Select the one that is best for you, print a copy and fill in the information requested. If student improves to yellow zone, send student to doctor or contact doctor. A list of the persons triggers and how to avoid them, instructions for taking asthma medicine, information on what to do during an asthma episode, instructions on when to call a doctor, and. A peakflowbased plan may be particularly useful for patients who have difficulty perceiving signs of worsening asthma. The asthma action plan chosen should be appropriate for the persons age, treatment regimen, asthma severity, culture, language, literacy level, and ability to selfmanage. Perform skin or blood allergy tests for all patients with persistent asthma. The goal of an asthma action plan is to reduce or prevent flareups and emergency department visits through daytoday management. Assess asthma control at every visit by selfadministered standardized test or verbal history. If you are in the red zone then you are experiencing a severe asthma episode. An asthma action plan or management plan is a written plan that you develop with your childs doctor to help control your childs asthma. Asthma action plan engpdf asthma and allergy foundation. The asthma action plan includes information related to treatment regimes and patient selfmanagement. Work with your childs doctor and come up with a written action plan for managing your.
This test should be done by your healthcare provider at least once a year. Follow the yellow and red zone plans for rescue medicines according to asthma symptoms. 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 activitiesorpeak flow. Asthma action plan health library unitedhealthcare. Asthma uk research shows that using an asthma action plan is one of the best ways to look after your childs asthma.
Green zone doing well breathing is good no coughing, wheezing, chest tightness, or shortness of breath during the day or night, and able to do usual activities work, play, and exercise, and peak flow is more than. Take a photograph of it and keep it on your phone you. Apr, 2020 the goal of asthma selfmanagement is to achieve better health through controlling and preventing asthma attacks. Having a written stepbystep plan in place provides clear instructions. Symptoms are same or worse after 24 hours in the yellow zone or very short of breath or quickrelief asthma medicines have not helped or cannot. When this happens there can be coughing, a whistling sound when you breathe wheezing, chest tightness, and difficulty breathing.
Intermittent mild persistent moderate persistent severe persistent heshe has had many or severe asthma attacksexacerbations school staff. The asthma action plan is to be completed by a primary care provider for each. I should continue using my normal medications as directed by my doctor, and remeasure my peak flow every weeks months. Asthma action plan the colors of a traffic light will help. Connect with us 1200 first street, ne, washington, dc 20002 phone. Take this to your doctor here is your asthma action plan. Make an asthma action plan the action plan looks at what triggers or brings on your childs asthma. This brochure provides an asthma action plan that will help you learn the steps to selfmanage your asthma so you can live a life as symptomfree as possible. Your personalised asthma action plan has all the information and tips you need to stay well. This plan is for patients with asthma or wheeze your. An asthma action plan is a written plan that tells you how to treat your asthma on a daily basis. Breathing is good no cough or wheeze can work and play sleeps well at. Asthma action plans national asthma council australia.
They comprise of either 3 or 4 stages depending on patient and health professionals. Connecticut department of health asthma action plans in pdf and word. Aug 24, 2019 use the action plan to recognize the signs of rapidly worsening asthma. You need to treat the inflammation in your lungs to minimize the longterm effects of asthma. Dec, 2017 the ramp asthma action plan was supported by cooperative agreement number 1u58dp00101601 from the centers for disease control and prevention. The colors of a traffic light will help you use your asthma medicines. Asthma action plan national heart, lung, and blood institute.
Help your child gain control over asthma, 402f04021. Providing this asthma education at the time of diagnosis and reinforcing it at all subsequent visits lead to better outcomes in terms of achieving the goals of asthma therapy, namely few symptoms, no limits on activity, rare exacerbations, and normal lung function. Asthma treatment plan student parent instructions the pacnj asthma treatment plan is designed to help everyone understand the steps necessary for the individual student to achieve the goal of controlled asthma. To take the guesswork out of managing your asthma, use an asthma action plan. Other medicines and devices eg spacers i use for my asthma every day. The plan also includes your childs daily medicineneeds. It causes swelling and narrowing of the airways inside the lungs. Keep this plan with you and take it every time you see the doctor or nurse at your gp surgery or hospital.
This asthma action plan is adapted from the asthma action plan created by the national institutes of health. Our library includes some of the many different written asthma action plans available. Developing an asthma action plan asthma health information. The zones correspond to the colors of a traffic light. Call our friendly helpline nurses mondayfriday, 9am5pm 0300 222 5800.
The action plan may have a place for you to list your asthma triggers and notes on how to avoid them. Your asthma action plan fill this in with your gp or nurse the stepbystep guide that helps you stay on top of your asthma name and date. And the plan lists rescue medicinesfor quickrelief during an attack or when asthma signs start. If student stays in red zone, begin emergency plan. Electronic, fillable pdf versions of asthma action plans. Ask your doctor to fill out an asthma action plan for you. Ask your healthcare provider to complete an asthma action plan to tell you what to do daily and what to do in case of an asthma flareup. You can use it as a strategy to identify when your asthma may be flaring up and how to manage your asthma when it gets out of control. These tools for asthma control were created following the evidencebased guidelines.
Asthma action plan library national asthma council australia. Electronic, fillable pdf versions of asthma action plans click below to open forms. A written asthma action plan encourages selfmanagement of asthma. Nhlbi asthma guidelines 2007 written asthma action plans may be based on pef measurements or symptoms or both, depending on the preference of the patient and clinician. In addition to the academy and dhmhs recommendation for using the asthma action plan, a study published in thorax by drs. Cdc asthma asthma action plan apr 24, 2009 people with asthma should have an asthma action plan the asthma action plan shows your daily treatment, such as what kind. Asthma action plans may be based on symptoms with or without peak flow measurements. Perform spirometry at baseline and at least every 1 to 2 years for patients 5 years of age. Using an asthma action plan nationwide childrens hospital. Action plan templates are available from many different sources.
For instance, if you are in the green zone, you are healthy and your action plan may include taking your daily medications only. The contents of the ramp asthma action plan are solely the responsibility of the authors and do not necessarily represent the official views of the cdc. Call our friendly helpline nurses mondayfriday, 9am5pm 0300 222 5800 uk your written asthma action plan can help you stay on top of your asthma. The plan also helps you deal with sudden increases in your or your childs asthma symptoms asthma attacks. The ramp asthma action plan was supported by cooperative agreement number 1u58dp00101601 from the centers for disease control and prevention. Cicutto reports that an individualized asthma action plan is necessary in supporting asthma management and is a communication and coordination tool between students, parents, the health care provider, and school personnel. A plan can be very helpful, especially during an asthma flareup. Aug 23, 2018 an asthma action plan is a written series of steps and management techniques that should be used when a patient with asthma experiences worsening in symptoms of the condition. Asthma action plan asthma severity see reverse side asthma triggers identified things that make your asthma worse. My written asthma action plan helps me judge how well i am and know what i need to do if im not. Merely noting the symptoms would not help to cure this disease if you do not know what actually you should take note of. For more information contact the asthma society of canada at. Before taking this form to your health care provider, complete the top left section with.
An asthma action plan is a written series of steps and management techniques that should be used when a patient with asthma experiences worsening in symptoms of the condition. Health literacy asthma action plans asthma case studies. Merely noting the symptoms would not help to cure this disease. Add up the numbers to get the total and record at the bottom 1.
Fill it in with your doctor so you can answer these questions. To download straight to your computer, right click and choose save target as. The goal of asthma selfmanagement is to achieve better health through controlling and preventing asthma attacks. An asthma action plan aap is a written plan of action that uses 3 stoplight zones greenyellow red to help decide what treatment relating to symptoms or peak flow results is recommended to get and keep asthma under good control.
If you use a peak flow meter, the action plan will also tell you when low peak flow readings signal that an asthma attack has become an emergency. The vicious cycle of personalised asthma action plan. How to adjust your medication according to your symptoms. Adapted from finger lakes asthma action plan and nhlbi revised 10. See your doctor every 3 to 6 months for an asthma checkup. Written asthma action plans are one of the most effective asthma interventions available. Use the action plan to recognize the signs of rapidly worsening asthma. In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or. Acute asthma and wheeze personal action plan healthy london. If you know what to watch for and what steps to take, you will be able to make timely and appropriate decisions about managing asthma.
The asthma action plan will give you information about when and how to use longterm control medications and quickrelief medications. Asthma action plans come in a number of different formats but most commonly. Gibson and powell confirmed that using a written asthma action plan improves health outcomes for persons with asthma. Personal asthma action plans paaps have been guideline recommended for years, but consistently underissued by health professionals and underutilised by patients. This brochure is a asthma selfmanagement action plan for adults to be completed by doctors together with their patients with asthma. Asthma action plan alabama department of public health. My asthma action plan name date doctor doctors phone number symptoms my breathing is normal. Previous studies have investigated suboptimal paap implementation but more insight is needed into barriers to their use from the perspective of professionals, patients and primary care teams.
Take a photograph of it and keep it on your phone you can check what to do if your asthma gets worse. Asthma and allergy foundation of america 1235 south clark street suite 305, arlington, va 22202 phone. Every person with asthma needs to have a personalized asthma action plan. Read our tips on getting the best from a childs asthma action plan. An asthma action plan is your personal guide to manage your asthma when it gets out of control. The current british thoracic societyscottish intercollegiate guidelines network guideline includes the asthma uk action plan in its annexes. Asthma uk research shows that using an asthma action. An as thma action plan should be completed by a healthcare provider in partnership with the patient. Breathing is good no cough or wheeze sleep thru the night can run and play if recommended, peak flow above yellow sick caution.