Asthma Action Plan

People with Asthma Should Have an Asthma Action Plan

All people with asthma should have an asthma action plan. An asthma action plan (also called a management plan) is a written plan that you develop with your doctor to help control your asthma.

The asthma action plan shows your daily treatment, such as what kind of medicines to take and when to take them. Your plan describes how to control asthma long term AND how to handle worsening asthma, or attacks. The plan explains when to call the doctor or go to the emergency room.

If your child has asthma, all of the people who care for him or her should know about the child's asthma action plan. These caregivers include babysitters and workers at daycare centers, schools, and camps. These caretakers can help your child follow his or her action plan.

Asthma Action Plan

The National Heart, Lung, and Blood Institute, a federal agency, recommends this sample asthma action plan. You and your doctor should develop a written asthma action plan to help control your asthma. Look on the back for a list of possible asthma triggers and ways to avoid them.

• Download a printable Action Plan
• View a web-based Action Plan

For: ______________________________ Date: ________________________

Doctor: ____________________________ Doctor's Phone Number: _______________________

Hospital/Emergency Department Phone Number: _____________________________

Green Zone: Doing Well

No cough, wheeze, chest tightness, or shortness of breath during the day or night

Can do usual activities

And, if a peak flow meter is used,

Peak flow: more than _________________ (80 percent or more of my best peak flow)

My best peak flow is: _______________

Take these long-term control medicines each day (include an anti-inflammatory).

Yellow Zone: Asthma Is Getting Worse

• Cough, wheeze, chest tightness, or shortness of breath, or
• Waking at night due to asthma, or
• Can do some, but not all, usual activities

-Or-

Peak flow: ____________ to ______________ (50 to 79 percent of my best peak flow)

First:

Add: quick-relief medicine--and keep taking your GREEN ZONE medicine.

Take short-acting beta2-agonist _______________________

2 or 4 puffs, every 20 minutes for up to 1 hour Nebulizer, once

Second:

If your symptoms (and peak flow, if used) return to GREEN ZONE after 1 hour of above treatment:

Continue monitoring to be sure you stay in the green zone.

-Or-

If your symptoms (and peak flow, if used) do not return to GREEN ZONE after 1 hour of above treatment:

Take short-acting beta2-agonist: _______________________

• 2 or 4 puffs, every 20 minutes for up to 1 hour
• Nebulizer, once

• Add oral steroid: ___________________________

• ________ mg per day
• For ___________ (3 10) days

• Call the doctor before/ within _____ hours after taking the oral steroid.

Red Zone: Medical Alert!

• Very short of breath, or
• Quick-relief medicines have not helped, or
• Cannot do usual activities, or
• Symptoms are same or get worse after 24 hours in Yellow Zone

-Or-

Peak flow: less than __________________ (50 percent of my best peak flow)

Take this medicine:

Short-acting beta2-agonist ______________________________ 4 or 6 puffs or Nebulizer

Oral steroid __________________________ mg

Then call your doctor NOW.

Go to the hospital or call an ambulance if:

• You are still in the red zone after 15 minutes AND
• You have not reached your doctor.

Danger Signs

• Trouble walking and talking due to shortness of breath
• Lips or fingernails are blue
• Take 4 or 6 puffs of your quick-relief medicine AND
• Go to the hospital or call for an ambulance at (phone) _______________________ NOW!

How To Control Things That Make Your Asthma Worse

This guide suggests things you can do to avoid your asthma triggers. Put a check next to the triggers that you know make your asthma worse and ask your doctor to help you find out if you have other triggers as well. Then decide with your doctor what steps you will take.

Allergens

Animal Dander

Some people are allergic to the flakes of skin or dried saliva from animals with fur or feathers.

The best thing to do:

• Keep furred or feathered pets out of your home.

If you can't keep the pet outdoors, then:

• Keep the pet out of your bedroom and other sleeping areas at all times, and keep the door closed.
• Remove carpets and furniture covered with cloth from your home. If that is not possible, keep the pet away from fabric-covered furniture and carpets.

Dust Mites

Many people with asthma are allergic to dust mites. Dust mites are tiny bugs that are found in every home-in mattresses, pillows, carpets, upholstered furniture, bedcovers, clothes, stuffed toys, and fabric or other fabric-covered items.

Things that can help:

• Encase your mattress in a special dust-proof cover.
• Encase your pillow in a special dust-proof cover or wash the pillow each week in hot water. Water must be hotter than 130º F to kill the mites. Cold or warm water used with detergent and bleach can also be effective.
• Wash the sheets and blankets on your bed each week in hot water.
• Reduce indoor humidity to below 60 percent (ideally between 30-50 percent). Dehumidifiers or central air conditioners can do this.
• Try not to sleep or lie on cloth-covered cushions.
• Remove carpets from your bedroom and those laid on concrete, if you can.
• Keep stuffed toys out of the bed or wash the toys weekly in hot water or cooler water with detergent and bleach.

Cockroaches

Many people with asthma are allergic to the dried droppings and remains of cockroaches.

The best thing to do:

• Keep food and garbage in closed containers. Never leave food out.
• Use poison baits, powders, gels, or paste (for example, boric acid). You can also use traps.
• If a spray is used to kill roaches, stay out of the room until the odor goes away.

Indoor Mold

• Fix leaky faucets, pipes, or other sources of water that have mold around them.
• Clean moldy surfaces with a cleaner that has bleach in it.

Pollen and Outdoor Mold

What to do during your allergy season (when pollen or mold spore counts are high):

• Try to keep your windows closed.
• Stay indoors with windows closed from late morning to afternoon, if you can. Pollen and some mold spore counts are highest at that time.
• Ask your doctor whether you need to take or increase anti-inflammatory medicine before your allergy season starts.

Irritants

Tobacco Smoke

• If you smoke, ask your doctor for ways to help you quit. Ask family members to quit smoking, too.
• Do not allow smoking in your home or car.

Smoke, Strong Odors, and Sprays

• If possible, do not use a wood-burning stove, kerosene heater, or fireplace.
• Try to stay away from strong odors and sprays, such as perfume, talcum powder, hair spray, and paints.

Other things that bring on asthma symptoms in some people include:

Vacuum Cleaning

• Try to get someone else to vacuum for you once or twice a week, if you can. Stay out of rooms while they are being vacuumed and for a short while afterward.
• If you vacuum, use a dust mask (from a hardware store), a double-layered or microfilter vacuum cleaner bag, or a vacuum cleaner with a HEPA filter.

Other Things That Can Make Asthma Worse

• Sulfites in foods and beverages: Do not drink beer or wine or eat dried fruit, processed potatoes, or shrimp if they cause asthma symptoms.
• Cold air: Cover your nose and mouth with a scarf on cold or windy days.
• Other medicines: Tell your doctor about all the medicines you take. Include cold medicines, aspirin, vitamins and other supplements, and nonselective beta-blockers (including those in eye drops).

Change in Albuterol Inhalers

Anyone in the United States who uses an albuterol inhaler containing chlorofluorocarbons, also known as CFCs, must change inhalers.

The propellant—the "puff" that pushes the medication out of the inhaler—has been changed from CFCs to hydrofluoroalkanes, also known as HFA. Since December 31, 2008, albuterol inhalers that contain CFCs are no longer sold in the United States. Albuterol inhalers that contain HFA have now replaced CFC inhalers.

CFCs damage the Earth's ozone layer and harm the environment. The HFA inhalers are safe for the ozone layer, and they contain the same albuterol medication.

Some people have already switched over to the HFA inhalers. If you use an albuterol CFC inhaler talk with your doctor now about switching to an albuterol HFA inhaler. There are enough albuterol HFA inhalers for everyone who needs them.

More information is available at the U.S. Food and Drug Administration (FDA) Web site at http://www.fda.gov/cder/drug/podcast/ albuterol_inhalers_20080926.htm.

Flu Shots - Get Vaccinated

People with Asthma Should Receive a Flu Vaccination Every Year

Influenza, commonly called "the flu," is caused by the influenza virus, which infects the respiratory tract (nose, throat, lungs). People with asthma are more likely to have serious health problems from getting the flu, yet most people with asthma don’t receive a flu shot every year.

If you have asthma, you need to take steps to prevent getting the flu. Respiratory infections such as the flu can affect your lungs, causing an asthma attack. Flu vaccine is the first and most important step you can take to protect yourself and your loved ones from the flu.

CDC’s Seasonal Flu

Learn more about the flu, how to prevent it, what to do if you get sick, where to find a flu clinic near you, and actions you can take to protect yourself and your loved ones.

2009 H1N1 Flu (Swine Flu)

This spring, a new influenza virus began causing illness in people and spreading around the world. Originally called “swine flu” because the virus genes were similar to some influenza viruses that infect pigs, the new virus has been named “novel H1N1.” Find out more about novel H1N1 and CDC’s public health response.

• H1N1 Flu (Swine Flu): General Information
• H1N1 Flu: Asthma Information for Patients and Parents of Patients

Seasonal Flu Information for Parents

Information about the danger of the flu and recommendations for flu vaccination for children and their contacts.

Adults with Asthma Should Receive a Flu Vaccination

Respiratory infections like influenza are more serious for patients with asthma because they often can lead to pneumonia and acute respiratory disease.