Asthma Action Plan

What is an asthma action plan?

Ask your doctor for written directions about how to prevent and treat asthma attacks at home. These written instructions are called your “asthma action plan.” Your plan will tell you how to take your controller and rescue medicines based on your peak flow meter readings.

Your doctor will show you how to use a peak flow meter and take your medicines. Checking peak flow meter readings regularly and following your action plan will help avoid the dangers of asthma that is out of control.

Download and print this asthma action plan and take it to your next doctor’s appointment. Complete the plan with your doctor and use it to guide your asthma treatment. Keep the plan on your fridge or somewhere that you can easily find it when you have an asthma attack. If your child has asthma, you should also complete the school authorization form and give it to your child’s school along with an extra copy of the plan.

Seek emergency medical attention

If you have the symptoms of a serious flare-up or if your peak flow is less than 50% of your personal best, call your doctor right away or go directly to the nearest emergency room (by ambulance, if necessary).

Introduction

An asthma action plan helps you understand how to manage your asthma and what to do when you have an asthma attack. The action plan is a color-coded plan that lists the symptoms that indicate whether or not your condition is under control and what actions to take.

  • If you have symptoms in the green zone, it means you are doing well.
  • If you have symptoms in the yellow zone, it means you are having problems.
  • If you have symptoms in the red zone, you need medical care right away.

Follow the plan that you and your health care provider develop. Review your plan with your health care provider at each visit.

What triggers your asthma?

Knowing the things that can trigger an asthma attack or make your asthma symptoms worse is very important. Talk to your health care provider about your asthma triggers and how to avoid them. Record your known asthma triggers here: _______________

What is your personal best peak flow reading?

If you use a peak flow meter, determine your personal best reading. Record it here: _______________

Red zone

Symptoms in this zone mean that you should get medical help right away. You will likely feel distressed and have symptoms at rest that restrict your activity. You are in the red zone if:

  • You are breathing hard and quickly.
  • Your nose opens wide, your ribs show, and your neck muscles become visible when you breathe in.
  • Your lips, fingers, or toes are a bluish color.
  • You have trouble speaking in full sentences.
  • Your peak flow reading is less than __________ (less than 50% of your personal best).
  • Your symptoms do not improve within 15–20 minutes after you use your reliever or rescue medicine (bronchodilator).

If you have any of these symptoms:

  • Call your local emergency services (911 in the U.S.) or go to the nearest emergency room.
  • Use your reliever or rescue medicine.
    • Start a nebulizer treatment or take 2–4 puffs from a metered-dose inhaler with a spacer.
    • Repeat this action every 15–20 minutes until help arrives.

Yellow zone

Symptoms in this zone mean that your condition may be getting worse. You may have symptoms that interfere with exercise, are noticeably worse after exposure to triggers, or are worse at the first sign of a cold (upper respiratory infection). These may include:

  • Waking from sleep.
  • Coughing, especially at night or first thing in the morning.
  • Mild wheezing.
  • Chest tightness.
  • A peak flow reading that is __________ to __________ (50–79% of your personal best).

If you have any of these symptoms:

  • Add the following medicine to the ones that you use daily:
    • Reliever or rescue medicine and dosage: _______________
    • Additional medicine and dosage: _______________

Call your health care provider if:

  • You remain in the yellow zone for __________ hours.
  • You are using a reliever or rescue medicine more than 2–3 times a week.

Green zone

This zone means that your asthma is under control. You may not have any symptoms while you are in the green zone. This means that you:

  • Have no coughing or wheezing, even while you are working or playing.
  • Sleep through the night.
  • Are breathing well.
  • Have a peak flow reading that is above __________ (80% of your personal best or greater).

If you are in the green zone, continue to manage your asthma as directed:

  • Take these medicines every day:
    • Controller medicine and dosage: _______________
    • Controller medicine and dosage: _______________
    • Controller medicine and dosage: _______________
    • Controller medicine and dosage: _______________
  • Before exercise, use this reliever or rescue medicine: _______________

Call your health care provider if you are using a reliever or rescue medicine more than 2–3 times a week.

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