Advice following Emergency Department attendance
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Information for parents and carers
- Your child has been treated for their asthma but is now well enough to go home.
- They may continue to have mild symptoms over the next day or so and the following information should help you manage your child’s asthma.
- If you are unsure if you need to return to us, please see the traffic light information at the bottom of this leaflet (‘General advice- When to seek help again urgently’) or have a look at our Alder Hey Symptom Checker via the Alder Hey website.
Treatment plan
- Continue to give your child 5 puffs of their salbutamol reliever inhaler (blue) every 4 hours via their volumatic spacer as you have been shown,
- OR follow the ‘Wheezy Action Plan’ if you have been given one
- As your child gets better you can give the inhaler less often, and then stop it.
- If they are regularly using the blue inhaler (salbutamol) when well, please review this with your GP or healthcare professional who looks after your child’s asthma.
Other medicines
- If your child has a preventer inhaler (may be coloured brown, orange, purple or red), continue to give this as prescribed by your General Practitioner (GP) or Hospital Doctor.
You should make an appointment to see your GP or Practice Nurse in a week’s time to review current treatment.
If at any time your child’s condition gets worse or does not seem to be improving with this treatment, please see your GP earlier.
Using inhalers correctly
Your child’s asthma will not be controlled if the medicines are not getting into their lungs.
Inhaler technique will be checked during your time in the emergency department. If you would like someone to check your and your child’s inhaler technique again please let a member of staff know.
Choose an appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
- Shake the inhaler well and remove cap
- Fit the inhaler into the opening at the end of the spacer
- Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
- Press the inhaler once and allow the child to take 5 slow breaths or slow count to 10 between each dose
- Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1-5 for subsequent doses.
Plastic spacers should be washed before 1st use and every month as per the manufacturer’s guidelines.
General advice if your child becomes unwell in the future
- If your child’s asthma suddenly get much worse (asthma attack), they will require treatment.
- Signs of an asthma attack include:
- being very wheezy
- having a tight chest
- finding it hard to breath
- being too breathless to speak
General advice – When to seek help again urgently
| RED | If your child: Is too breathless to talk / eat or drinkHas blue lipsHas symptoms of cough/wheeze or breathlessness which is getting worse despite 10 puffs blue (salbutamol) inhaler every 4 hoursIs confused and drowsy OR excessively tired and pale | Ring 999 immediately for help. Give 10 puffs of blue (salbutamol) reliever inhaler via their spacer device every 10 minutes until ambulance arrives. Keep child in upright position and reassure them. |
| AMBER | If your child: Is wheezy and breathless and the blue (salbutamol) reliever inhaler 5 puffs is not lasting for 4 hoursIs having a cough or wheeze/tight chest during the day and nightIs too breathless to run / play / or do any of their normal activities | Immediately contact your GP or call NHS 111 and make an appointment for your child to be seen that day face to face. Increase blue (salbutamol) reliever inhaler to 5-10 puffs every 4 hours. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features. |
| GREEN | If your child starts to cough, wheeze or has a tight chest but can continue their day to day activities *Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend. | Give 2-5 puffs blue (salbutamol) reliever inhaler every 4 hours until symptoms improve. If you are still worried, please see your local pharmacist or call NHS 111 (telephone 111) |
Useful contacts for further information and advice
- Alder Hey Symptom Checker via the Alder Hey Website
- Your own GP or practice nurse
- Your hospital asthma nurse (if already under the care of the hospital)
- NHS 111 (Telephone 111)
- Asthma UK – Asthma Help Line (Monday to Friday 9am – 7pm)
Tel: 08457 01 02 03 (calls charged at local rate)
Asthma UK
Providence House
Providence Place
London N1 ONT
This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.
This information can be made available in other languages and formats if requested.
Alder Hey Children’s NHS Foundation Trust
Alder Hey
Eaton Road
Liverpool
L12 2AP
PIAG 518