Your child's asthma discharge plan
What to do after an asthma attack, how to give the medicines, and when to get urgent help.
Your child has been treated for an asthma attack and has been assessed as safe to go home. Symptoms can return after discharge. Follow the completed medicine plan below, use the spacer as you were shown, and keep your child's personalised asthma action plan nearby.
Your care details
To be completed by the ED team before you leave. Your child must not go home without the reliever plan filled in.
These mean your child needs emergency help straight away.
- The reliever is not helping, or your child is getting worse despite following the written plan.
- Your child is too breathless to speak, eat, drink, walk or sleep.
- Breathing is very hard or fast, with marked pulling-in at the ribs or neck.
- Lips, tongue or skin look blue or grey.
- Your child becomes exhausted, confused, unusually drowsy, quiet or floppy.
- Your child is difficult to wake, faints or collapses.
If your child's symptoms start to worsen
- Sit your child upright, reassure them and try to keep them calm.
- Give the reliever exactly as written in the plan above and in their personalised asthma action plan.
- For a pressurised inhaler, give one puff at a time through the spacer, letting your child take several normal breaths after each puff, as the ED team showed you.
- If you are unsure what to do 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 the plan, call 999.
Giving the reliever after discharge
Most children go home with a short-acting reliever such as salbutamol, given through a spacer. The exact number of puffs and the timing are written in Your care details above by the ED clinician — current BTS/NICE/SIGN guidance supports discharge once a child is stable on inhaled bronchodilator treatment that can be continued at home, commonly every 3–4 hours at first. Do not give more than the maximum written above. If your child needs the reliever more often than the plan allows, it is not lasting until the next planned dose, or they need increasing doses, seek urgent help.
Medicines to continue at home
- Some older children use a MART inhaler as both their regular treatment and their reliever. If this applies, follow that child's specific MART action plan — do not use a salbutamol schedule unless it has been prescribed.
- Continue the regular preventer or MART inhaler exactly as prescribed. Do not stop it because your child feels better.
- Finish any oral prednisolone exactly as prescribed. In children the course is usually short — follow the dose and final date written above.
- Keep your child away from tobacco smoke and vaping aerosols.
Follow-up is part of your child's treatment
- Arrange or attend a GP or asthma review within 48 hours (2 working days), or sooner if the ED team advised.
- Take all inhalers, the spacer or mask, and the personalised asthma action plan with you.
- The review should check recovery, inhaler and spacer technique, how well the medicines are being taken, triggers, regular ICS-containing treatment, and whether the action plan needs updating.
- Seek advice sooner if your child needs the reliever more often than the plan allows, is waking at night, cannot manage usual activity, or is not steadily improving.
- Children with life-threatening features, repeated attacks, uncertain diagnosis or poor control may need paediatric respiratory follow-up — use the local pathway.