Asthma Healing - Developing an Asthma Action Plan

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Developing an Asthma Action Plan

What Is an Asthma Action Plan?

An asthma action plan is a written plan developed by your doctor or asthma specialist to help you or another family member, including teenagers and children, manage asthma and prevent asthma attacks. The plan is designed to tell you or other family members what to do when there are changes in the severity of asthma symptoms and in peak flow numbers.

How Are Asthma Action Plans Designed?

An asthma action plan gives you and your family important health information that can be used in the event that you or other family members (including teenagers and children) with asthma experience an asthma emergency.

Asthma action plans can be organized in a number of ways. Your asthma action plan may include:

A list of asthma triggers that are responsible for asthma symptoms and how to avoid them
A list of peak flow meter readings and zones based on the person's personal best reading
A list of routine asthma symptoms such as coughing, wheezing, tightness in the chest, shortness of breath, and excess mucus production, as well as what you should do if these symptoms occur
The name and dose of the daily asthma medication that needs to be taken even when you don't have asthma symptoms
The name and dose of the quick-acting or rescue medication that needs to be taken when you develop asthma symptoms
The name and dose of the reliever medication that needs to be taken when you are having an asthma attack
Emergency telephone numbers and locations of emergency care
Instructions about when to contact the doctor, whom to call if the doctor is unavailable, and a list of where to get emergency asthma treatment.

For convenience, asthma action plans are often broken down into three zones on your peak flow meter: green, yellow, and red. In each zone, your asthma action plan will give you doctor-written instructions on how to handle each circumstance.

Green Zone: Where you should be every day -- NO asthma symptoms. You are able to do usual activities and sleep without coughing, wheezing, or breathing difficulties. Peak flow is 80%-100% of personal best.
Yellow (Caution) Zone: This is NOT where you should be. Your symptoms may include coughing, wheezing, and mild shortness of breath. You may have nighttime asthma and daily activities may be disturbed. You may be more tired than usual. Peak flow is 50%-80% of personal best. Call your doctor if you keep dropping into the yellow zone. The green zone plan may need to be changed to prevent this.
Red Zone: Red zone means you need urgent medical care. Your asthma symptoms may include frequent, severe cough, severe shortness of breath, wheezing, trouble talking, walking, and rapid breathing. Peak flow is <50% of personal best. If you are gasping for air, have blue lips or fingernails, or are unable to do a peak flow, call 9-1-1.

Your Asthma Action Plan (Adults and Teens)

You can print out and use WebMD’s Asthma Action Plan (at the end of this article) to record important information about your asthma. You can also use the same form for another family member with asthma, including teenagers. In this online form, you’ll have ample space to record the names and emergency phone numbers of your health care providers and asthma specialists.

Take this asthma action plan to your asthma doctor at your next visit for help with asthma. Your doctor can fill in the specific asthma medications, dosages, and frequency, depending on your peak flow reading (whether green zone, yellow zone, or red zone).

Each time you use your peak flow meter throughout the day, compare the reading with the percentages on your personal asthma action plan. If your peak flow level puts you in the green zone, you’re all clear. If you’re in the yellow zone, read the instructions your doctor wrote down in how to treat the symptoms. If your peak flow level is the red zone, this is an emergency. Read your doctor’s instructions in how to quickly act to reverse symptoms with asthma medication. If there is no change in your asthma symptoms, go to the emergency room or call 9-1-1.

An Asthma Action Plan for Your Child

You can also print out and use WebMD's Asthma Action Plan (at the end of this article) to record important information about your child’s asthma. Fill in the names and phone numbers of your child’s health care providers. Ask your child’s doctor to fill in the instructions for all asthma medications, dosages, and frequency, depending on your child’s peak flow level (green zone, yellow zone, red zone).

Help your child understand his asthma by reviewing the asthma action plan daily. If your child’s peak flow reading is in the green zone, your child should have no asthma symptoms and medications should be given as listed on the plan. If your child’s peak flow level falls into the yellow zone, check the asthma action plan for the doctor’s instructions. Be sure to contact the doctor or nurse if the medications do not seem to be helping your child.

If your child’s peak flow reading falls into the red zone, this means it’s time to act quickly with the doctor’s instructions. First, read your child’s asthma action plan and make sure you are giving the proper emergency treatment. If this asthma treatment fails to help your child’s asthma symptoms, then go to the emergency room or call 9-1-1.

The asthma action plan outlines everything you need to do for a normal day with no asthma problems to a time of asthma emergency. Make sure your child’s teacher and any other adult caregiver has a copy of this asthma action plan.

Review Your Asthma Action Plans

Asthma action plans should be reviewed with your asthma doctor at least once a year. Changes in the asthma action plan may be needed because of changes in your peak flow numbers or the medications you are taking.

Always keep your asthma action plan where it can be easily found by you or your family.

Print Out Asthma Action Plan

Print out and use this asthma action plan to record important information about your asthma or a family member’s asthma (including teenagers and children).

Date:	Person's Name / Clinic Number
Disease Severity:
Doctor: Phone:
Nurse or Therapist: Phone:
Evening / Weekend Phone:

Personal Best Peak Flow (PF):

GREEN ZONE: All Clear
Where you or your family member should be every day -- NO asthma symptoms. Able to do usual activities and sleep without coughing, wheezing, or difficulty breathing. Peak flow is 80%-100% of personal best.

ACTION: Control asthma. Use these medicines every day, on good days and bad days, to prevent asthma symptoms. Use a spacer with metered dose inhalers (or other asthma inhaler and/or medications prescribed for a child).

Medication ____	Dose ____	Morning ____	Afternoon ____	Evening ____	Bedtime ____
Medication ____	Dose ____	Morning ____	Afternoon ____	Evening ____	Bedtime ____
Medication ____	Dose ____	Morning ____	Afternoon ____	Evening ____	Bedtime ____
Medication ____	Dose ____	Morning ____	Afternoon ____	Evening ____	Bedtime ____
Medication ____	Dose ____	Morning ____	Afternoon ____	Evening ____	Bedtime ____
Medication ____	Dose ____	Morning ____	Afternoon ____	Evening ____	Bedtime ____

Use ______ 15-20 minutes before exercise or exposure to a known trigger.

YELLOW ZONE: Caution
This is NOT where you should be. There may be coughing, wheezing, and mild shortness of breath. Sleep and usual activities may be disturbed. You may be more tired than usual. Peak flow is 50%-80% personal best.

ACTION: Relief of Symptoms.

Keep taking green zone medicines listed above. Use spacer with metered dose inhalers (or other device prescribed for a child).
Add quick-relief medicine: Albuterol or Maxair ____ puffs or ________ in nebulizer. May use every 4 hours as needed. Also add: ____________________.
After taking quick-relief medicine, symptoms should be relieved in 5 to 15 minutes. If symptoms do not improve completely, REPEAT quick-relief medicine 1 to 2 more times, 5 to 20 minutes apart (up to 3 treatments in one hour). (For children, repeat albuterol 1 to 2 more times, 15 to 20 minutes apart; use up to 3 treatments in one hour.) If there is no improvement, ADD: ____________________.
CALL your doctor or nurse/therapist for further advice.
If you or other family member improves completely after 2 to 3 treatments, continue the quick-relief medicine 4 times per day for the next 24 hours. Call for further advice.
For children: If symptoms completely go away but return in 4 hours or less, repeat albuterol dose and continue to use 4 times per day for the next 48 hours. ADD:

NOTE: Call the doctor if you or other family member keeps dropping into the yellow zone. The green zone plan may need to be changed to prevent this.

RED ZONE: Medical Alert -- This is an Emergency!
Red zone means you or your family member, including teenagers and children, need urgent medical care. Symptoms may include frequent, severe cough; severe shortness of breath; wheezing; trouble talking and walking; and rapid breathing. Peak flow is < 50% of personal best.

ACTION: Reversal of symptoms

Take these medicines: Albuterol with spacer or Maxair ______ or _______ in nebulizer.
ADD: __________________.
Give your child albuterol 2 puffs or nebulizer treatment or albuterol or Xopenex.
If there is no change, GO TO THE EMERGENCY ROOM.
If you or your family member (including teenagers and children) has trouble walking or talking, is gasping for air, has blue lips or fingernails, or is unable to do a peak flow, this is an emergency. CALL 9-1-1.
If symptoms improve but do not go away completely, return to the yellow zone plan and follow the instructions. Call your doctor for further advice.

Signature:

Print Name:

Remember to take the asthma diary and asthma action plan to each doctor visit so the doctor can assess how well the treatment plan is working.

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