Respiratory Emergencies
Someone who cannot breathe cannot wait. Oxygen, nebulisers and steroids are started on arrival rather than after tests, because in a severe asthma attack or acute breathlessness the treatment is more urgent than the diagnosis.
- Treatment starts before investigation
- Blood gases tested at the bedside
- Non-invasive ventilation available
- Intensive care in the same building
Stay
Hours to several days
Duration
Treatment starts on arrival
Anaesthesia
Sedation if ventilation is needed
About Respiratory Emergencies
Severe breathlessness has several causes that look similar at the door: asthma, COPD, pneumonia, heart failure and clots on the lung. Initial treatment covers the most likely while tests separate them. Blood gases, a chest X-ray and an ECG usually settle the question within the first hour, and treatment is then narrowed.
- Several very different causes look similar at first
- Oxygen and nebulisers start before the diagnosis is confirmed
- Blood gases show how severe it is better than appearance does
- Non-invasive ventilation avoids a tube in many patients
Before you read on
Everything here is general information about respiratory emergencies. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest respiratory emergencies.
- Severe asthma attack
- Acute exacerbation of COPD
- Pneumonia with breathing difficulty
- Sudden breathlessness at rest
- Suspected clot on the lung
- Breathlessness with chest pain
- A child with laboured breathing
Procedure details
The usual sequence, from first consultation through to follow-up.
Immediate treatment
Oxygen, nebulisers and steroids are started at once, before tests, because delay in severe breathlessness is what causes harm.
Assessment
Blood gases, chest X-ray and ECG are done quickly to separate the possible causes and grade severity.
Escalation if needed
Non-invasive ventilation is used where oxygen alone is not enough. Full ventilation and intensive care are available if required.
Ongoing care
Antibiotics, further nebulisers or diuretics depending on the cause, with admission for observation in most severe cases.
How to prepare
What to sort out before you come in.
- Come immediately, and call 108 if speaking in full sentences is difficult
- Bring your inhalers and any home nebuliser
- Bring a list of medication, especially steroids and oxygen at home
- Tell staff about previous admissions or intensive care for breathing
- Do not delay to finish home nebulisers if you are getting worse
Recovery
What to expect afterwards, and roughly when.
- Most asthma and COPD attacks improve substantially within hours of treatment
- A course of steroids is usually prescribed and should be completed
- Inhaler technique is checked before discharge, since poor technique causes many attacks
- A follow-up with the chest team is arranged, because an attack means the plan needs review
- Return immediately if breathlessness returns or speech becomes difficult
Why choose Humayun for a respiratory emergency
Severe breathlessness is treated before it is investigated, which needs everything at the bedside.
- Oxygen, nebulisers and steroids started on arrival rather than after tests
- Blood gases tested at the bedside rather than sent away, so severity is graded immediately
- Non-invasive ventilation available in the department, which avoids intubation for many patients
- Intensive care in the same building for those who need full ventilation
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