Post-discharge asthma

Patient information leaflet

Asthma care after your child leaves hospital

Overview

• This leaflet has been given to you as your child was treated in hospital for asthma.
• It will guide you on how to continue treating their asthma once discharged.
• If you have any worries, concerns, or questions about your child, please make sure you ask the team before discharge or book an appointment with your GP.

What is asthma?

• Asthma is a common condition that affects the airways, which are the small tubes that carry air into and out of the lungs.
• Asthma is a life-long condition, but the symptoms come and go.
• There are many things that can trigger asthma, such as viruses, dust, and pollen.
• These can make the airways narrow and sticky with mucus, which makes breathing harder.

What is the difference between ‘preventer’ and ‘reliever’ inhalers?

• There are many different types of inhalers.
• They are usually grouped into two types: “relievers” and “preventers.”
• Each type has different medicines that help your breathing in different ways.
• It is important to always use a spacer with an inhaler.
• A spacer is a plastic empty tube that slots over the inhaler at one end and has a mouthpiece on the other end.
• If you do not use a spacer with an inhaler, most of the medicine will not reach your lungs. This means it will not work properly.

Relievers

What do they do?

• Salbutamol (‘the blue inhaler’) is a medication used to relieve the symptoms of asthma.
• It only helps when the symptoms of asthma are present, it does not stop them happening.

How do they do it?

• Salbutamol is a ‘reliever’ medication.
• It works by relaxing a type of muscle in the airways called ‘smooth muscle’.
• This helps make the airways wider, relieving the symptoms of asthma.

When are they used?

• Relievers are only needed when asthma symptoms are present. • They do not need to be used regularly if there are no symptoms.

Preventers

What do they do?

• ‘Preventer’ inhalers are prescribed for some children to prevent the symptoms of asthma.
• They generally contain a steroid.

How do they do it?

• Preventors reduce the inflammation and mucus production in the lungs.
• This makes the airways less likely to become narrow.

When are they used?

• If prescribed, preventor inhalers must be used every day, even when there are no symptoms.
• If there are no symptoms when using a preventor, this means the preventor is working.
• If the preventor is not used regularly or the wrong technique is used, the symptoms could come back.

When to give your child Salbutamol after discharge

• If your child was treated with Salbutamol in hospital, they may need more once discharged.
• They will only need more Salbutamol if they have symptoms.

Symptoms to be aware of:

• Coughing
• Wheeze
• Chest Pain
• Tracheal Tug (Sucking in and out at the base of the neck)
• Chest Recessions (Sucking in and out in-between/ below the ribs)
• Nasal Flaring (Nostril moving in and out).

Fast breathing (respiratory) rate (number of breaths per minute)

• Count the number of breaths by looking at their chest and count how many times it moves up in 60 seconds.
• If the number is higher than the ‘acceptable respiratory rate’, they have a fast respiratory rate.

Flow chart

When to call 111 or take your child back to A&E

• If their symptoms return less than 4 hours after having Salbutamol or they need 6 puffs of Salbutamol, and their symptoms are still there.
• At any point, they look unusually exhausted, scared, have blue lips or mouth, or they are unable to talk in full sentences.
• In any of these situations, call 111 to ask for advice. Alternatively, take your child back to A&E.
• The concern is that your child’s asthma may be worsening, and they may need additional treatment.
• If you are unable to get medical advice or bring your child to hospital quickly, call 999 for an ambulance.

GP Review within 48 hours (2 working days)

• Your child must see their GP within 48 hours (2 working days) of leaving hospital. This will need to be booked with the GP upon discharge.
• This is to make sure they are not at risk of another attack.
• This appointment is important to keep, even if they feel better or are back to their baseline.
• If their symptoms get worse before the GP appointment, or they cannot go 4 hours without using their salbutamol (blue) inhaler, do not wait.
• You must call 111 or go to A&E straight away, even if the GP appointment is within the next 48 hours.

More information

Please visit the Asthma + Lung UK website https://www.asthmaandlung.org.uk/symptoms-tests-treatments/treatments or scan the QR codes below.

Contact our service

If you have any non-urgent questions, concerns or comments about your child’s asthma, their treatment or the information you have been provided with, please call us on 020 7288 5231/5059 or email us at whittpaedasthma@nhs.net. We are available Monday to Friday 9am to 5pm. We will aim to respond to any emails within 48 hours.