Asthma SOS - getting help from the experts in the hospital

Some people are at higher risk of life-threatening asthma attacks and need closer supervision in the hospital. They should seek urgent care early in the course of their attacks. These individuals include those who:

  • are currently not taking inhaled steroid medications
  • are currently taking, or recently stopped, oral steroid medications
  • have a history of psychiatric or psychosocial conditions
  • have certain medical conditions such as diabetes or arrythmias
  • have a history of near-fatal asthma needing emergency breathing assistance in the hospital (intubation and mechanical ventilation)
  • have a history of not taking asthma medications or following their asthma action plan as prescribed
  • have been hospitalized or had an emergency care visit for asthma in the past year
  • highly use fast-acting inhaled bronchodilators, especially those who use more than one salbutamol inhaler (or equivalent) per month
  • have both food allergies and asthma

Regardless of risk level, any person who thinks they may be having a severe asthma attack should see or contact their doctor immediately. They should also consider going to the nearest clinic or hospital that provides emergency care for people with acute asthma.

The usual treatments for severe asthma attacks are repeated doses of fast-acting bronchodilators, other inhalers or medications for asthma, steroid injections or pills given early in the treatment course, and oxygen.

During and immediately after an asthma attack, it may take some time for you to respond to the treatments. Your health care team will monitor you closely for improvements in lung function (peak expiratory flow rates or other lung function measurements). Once your lung function has stabilized, your doctor will decide whether to admit you to the hospital for more follow-up or discharge you to go home.

Individuals can be safely discharged after their peak expiratory flow rates stabilize or return to their previous personal best. Upon discharge, people who have had a severe asthma attack will likely also be given a prescription for an oral steroid medication, as well as an inhaled steroid if one was not being used previously. They will be educated about use of their inhalers, peak flow meters, and action plans. They will also be asked to see their regular doctor or asthma specialist for further follow-up.

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