Asthma care in intensive care

The intensive care unit (ICU) is for treating people in hospital who are seriously ill.  

It is sometimes called the critical care unit (CCU) or intensive therapy unit (ITU).

Although a lot of asthma attacks can be treated in A&E, you may need to go to ICU if:  

• you’re having a severe asthma attack that is not responding to treatment
• you’re showing signs of being exhausted, drowsy or confused
• your oxygen levels are lower than they should be
• you’re struggling to breathe on your own and there’s a risk that you could stop breathing.

In ICU, specialist doctors and nurses can give you the treatments you need to get your asthma attack under control.

There are different treatments ICU staff may use to help you breathe well again. They can also monitor your heart rate, blood pressure, and oxygen levels.

You may be given medicine that makes you relaxed (sedatives) and painkillers to make you feel more comfortable.

There is a lot of special equipment in ICU, including ventilators, nebulisers, and monitoring equipment.

You may need to be connected to machines with a lot of tubes and wires, for example:  

• A nebuliser. Nebulisers can give you high doses of reliever medicine if you’re struggling to breathe.
• Intravenous (IV) lines. IV lines can pass fluids and medicines straight into your bloodstream. A cannula (a tube) is put into a vein and connected to a narrow tube called an IV line.
• A face mask. This goes over your nose and mouth and gives you air and oxygen to help your breathing.
• A ventilator. This is a machine that helps your breathing. You might be put on a ventilator if doctors are very worried about your breathing, or your blood oxygen levels are low, or if you’re unconscious. The doctors will put a tube through your nose or mouth into your airways. You’ll be given medicines to relax and sedate you first, so you’re more comfortable.

As you get better, the ICU team will gradually reduce the amount of help you’re getting if ventilators are supporting you to breathe.

You may move into HDU (High Dependency Unit) so that staff can continue to monitor you closely.

When you’re well enough, you’ll be moved to a general ward, to continue your recovery. The ICU team will give the general ward a written plan letting them know the care you need.

Whether you’re in HDU or on a general ward, your care team will continue to give you the treatment you need to get your asthma back under control and monitor you to see how well you’re recovering.

You may be offered physiotherapy, help with speech and swallowing, or talking therapies.

Find out more about being in hospital for your asthma.

Most people who have been treated in ICU recover very well. But it can sometimes take a while before you feel physically and emotionally well again.

You may feel tired, lacking in energy, emotional, anxious, or have a poor appetite.

It’s important to allow yourself enough recovery time:  

• Don’t feel you have to get back to daily routines, including work or socialising, too soon.
• Get plenty of rest, and find ways to get a good night’s sleep.  
• Try eating little and often if your appetite is poor. It’s important to get the nutrition you need to help your recovery.
• Find ways to improve your mood and sense of mental well-being.
• Share how you’re feeling with close friends and family or talk to your doctor if you’re struggling with feelings of depression or anxiety.  

Some ICU departments may allow patients to come back for a look around the unit, as a way for them to come to terms with their experience.

If you think you’d benefit from doing this, call first to see if it’s possible. It’s good to think carefully, though, about if you want to do this, and if you think it will help.  

ICU Steps is an intensive care patient support charity. They have lots of advice about returning home after being in intensive care.  

You may find it helpful to know you’re not alone. You can also read about others’ experiences on the ICU steps website.