He was a 4 year old boy suffering from Mild Asthma. He was on regular Budecort inhaler and was
well controlled. His parents brought him one day with problem of cold and runny nose. I thought
he had viral illness. I prescribed Benadryl syrup and Asthalin inhaler for emergencies.
I could not judge that emergency was to follow the same night.
His mother called me at 1 in the night that he had high fever and was breathless.
i advised paracetamol, repeated puffs of Asthalin and to rush him to hospital where he could be nebulised and assessed.
They lived atleast 45 minutes from the hospital. They did have the Nebuliser at home but did not have any nebulising solutions. There was no chemist nearby.
They had already lost a child due to croup.
I was also worried but convinced them to reach hospital quickly or ask for an ambulance in case baby needed oxygen.
They  said they had Omnacortil at home, i told them to give it to baby and rush to the hospital which
they did. In the hospital they did not find him in distress , assessed him and sent him home with
nebulising solutions as child did not cooperate to take nebuliser in unfamiliar surroundings of hospital.
They nebulised him at home and brought him to me next day in outpatient.
I realized the importance of giving a written protocol to patients to handle emergencies at home.
No matter how trivial the viral infection is the viruses multiply rapidly and can trigger serious Asthma attack
as happened in this baby, I gave them step wise  written protocol to judge the emergency and to start treatment until you reach medical facility.
To my mind this is a very crucial step in any disese , is a part of health education but is often neglected.