When Should You Take Your Child to the ER for Asthma?

This is always a scary time, and as mom to three kids with asthma, we had a lots of trips to the hospital when my kids were little.

They were in the hospital 12 times for asthma (two of those were ICU). By the way....I REALLY hate pneumonia and smoke from forest fires. That caused all of the hospitalizations.

How to know if you need to go to the hospital

How do you know if you can take care of your child at home? Or should you go to the hospital?

Nemours Hospital has a webpage called “When to go to the ER if your child has asthma”. 

If you have any of these, Nemours says you should “see your doctor immediately, go to the ER, or call an ambulance.1

  • Your child has constant wheezing.
  • Your child uses quick-relief medicines (also called rescue or fast-acting medicines) repeatedly for severe flare-up symptoms that don't go away after 15–20 minutes or return again quickly.
  • Your child has a lasting cough that doesn't respond to inhaled quick-relief medicine.
  • There are changes in your child's color, like bluish or gray lips and fingernails.
  • Your child has trouble talking and can't speak in full sentences.
  • The areas below the ribs, between the ribs, and in the neck visibly pull in during inhalation (called retractions).

All of these are symptoms that you can see with your child. But some parents like to use oxygen monitors, (called oximeters) to see a number on the screen.

It's important that you go by the symptoms, NOT the oxygen level.

Doctors told us this many times when our kids were little. This article called “Let’s talk oximeters” explains it this way:

“Oxygen saturation is not a good indication of how bad your asthma flare-up is. Asthmatics are notoriously good oxygen compensators and can have near normal or completely normal oxygen stats during the midst of a severe asthma attack. Asthma is a disease of the airways, not the little air sacs (alveoli) where the gas exchange itself takes place. So even if your airways are very constricted and tight, often enough oxygen is able to pass through to your blood and therefore show a normal or near normal oxygen saturation. Now if you have been working really hard to breathe for a time (which can be days if you’re in the middle of a bad flare up) your body will eventually tire out as you won’t be able to compensate anymore and your oxygen levels will start to rapidly drop.”

Kids can go from bad to worse VERY quickly. I have had that happen with my kids - even shocking the doctor at the hospital with how quickly my son ended up in ICU.

And there's the matter of death. Many people are surprised to find out that people still die from asthma - in fact, 10 people die every day from asthma.

PLEASE make a plan with your doctor so you know when you need to take your child to the emergency room!

The role of asthma action plans

An Asthma Action Plan can help. It has green (good), yellow (caution), and red (emergency) zones that help you know how to treat your asthma. You can download a copy and fill it out with your doctor.

With my kids, we learned that sometimes it is best to let the hospital take over medical care for our kids. They are fully trained and have all of the equipment to monitor them.

For those of you with small children that have asthma, pay close attention to their symptoms! Have a plan of what to do if your kids have any of the symptoms listed above - whether to call your doctor, call 911 or head to the hospital.

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