Asthma is a chronic condition that causes swelling and narrowing of the bronchial tubes, making breathing difficult. While most asthma attacks can be managed at home, severe attacks require emergency medical treatment at a hospital. Knowing when to go to the emergency room can be challenging for asthma patients, but getting prompt treatment for serious symptoms can be life-saving.
Seek emergency care for severe asthma symptoms
The most important signs that warrant an immediate trip to the emergency room include:
- Difficulty speaking or walking due to shortness of breath
- No improvement even after taking a rapid-acting inhaler
- Chest pain or tightness
- Coughing that won’t stop
- Lips or fingernails turning blue from lack of oxygen
If an asthma attack reaches the point where you are struggling for each breath, this indicates severely obstructed airways that require urgent medical intervention. Wheezing or whistling sounds while breathing, hunched posture, anxiety, and rapid pulse are also red flags.
Monitor breathing difficulties carefully
Pay close attention to any signs that your breathing is worsening or not responding to medication. Determining when to go to the ER depends greatly on how well you can gauge the severity of your symptoms.
Use a peak flow meter at home to objectively measure how obstructed your airways are. Compare the reading against your personal best level when your asthma is well-controlled. If the number is 50-79% of your personal best, this yellow zone indicates moderate breathing difficulty that warrants a call to the doctor. A reading less than 50% – the red zone – signals a medical emergency.
Go to the hospital if symptoms don’t improve after initial treatment
When asthma flares up, take your quick-relief inhaler as prescribed. This medication acts within minutes to open constricted airways. If your breathing problems persist even after multiple inhaler puffs, going to the ER is imperative.
Similarly, take oral steroids at the first sign of an attack. These drugs reduce inflammation but can take hours to reach full effect. Go to the hospital right away if you don’t feel significantly better within 1-2 hours of taking the medication.
Seek care for danger signs of a severe attack
In addition to major breathing problems, certain signs indicate your asthma attack is progressing to a life-threatening stage. Go to the emergency room immediately if you experience:
- Confusion, drowsiness, or loss of consciousness
- Chest pain or pressure that worsens with deep breaths
- Trouble walking or talking due to shortness of breath
- Lack of improvement after taking quick-relief medication
- Blue lips, nails, earlobes, or skin
Rapid, shallow breathing, sweating, and hunched posture are also warning signs that your oxygen levels are critically low and emergency intervention is needed.
Don’t ignore milder asthma symptoms
While dramatic breathing difficulty demands an immediate ER visit, asthma sufferers should still visit the hospital if mild or moderate symptoms persist.
Prolonged wheezing, coughing, shortness of breath, or chest tightness indicates your airflow isn’t fully obstructed but inflammation is making bronchial tubes increasingly sensitive. Getting medical treatment can halt the attack before it progresses to a life-threatening stage.
Consider going to the ER if:
- Your rescue inhaler doesn’t provide 4+ hours of relief
- Breathing problems wake you up at night
- Peak flow is 50-80% of your personal best
- You need to take your rescue inhaler more often
Don’t downplay lesser symptoms. Frequent or resistant asthma flare ups are a sign that your condition is poorly controlled. Getting checked at the hospital can help prevent a future severe attack.
Call an ambulance for a severe attack
Anyone experiencing a life-threatening asthma attack should call 911 instead of trying to make it to the hospital yourself. Emergency medical personnel can provide oxygen and breathing treatments en route to get symptoms under control.
Dial 911 immediately if:
- You are struggling for air and can barely speak, walk, or stand
- Lips or nails turn blue
- You don’t improve at all after taking quick-relief medication
- Initial asthma treatments provide no relief
- You are becoming drowsy or confused
A severe asthma attack requires close monitoring and aggressive bronchodilator medications. Don’t risk getting stranded en route to the hospital – call for an ambulance instead.
Talk to your doctor about an action plan
To avoid uncertainty during an attack, have an emergency action plan mapped out with your doctor in advance. This written set of instructions explains exactly which medications to take and when to seek emergency care based on your symptoms.
Your doctor can also provide a personalized symptom assessment to help you decide when to go to the hospital. Having defined parameters takes the guesswork out of this high-stakes decision.
Questions to discuss include:
- What peak flow reading indicates I should go to the ER?
- How long should I wait after taking medication before seeking hospital care?
- Which over-the-counter medicines are appropriate for me to take?
- What symptoms or side effects warrant emergency care?
You should also ask your doctor for copies of their after-hours contact information so you can easily reach them whenever an attack occurs.
Go to the hospital for comorbid conditions
Underlying medical problems combined with asthma symptoms require more cautious emergency evaluation. Go to the hospital promptly if you have asthma along with:
- Heart disease or high blood pressure
- Lung disease like COPD or bronchiectasis
- Pregnancy
- Weakened immune system from illness or medication
- Poor lung function or low blood oxygen levels
Having concurrent lung conditions makes asthma attacks more difficult to treat. The same goes for heart problems, which worsen when the heart has to work harder to compensate for poor lung function. Pregnant women also need closer monitoring since asthma can affect blood oxygen levels for both mother and baby.
Conclusion
Asthma symptoms can worsen very rapidly, so quick action is key in an emergency. Call 911, take emergency medications, and get to the hospital immediately if you experience signs of a severe asthma attack like breathing trouble, poor response to quick-relief treatment, or blue lips and nails. For persistent milder symptoms or any danger signs, don’t hesitate to seek care in the ER where lifesaving treatments are readily available. Being vigilant and proactive can prevent an asthma attack from becoming life-threatening.