After an asthma attack — adult discharge plan
How to take your medicines after an attack, and the warning signs to act on.
You have been treated for an asthma attack and have been assessed as safe to go home. Symptoms can return after discharge. Follow the completed medicine plan below and your personalised asthma action plan, and keep both somewhere you can find them quickly.
Your care details
To be completed by the ED team before you leave. Do not go home without the reliever plan filled in.
These mean the attack is becoming dangerous and you need emergency help.
- Your reliever is not helping, or wears off much sooner than the plan says it should.
- You are too breathless to speak in full sentences, eat, walk or sleep.
- Your breathing is very hard or fast, or your chest feels very tight.
- Your lips or fingertips look blue or grey.
- You feel exhausted, confused, agitated or drowsy.
- You faint or collapse.
If your symptoms start to worsen
- Sit upright — do not lie down — and try to stay calm.
- Take your reliever exactly as written in the plan above and in your personalised asthma action plan.
- If your reliever is a salbutamol inhaler, use it through a spacer: one puff at a time, with several normal breaths after each puff.
- If you use an ICS-formoterol (AIR or MART) inhaler, follow the specific emergency instructions on that plan — the doses are different, so do not use a salbutamol schedule.
- If you are unsure and it is not life-threatening, contact NHS 111 urgently.
- If symptoms worsen, the reliever does not help, or you reach the maximum stated in your plan, call 999.
Your reliever after discharge
The exact reliever, dose and timing for the next few days are written in Your care details above by the ED clinician. Current NICE/BTS/SIGN guidance treats the reliever as part of a personalised plan, not a fixed dose for everyone — for many adults this is now an ICS-formoterol inhaler rather than a blue salbutamol inhaler. Do not exceed the maximum written above. If you need your reliever more often than the plan allows, it is not lasting until the next dose, or you need increasing amounts, seek urgent help.
Medicines to continue at home
- Continue your regular preventer or MART inhaler exactly as prescribed. Do not stop it because you feel better — this is the treatment that prevents the next attack.
- Finish any steroid tablets exactly as prescribed, even once you feel well.
- Check your inhaler technique with the ED team, your pharmacist or the asthma review — poor technique is one of the commonest reasons an attack returns.
- Do not smoke or vape, and avoid the triggers you know set your asthma off.
Follow-up is part of your treatment
- Arrange or attend a GP or asthma review within 2 working days, or sooner if the ED team advised.
- Take all your inhalers, your spacer and your action plan with you.
- The review should check your recovery, inhaler technique, how well you are able to take the medicines, triggers, your regular ICS-containing treatment, and whether the action plan needs updating.
- Seek advice sooner if you need your reliever more often than the plan allows, you are waking at night, or you cannot manage your usual activity.
- If you had life-threatening features, repeated attacks, an uncertain diagnosis or poor control, you may need respiratory clinic follow-up — use the local pathway.