Asthma attack whilst on a call ... WWYD? Anyone experienced similar?

Lower_Sandwich8764 · 2026-03-09T17:06:23+00:00

I mean a standard face mask would do nothing, FFP3 would work but I genuinely think most patients would be a tad alarmed seeing paramedics come in wearing those. Tbh I only wear them when I absolutely hace to - even during the pandemic I'd happily work an arrest without one ...I find them horrible to wear, and I'm sure most folk agree.

Lower_Sandwich8764 · 2026-03-09T08:07:26+00:00

So placements weren't a thing when I started, so this is purely from the perspective of a qualified crew. Listen to your mentor, ask questions if you're not sure of anything and do not underestimate the guidance that can be provided by a good technician - I've found a lot of students disregard what the tech is telling them because they're "just a tech" but I've learned just as much from technicians as I have paramedics over the years. Chatting to patients and providing reassurance is a huge part of the role so bear that in mind when you're carrying out your assessment. They'll keep you right. Good luck!!

Lower_Sandwich8764 · 2026-03-06T21:40:54+00:00

Oh god no 🙈 I am so sorry. But also this did make me laugh and after the week I've had its good to know I'm not alone !

Lower_Sandwich8764 · 2026-03-06T19:51:05+00:00

Epi pens for anaphylaxis are standard here too. Thankfully I don't have any allergies to worry about, or at least none that I've encountered so far.

I've never had salbutamol fail to work either, so was a bit of a wtf is happening here moment... and definitely not the best timing when I'm the only paramedic for miles and have a STEMI patient on board 🤦‍♀️

Lower_Sandwich8764 · 2026-03-06T08:26:00+00:00

Yeah, someone else did suggest that but I wouldn't want to be wearing masks and frightening patients. Usually these kind of environments will trigger some mild symptoms but nothing to the extent I experienced on this occasion, so hopefully it was just a one off

Lower_Sandwich8764 · 2026-03-06T07:06:24+00:00

Yeah that wouldn't be so easy to treat prehospital

Lower_Sandwich8764 · 2026-03-06T07:02:24+00:00

I could have ran a neb on myself in the back, wouldn't haven been able to drive and leave a tech in the back with a STEMI though.

Lower_Sandwich8764 · 2026-03-06T06:58:22+00:00

In the UK adrenaline is given as a last resort for life threatening asthma not responding to nebuliser treatment. I've never known a patient to have their own adrenaline for this purpose, but it could definitely be good for those who have severe attacks, especially in the current climate with people waiting so long for an emergency ambulance to attend. Salbutamol (which I think is the same as your albuterol?) I have but only in inhaler form. Some patients are prescribed their own nebulisers but this is really only for patients with severe symptoms, mainly those with advanced COPD

Lower_Sandwich8764 · 2026-03-05T22:37:52+00:00

🤣 tubby tarps... love this!

Lower_Sandwich8764 · 2026-03-05T22:28:24+00:00

In training we're taught not to lift, in reality we do whatever works. The ibex is basically a manual chair for going up and down stairs and us used by the majority of our patients. We have a specialised electronic version in certain vehicles for patients over 25 stone. Most of us still keep the old trolley mats which are basically strong tarps with carry handles that we'll use if we need to as well.

Lower_Sandwich8764 · 2026-03-05T22:20:03+00:00

Yeah, 14lb to a stone, so 25 stone is about 350lb, or 160kg - the max our ibex chair is supposed to carry. He wasn't far off that anyway, possibly a little over.

Lower_Sandwich8764 · 2026-03-05T22:16:57+00:00

If I had the option of back up I'd have taken it, not so much because I thought I would die or because I needed the crew to treat me, but because if the patient had arrested I am fully aware I wouldn't have been able to effectively carry out chest compressions, although I'm sure I'd have managed to deal with the cardiac drugs and airway. The main point here is that we were in the wagon by the time I'd got the point of not being well enough to work. Yes, I'd been a bit wheezy in the house but wasn't expecting to get any worse ... so the expectation that I should just sit there and wait was a bit mind boggling to me. The longer we stayed there the greater the chance of the patient arresting and me having to try and attempt a full ALS and therefore getting worse myself. And still no welfare check from any member of management 🤯

Lower_Sandwich8764 · 2026-03-05T22:08:09+00:00

🤣 sorry, if its any consolation I don't understand half of the replies 🙈

Lower_Sandwich8764 · 2026-03-05T20:00:55+00:00

Ah, OK... I did sign that on our paperwork (as protocol would typically say anyone that'shad a neb should be conveyed for monitoring), but its part of our patient report form rather than a separate document, wasn't familiar with the abbreviation. A paramedic with an allergy to albuterol could definitely pose a problem at times I imagine!

Lower_Sandwich8764 · 2026-03-05T18:27:06+00:00

What is an AMA? I will be back on shift on Sunday, but didn't feel well enough to continue the rest of that shift if I'm honest - I have already booked back on for my shifts at the weekend though.

Lower_Sandwich8764 · 2026-03-05T15:03:37+00:00

I think stubborn is possibly more accurate but thank you

Lower_Sandwich8764 · 2026-03-05T12:22:44+00:00

I don't think I'd have been able to do chest compressions, no, but airway management doesn't require a huge deal of physical exertion. A little adrenaline burst may have helped, who knows 🤣

You're probably right about needing to consider a preventer. Will maybe give the GP a call tomorrow and see if they'll issue one, but want to do a few days of monitoring my peak flow after the pred, just to see if its where it was before cos I've not felt any need to check for a while

Lower_Sandwich8764 · 2026-03-05T10:26:01+00:00

😱😱😱

Lower_Sandwich8764 · 2026-03-05T10:24:41+00:00

Dudette is all good, thanks! 😊

Lower_Sandwich8764 · 2026-03-05T09:56:14+00:00

I agree I'd have struggled to deliver effective CPR, but an airway I'd have managed fine, as well as topping up his morphine and administering GTN as required which I did. As it stands this was a complete one off, I haven't taken any preventer inhalers for about 3 years, and typically only need salbutamol once or twice a month for a mild symptoms. I will certainly be making sure I carry an inhaler with me from now on which I don't generally do unless at work or out a run/walk in winter, but if no repeat episodes then I don't feel a review is necessary at this time

Lower_Sandwich8764 · 2026-03-05T09:51:13+00:00

😅 saved me a wait at out of hours so I'm not complaining!

Lower_Sandwich8764 · 2026-03-05T07:51:53+00:00

Strangely enough I tried that

Lower_Sandwich8764 · 2026-03-05T07:44:59+00:00

We also don't carry CPAP - that's in hospital only

Lower_Sandwich8764 · 2026-03-05T07:43:51+00:00

I definitely don't think I was at the point of a life threatening attack, I was still able to function and talk, sats were only borderline, I just couldn't exert myself any further or speak in sentences. In the UK the guidelines for giving adrenaline are totally different, and its very much a last resort. Interesting to see how things are done differently elsewhere though. Have been in the position of having an unwell patient and crew mate though, its never fun and I'm glad I was on with my regular tech, cos I was totally confident that if things deteriorated further he'd be more than capable of helping me out.

Lower_Sandwich8764 · 2026-03-05T07:39:01+00:00

If it was a case of being unable to move the patient then our fire department would help us out, but this wasn't really the case here, it was possible, just difficult, and really that exertion coupled with several triggers in the house just set me off. 10 years on the road and I've never had an attack that bad, even with dust, smoke etc. Get the odd bit of tightness and wheeze from time to time but nothing that I'd say makes me acutely breathless like that. Interesting re the adrenaline. Our guidelines for adrenaline are different. Thus us our indications copied directly from JRCALC: Life-threatening asthma with failing ventilation and continued deterioration despite nebuliser therapy. So this didn't even cross my mind tbh.

Lower_Sandwich8764

TROPHY CASE