One of the most difficult decisions to make as an asthmatic is this:  "When should I call my doctor?"  Or, "At what point in the progression of asthma symptoms do I decide to go to the ER?" 

Obviously if asthma hits hard and fast the answer is easy:  "You GO RIGHT TO THE ER NOW!"  In fact, you may even be justified calling an ambulance. 

However, most asthma attacks progress over a period of time.  And many times you are having an attack and can still function.  You may not be comfortable, but you are not yet miserable.

Then, over time, you become a little more winded. Now you think you're worse than you've been in a long time.  Now you're coughing.  Now your chest feels tight.  Now you think your respiratory rate has increased.  Yet, you still don't really WANT to go to the ER.  Right?  No one does.

I'll tell you from personal experience that deciding what to do when your asthma is acting up is never easy. In fact, just the other day I was working and there was a microwave fire in the critical care unit.  The unit filled with smoke. 

The nurse working there had an asthma attack.  She came to me hoping I would give her a breathing treatment.  I said, "You need more than a breathing treatment. You need to go to the ER."

"But," she said, "I don't think I'm that bad."

"Trust me," I said, "You need to go to the ER."

Ironically, I repeated this same scenario with the other CCU nurse later in the night.  While they both knew they had asthma, and were both gallant asthmatics, they still needed assistance deciding what to do.

No asthmatic is an exception to this rule, including myself.  Even while I'm a lifelong asthmatic, there have been many times I've had trouble making the decision of what to do for my asthma. 

Yes, it sounds like this would be an easy decision.  But, trust me, it is not.  So, that in mind,  I would like to provide you with five tips that should help you know when it's time to go to call your doctor or go to the ER: 

1.  Ask a friend. I don't care how much of an asthma expert you are, it is never easy to make such a decision on your own.  It is far easier to tell someone else what to do than to make the same decision for yourself. I have done this many times, and so have many of my asthmatic RT and RN co-workers.

2.  Use your peak flowmeter. Of course you were a gallant asthmatic and determined your personal best, "or highest number you regularly blow," when you were feeling good.  Right?

(If you want to learn more about how to use a peak flow meter, click here.  If you want to determine your own personal best and how to use it to decide what to do, check out this link to nationaljewishhealth.com.)

According to National Jewish Health, every asthmatic should blow into his pf meter twice a day first thing in the morning before you take any meds, and before bed.  After two weeks, you take the highest number that you blew and this is your personal best.