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If you come or are are brought to our Children's A&E department at Darent Valley Hospital, you will quickly be triaged by a Triage Children's Nurse. Your observations will be taken to include breathing rate, heart rate, and oxygen levels, to stratify how tight and narrowed your airways. Following this it will be arranged for you to see a doctor or advanced nurse practitioner. 

If you are having a severe asthma attack, medications will be given immediately. If you are having low oxygen levels, you will be given oxygen immediately too.

Acute Asthma Management

shutterstock_768090934.jpgOxygen will be delivered with a face mask or nasal prongs. It may feel a little uncomfortable but it is important to try to keep it on. 

Acute asthma management is based on the British Thoracic Society guidelines. Usually you will be given reliever medication and a steroid tablet/syrup. The steroids are given to reduce inflammation. The reliever medicine contains the same medicine as your blue inhaler called Salbutamol and another medication called Atrovent (also known as ipratropium bromide). Both of these medicines are designed to relax the muscles in the walls of the tight and narrowed airways. See more in Inhalers and Medicines sections.

If you don't need oxygen your inhaler will be used as it is proven this route is very effective. If you need oxygen, the salbutamol and atrovent medications will be delivered via a nebuliser. They may be repeated if needed.

Admission and further care

shutterstock_168767147 cropped.jpgIf you had a severe asthma attack or there are other risk factors such as needing oxygen, other medical vulnerabilities/conditions, pneumonia, or history of severe exacerbations, it is likely you will be admitted to hospital. 

If your asthma attack was less severe, you may either be sent home after a period of observation in A&E, or transferred to the co-located Paediatric Assessment Unit for more observation.

If you do go home, please make sure you:

  1. Follow the advice in Emergency Recovery Care plan, unless advised otherwise
  2. Make an appointment with your GP in the next 48 hours. 

If there are still concerns, you may be admitted to the Children's ward. See Inpatient Care for more information. In some children and young persons, a severe asthma attack may need more intensive care - from medicines which relax the airways through an intravenous drip, to specialist breathing support (e.g. High flow oxygen support called Optiflow), to transfer to a Specialist Intensive Care. Although this is rare, it is crucial to follow your personalised Action Plan to achieve best control of your asthma to reduce the chance of getting so poorly. 

We will explain everything to you and keep you updated throughout you or your child's care.