There may come a time in the course of your life that you may need to take your asthmatic lungs to the emergency room. Many of us have experienced this already. So what's it like? What happens to us asthmatics in the emergeny room?

I've experienced this both as the patient and as a therapist. I've written about my experience wavering whether or not to go to the ER, and I've written about my experience taking care of asthmatics. So now it's time for a little more detail.

Here is what might happen in the ER.:

1. Fast pass: Come in with the chief complaint of shortness of breath and you will get a fast pass to the front of the line.

2. Respect: You will be treated with utmost respect. No one will lecture you becasue you're not short of breath enough. In fact, if you come in before your asthma gets too bad we will respect you all the more.

3. Breathing treatment: By the time you get to your room and slip on a gown your friendly respiratory therapist should already be on his way. As soon as he arrives you'll be given a breathing treatment of either Albuterol (Ventolin) or Levalbuterol (Xopenex).

For many of you this may be all you need to catch your breath. Yet for others, more therapy may be required.

4. Subsequent breathing treatments: Chances are if you've already used your rescue medicine at home, more than one breathing treatment may be required. You may be jittery as a jackhammer by the time they're finished with you, but it will be worth it because you'll have your breath back.  

4. Systemic Corticosteroids: Systemic steroids may be given as early as possible to help reduce the inflammation (swelling). These may be given by IV route, or intramuscularly (shoulder or butt). It may take an hour or more for this medicine to start working, so bronchodilators can be used liberally in the meantime if needed.

5. Sputum sample: If you can, a sample of your sputum should be obtained and sent to the laboratory to test  for an infection in your lungs and the best antibiotic to kill it.  

6. Lab draws: Lab may also draw your venous blood to test for signs of infection or other indicators that show what might be the cause of your trouble. This may not be indicated if all you needed was one or two breathing treatments and are discharged.

7. X-Ray: This is generally done for two reasons. One, it can rule out other causes to your problem, such as pneumonia. Two, it can show how bad your asthma attack is. After a while an asthma attack may cause your lungs to hold extra air (air-trapping), and this can show up on the x-ray as hyper-inflation. Air trapping may also cause you to have a barrel chest, or a wider chest as a result of too much air in your lungs.

8. Oxygen: For mild asthma attacks it is rare for your body to have trouble taking in oxygen. In fact, in the early states of an acute asthma attack, your oxygen intake may actually be increased as you breathe faster.