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Hospitalization For Severe Asthma Attack: What To Expect

If you have an asthma attack, it's important to follow your asthma action plan and take your medications as directed. You may also need a rescue inhaler.

It's often possible to manage an asthma attack at home with treatment. Usually, this means using your rescue inhaler.

However, in 2020, nearly 1 million adults and children visited the emergency department for asthma. To help prevent this, always follow the asthma action plan you and your doctor have put together, and take your medications as directed.

That said, if your symptoms don't improve, you may need emergency medical care. Knowing what to expect can help ease any worries you may have about going to the hospital for emergency asthma treatment.

It's important to get emergency care for an asthma attack if you:

  • have severe shortness of breath or wheezing
  • are unable to speak
  • are straining your chest muscles to breathe
  • experience worsening symptoms or no improvement in your symptoms after using your rescue inhaler
  • If you cannot make it to a hospital, you can still call 911 or your local emergency number, which will send over an ambulance. The ambulance will have medication and tools to treat an asthma attack, which may be faster than trying to get to a hospital. Do not drive if you are having an asthma attack.

    At the hospital, healthcare professionals can often treat an asthma attack and discharge you on the same day.

    For some people, however, a severe asthma attack may require hospital admission.

    Once you arrive at the emergency room, you'll need treatment right away, depending on the severity of the attack. You may receive one of the following treatments:

  • Short-acting beta-agonists like albuterol: These are the same types of medication as your rescue inhaler, but at the hospital, you may be able to take them with a nebulizer. You'll wear a mask to breathe the medication deep into your lungs for quick relief.
  • Corticosteroids: You can take these in pill form, or they may be given intravenously in severe cases. Corticosteroids will help decrease inflammation in your lungs. It often takes several hours for corticosteroids to start working.
  • Ipratropium (Atrovent HFA): This medication is a bronchodilator that is sometimes used to open your airways if albuterol isn't effective at getting asthma symptoms under control.
  • In life threatening circumstances, you may need a breathing tube and oxygen in the hospital. This occurs only if other treatments haven't worked and your symptoms continue to get worse.

    If you have persistent signs and symptoms of a severe asthma attack even after ongoing treatment in the emergency department, it's likely you'll be admitted to the hospital for additional treatment and monitoring.

    The amount of time you spend in the hospital will depend on how your symptoms respond to emergency treatments.

    Once your symptoms improve, your doctor will likely monitor you for a few hours to make sure you don't experience another attack. They may test your blood oxygen level, perform spirometry to examine how much air you can breathe out in 1 second, or check the speed with which you exhale in a peak expiratory flow (PEF) test.

    Once your symptoms are well managed, you can go home. But if the results of your test still show a problem or if your symptoms don't improve after emergency treatment, you may be admitted to the hospital and stay overnight or for a few days.

    In severe, life threatening cases, a person with asthma may need to stay in the intensive care unit.

    Your doctors will continuously monitor your progress, giving you medications and checking your peak flow levels as needed. Doctors may also perform blood tests and X-rays to check your lungs.

    Once your doctors determine you're healthy enough to return home, they'll supply you with a discharge plan.

    This plan typically includes instructions on what medications you need to take and how to take them. You may also receive instructions to help you better recognize your symptoms and know what steps to take if you experience another asthma attack. If you have any questions about your symptoms or treatments, this is a good time to ask.

    Within a couple of days after leaving the hospital, it's important to see your doctor for a follow-up appointment. Hospitalization for asthma attacks often means that your usual asthma medications aren't working effectively for you anymore. Even if you feel fine, it's important to see your doctor to discuss adjusting your asthma treatments and your asthma action plan.

    An older systematic review from 2009 suggests it's better to see an asthma specialist (like an allergist or pulmonologist) or go to an asthma clinic after hospitalization than visit a primary care physician. Seeing a specialized healthcare professional may reduce the likelihood of needing emergency care in the future.

    You may be mentally and physically exhausted after returning home from the hospital. After a potentially life threatening experience, it can take days or weeks to recover fully.

    Take your time getting back to your usual routine. Rest at home for as long as you can and avoid as many asthma triggers as possible. Ask friends and family to help you with household chores and tasks until you feel better.

    It may also be helpful to reach out to an asthma support group. An asthma attack that requires hospitalization can be emotionally draining. It helps to hear from and talk with others who've gone through similar situations.

    Do you have to stay in the hospital after an asthma attack?

    If your symptoms don't improve after emergency treatment or if your asthma attack is serious or life threatening, you will likely be admitted to the hospital for care and stay there until your symptoms improve.

    Is asthma a major emergency?

    This depends on your symptoms. If your asthma attack is serious or life threatening, you will likely be admitted to the hospital for treatment.

    Is asthma considered a disability?

    Yes, asthma can be considered a disability and has been included in the Americans with Disabilities Act (ADA) since the 2014 Amendment of Americans with Disabilities Act.

    Asthma attacks can be life threatening, so it's important to know when to head to a hospital for treatment. Knowing the first signs of an asthma attack can help you get the treatment you need sooner.

    You and your doctor can also adjust your treatment plan to keep your asthma well-managed and prevent future attacks.


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