48 per min after his inhalers, which is still too high isn't it

A and E

Ye that is still high. I know breathing rate is faster when younger but Ds is 2.9 and we have to take him in if resp rate is over 40 can't remember what the cut off was last year.

Hopefully going early in the day means he can be controlled without being admitted

A&e. Go.

Yes deffo A&E. Sounds like he needs a nebuliser to get his breathing back under control. Be warned though that if they give him a nebuliser at A&E (which sounds like he needs) that their protocol is to give at least 2 nebulisers 4 hours apart and to monitor and then at least another 2 nebulisers 2 hours apart and then to monitor him back on just inhalers and then without anything for another 4 hours. So you may be there a while, definitely overnight I would imagine.

I think that differs from hopsital to hospital. Our hospital does one neb then monitors for 4 hours then if possible moves to inhalers and after a few more hours on monitoring will discharge (assuming all is controlled of course)

Sirzy, you may well be right. We actually questioned the point of a 3rd nebuliser when DS was admitted and asked if they could not just move him on to inhalers at that point. They weren't happy about it but did it. Then when he seemed controlled we asked for him to be discharged. They weren't happy about that either as they wanted to observe overnight but we live close to the hospital and I couldn't see the point of taking up a bed for another night. So we went home and he was fine.

Thank you all so much for your replies, I took him straight to a&e his resp rate was 80 when we got here and O2 levels were 90 :-( so had some oxygen and a couple of nebulisers and they have admitted him

Poor little guy, glad he's in the right place though. I hope he's better soon.

I hope he feels better soon. What a worry for you.

poor little guy :( So scary. I hope he gets better soon.

As a rule of thumb, I always think that if they are needing blue inhaler more than 10 times in a 4 hour window, they need to be seen at A&E.

Or an OOH doctor.

Hope he is better soon x

Ah bless him, so scary hope he's better soon

how is he doing OP?

Sorry I've not had much time to reply but thank you all so much for your help.
DS needed oxygen all through the night last night as O2 levels were dropping below 85 and he has also had some more today so we are staying in tonight too
Poor little man x

How is it going? Do you already know what is causing the high respiratory rate/low oxygen? Have they taken a chest X ray? Wish you all the best and a speedy recovery for your dc.

Hope he starts improving soon x

Thank you, they are not sure what's caused this episode, I suppose the weather doesn't help, we seem to be going through all four seasons in one day at the moment!

He has been diagnosed with asthma, early but we have family history and this is his 8th hospital admission now, although he has been doing better since he has been on the steroid inhaler.

He seems to be a lot better tonight, he hasn't needed any oxygen yet tonight so fingers crossed we can go home tomorrow, he is a lot brighter in himself too x

good to hear OP. SOmetimes it takes a while to get the right inhaler combination.

If you feel he is still having too many attacks, ask for a review - they could try a different inhaler again. I did this when DS was diagnosed at 4.... he started on a brown inhaler, and while it helped, he was still very wheezy. Then we changed to an orange/green combo, and the difference was amazing. You dont realise how much they cough until they stop!

He recently changed again, as the orange/green combo of 8 years stopped working.

Thanks hatti, we have an appointment with his consultant in September so I will have a chat with her about that.
He had a much better night, no oxygen needed so were just waiting for the doctors to come round but I can see any reason why they would want to keep him in again tonight, looking forward to getting home and tucking him up in his own bed (and me in mine)!!

duvet, DVD and take out in order I think. And a bath for the young man so he doesn't smell of hospital. Take it easy - both of you!

Hope you get home today!

I agree the key is getting the right combination of medicine, it harder when they are little coz the options are more limited but there are lots of good drugs out there

WERE HOME!!! whoop whoop!! Cup of tea and snuggled on the sofa with toy story 3 .... Perfect

Thank you all for all your support xxx