Asthma Advice For Patients Seen In The Emergency Department

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What is asthma?

• Asthma is a common disease which makes the airways of the lungs more sensitive. When the airways become irritated by certain triggers, they become inflamed and narrowed, causing wheezing, shortness of breath, coughing and chest tightness
• Asthma can sometimes get worse for no clear reason, but common triggers include pollen, dust and animal fur. Sometimes exposure to substances at work (such as fumes or dusts) can trigger asthma. Other triggers include chest infections, the common cold, exercise, changes in the weather, smoking and pollution
• Asthma is a chronic (long-term) disease. There is no cure for it but with treatment, most people lead normal lives
• For further information, see www.patient.co.uk/asthma or www.asthma.org.uk

How is asthma treated?

• Inhalers (and very occasionally, tablets) are usually used to treat asthma. There are two main types of inhalers: relievers and preventers
• Relievers are used when symptoms occur. They quickly help to reduce narrowing of the airways and make breathing easier
• Preventers need to be taken regularly, even if you do not have symptoms. They help to stop symptoms from developing
• Steroids are often prescribed to reduce inflammation in the airways
• You may need to see a specialist lung doctor in an outpatient clinic if the diagnosis is not clear or if the treatment is not working as well as it should

Managing at home

Monitor your asthma

• We may give you a peak flow meter to take home. This is a small hand-held device which can measure how fast you can blow air out of your lungs (your peak flow). It is very helpful to keep a diary of your peak flow readings to see how well your treatment is working
• Your GP surgery might have an onsite asthma nurse who can also help you assess the effectiveness of your treatment

Stop smoking

• Smoking or breathing in other people’s smoke (passive smoking) can make your asthma worse. You GP or practice nurse can offer free advice and support. You can also get free help from a smoking cessation clinic
• See www.nhs.uk to find your local Stop Smoking Service

Using your inhaler properly

• Some people find using inhalers difficult. Establishing a good technique allows medication to get down into the airways where it needs to work
• We will check your inhaler technique before you leave the hospital, but you may also ask your practice nurse to check your technique when you get home
• If you are having problems with inhalers, you might be given a spacer (a plastic tube) to connect to the mouthpiece of the inhaler, which improves the delivery of the inhaler spray to your lungs

Avoid triggers where possible

Your doctor and asthma nurse can help you to identify and create a plan for avoiding things that make your asthma worse. You should stick to this plan wherever possible.

Use an asthma action plan

Your doctor should agree a written action plan with you. This is a personalised document that gives advice on how to keep well, what to do if your symptoms worsen, and how to manage an asthma attack. You should refer to it for help in managing your symptoms.

General advice

Before you leave hospital we will make a care plan with you, with details of how to look after yourself at home and any treatment to take.

It is important that your GP knows that you have been in hospital. We will send them a summary of your hospital visit. You should book an appointment with your GP straightaway. You should also see your GP or practice nurse if your symptoms get worse or you are using your inhalers more frequently.

Signs of worsening asthma

The following are signs that your asthma might be worsening or not under control

• Needing your reliever treatment more frequently
• Waking up at night coughing, wheezing, short of breath or with chest tightness
• Having to take time off work
• A fall in your peak flow
• Inability to continue your normal level of activity or exercise

Please contact your GP, or your asthma nurse if you experience any of the above.

Managing an asthma attack

An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways (bronchospasm). You will feel very breathless and may find it difficult to talk.