Hospitalization for Severe Asthma
Whether your asthma is severe or usually well controlled, you may sometimes find it very difficult to breathe. A mild asthma attack even with a rescue inhaler could turn into a life-threatening emergency. But how do you know if a heart attack is bad enough to go to the hospital, and what can you expect when you get there?
Check Your Asthma Program
The plan you wrote with your doctor to help control your asthma does more than tell you which medications to take. It also lists the symptoms you should look for and when to call your doctor or go to the ER if they get worse.
You should call 911 or get to the hospital immediately if:
- Have a respirator or respirator that can be improved if you use your rescue inhaler
- You breathe so much you can’t speak or walk normally
- Have green lips or nails
- Take no more than 25-30 breaths per minute
- You need to strengthen your chest muscles to breathe
- Have a heart rate of over 120 beats per minute
Very few people need to stay in hospital for asthma treatment. It may be necessary if:
- You have had a bad breath before
- You went to the ER or stayed in the hospital because of your asthma in the last 10 days
- Take steroid medications regularly to control your asthma
- Use your recovery inhaler more than twice a month
- Have other long-term health problems, such as heart or lung disease
What to Expect at the Hospital
The emergency room doctors will decide if you can be treated and discharged or hospitalized. They will examine you, recognize your symptoms, and examine your lungs.
Depending on your symptoms, different medications and treatments may be prescribed in the ER to control your asthma attacks. These include:
- Bronchodilator drugs supplied with an inhaler or nebulizer to open your respiratory tract
- Corticosteroid drugs are given in pills or IVs to reduce lung inflammation
- Extra oxygen
While they are treating your asthma attacks, your doctors will probably use tests to see how helpful they are. These tests may include:
- High flow reading, which measures how fast you breathe
- Spirometry, which measures how much air you exhale in 1 second
- Levels of blood pressure, as measured by the device at your fingertips
Even if your symptoms improve immediately, your doctor may want to keep you in the ER for a few hours to make sure the symptoms stay under control.
If you still have symptoms of asthma after a few hours of treatment, doctors may ask you to stay in the hospital.
Sometimes oxygen levels drop so low during an attack that doctors are concerned that you may develop lung failure without immediate treatment.
A hospital stay for asthma attacks usually lasts 3-5 days. Rarely, an asthma attack is so severe you may need a respirator to pump oxygen to your lungs.
I’m Going Home
Not all of your asthma symptoms need to go away for your doctor to allow you to leave the hospital. But they have to be much better. You will need a follow-up visit immediately after release. Your doctor will give you instructions on what to do if you have another attack.
You will usually be given corticosteroid drugs to take home to reduce the chances of another serious attack. If your lung test results are a little low, your doctor will also be more likely to release you if he or she thinks you will be taking your medication correctly.
Prevent Upcoming Emergencies
The best way to prevent other serious attacks is to treat asthma early with a nebulizer and possibly corticosteroid pills. Take all your usual medications as prescribed in your asthma plan.
Another important step is to avoid your specific causes of asthma. Talk to your doctor to find out what causes your asthma (such as dust, smoke, cold weather, exercise, or germs). Washing hands regularly can help reduce the risk of catching a cold or other infection.
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