When do you go to a&he/out of hours/call ambulance? ASTHMA

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Hello

Have a teen dd with severe asthma (been ventilated this year, lots of nasty attacks etc) and, although I've dealt with this for a long time, always struggle to know when to take her in.

She is on long term pred is any help.

TIA

If she's on long term pred and is struggling then A&E or ambulance as things can deteriorate quickly.

Teen years very tough for asthma and this flu bug that's going around is horrible on chests.

Has she not been given a care plan?

With ds we have to take him in when 10 puffs of ventolin don't last 4 hours. But that will be different for each child dependant on their asthma. If in doubt get her checked

Hope she is ok

Just to add, it is easy to get complacent when you're used to asthma but anything involving the airways can change in minutes and it is never a problem to err on the side of caution and get help ASAP.

Just because she has had asthma for a long time does not mean it's not potentially life threatening if it worsens.

No ambulance crew would ever tell you off for time wasting if they came and said she didn't need hospitalisation. Always better to be safe x

My ds 7, has asthma and I've always been too 'scared' to call an ambulance but after his last attack, when I decided to drive him to a&be (we'd been controlling it all day at home) and seeing how quickly he started turning blue in front of me as we got to the hospital, I promised I will never ever again drive or wait. If in any doubt I will call an ambulance x

You should have a clear care plan from her paediatrician telling you exactly who you call and when.

You need to raise this at your next appointment - if she's been ventilated this year, her hospital team are likely to want to see her early on rather than you wait for OOH.

Also ask if going to A+E should you call an ambulance or take her yourself.

Go, please...Can you drive/get taxi ?

I think if you are wondering if you should take her, then it means you should. Noone is going to tell you off or accuse you of over reacting.

As per Buddy's experience - when she is ill she needs oxygen in the ambulance, not a trip in the car.

We always had open access to the ward after several admissions - that cut through hours of waiting in a&e

I understand about not driving and getting ambulance...am speaking from experience where I would dither about calling ambulance and by the time I had decided I could have driven...I know it's stupid it's just the whole 999 thing even though I know it is an emergency, it's always the I didnt want to bother anyone syndrome

I tend to drive ds is but only because we are 6 minutes drive away and last time I called an ambulance it took 20 to turn up so as we are lucky to be close its easier for us to go straight in the car.

My Asthma management plan given by my doctor says this:

it is an emergency if:
*your reliever does not help
*You are too breathless to speak
*Your peak flow reading is below 33% of best or predicted.

ACTION -
if there is no immediate improvement continue to take your reliever via spacer, every minute for 5 mins or until symptoms improve.

if they do not improve in 5 mins or if you are in ANY doubt you must call 999 . Continue to take reliever every minute until help arrives.

                               <strong>*</strong><strong>*</strong><strong>*</strong><strong>*</strong>*

I know this is MY action plan, but it speaks sense that if your daughter is struggling, too breathless to speak, reliever isn't helping, then call that ambulance, that's what they're for.
I was once told they'd rather be called out as sometimes, if they can treat you at home, help you to recover quicker, they may be able to prevent a journey to hospital.
Is there an asthma clinic attached to your GP service? I ask as mine (run by specialist nurses) have been brilliant, and after a lot of trial and error, they have stabilised mine, and it's made me feel an awful lot safer.

Sorry if i alarmed anyone, I didn't mean she is having an attack currently just for future reference.

Thanks very much for replies. She does have a care plan but it's a bit rubbish if I'm honest - completely reliant on peak flow, which isn't always a good indicator for her. Are they all based on this?

Asthma nurse is okay but tbh doesn't know any more than us, consultant excellent in dealing with asthma but not very easy to talk to and her community nurse is great but hard to track down. Lots in place, but everyone seems overstretched.

Another issue is dd is often very reluctant to go to hospital, so I often end up calling an ambulance anway.

TIA X

Ds care plan isn't based on peak flow as he is only 5 so we are only just getting into peak flow. His is based upon his ability to talk/walk upstairs, his tracheal tug and how long the ventolin lasts.

I would ask the consultant next time you see him to give some clear guidance so you know what your working with and so your DD knows that you are right to seek extra help.

Oh and his care plan is always straight to a and e. For him we have clear instructions to not bother with GP/OOH this is due to errors made by both in the past and the severity of his asthma/speed of deterioration

Going to try and get one made then like the one for your ds *. Although I do understand that this is because he is very young.

I have problems with out of hours too. Went in March, given steroids , sent home. Ended up being ventilated next day after being rushed in by ambulance.