I have had so many panic attacks that I actually grade them from 1-10, I have only had 3 10's but didn't go to the ER for any of them mainly because my Mom and Grandmother had this and I know what it is since I have had it so long.
What to do. If they strike from out of nowhere find someplace quiet and non stimulating your nerves are completely on edge, tell yourself it is just a panic attack and this is a normal response to fear, you may have to repeat this statement a few times depending on how long the attack lasts and severity. If you feel it coming on, and you may feel a buzzing in your head and dissociation creeping in try to pull over or get to a quiet place and talk yourself down, if that doesn't work know it will be over soon. The key is to lower your fear level, your going to get hit with a truck of chemicals designed by hundreds of thousands of years to make you fight or flight, so the best you can do is not fear and ride it out.
Shake it off and smile, once the PA is over dont think about it, move on, its the best thing you can do. Theres a ton of coping theories out there, most say the same thing, let it flow through you, It ***** but its what needs to be done, and the less you fear the less intense they typically are.
Good Luck.
I would suggest searching around and scheduling an appointment with a psychiatrist and discussing your otpions to control your anxiety and make your life more manageable. And certainly, if one gets bad enough the ER is open 24/7 and for you an anxiety attack is an emergency and the ER will never turn you away, they will help you.
I get panic attacks very often and have never gone to the ER. For me when I get a panic attack first of all cry and scream and get all the bad feelings out...then I lay on my back and take 3 really really deep breathes. When Im calm enough to start to focus, I then start to read a book or watch tv becase it gets your mind off of whatever gives you the panic attack.
They always eventually pass. There is a great program called "Attacking anxiety and depression" available through the Midwest center. It sounds silly on TV but really works for panic attacks. It teaches you how to breath, speak soothingly to yourself and not be afraid of panic attacks.
Also, have you tried calming herbs like valerian, kava, passionflower, hops etc? Or, there is a drink called A to B Calm. It has magnesium and calcium. Other magnesium drinks work well and quickly too. They are powders that you mix in hot water, almost like tea.