Why Have an Action Plan?

Breathe easier with a written asthma action plan. Your doctor can help you develop it.

If you have asthma, you’re in the driver’s seat to monitor and manage it. But even a great driver needs a roadmap at times. Your map can be your personal asthma action plan. Whether this plan is for you or a child who has asthma, it can also be used to encourage self-management.

You and your doctor or asthma specialist should develop this plan together. This individualized worksheet can help you learn how to:

• Manage your daily symptoms and know when to take which medications
• Control your asthma over time
• Handle an asthma flare-up or attack
• Know when it’s time to see your doctor or seek emergency care

The action plan typically has two parts: information about you and a section that includes a scale to measure and track your symptoms. It also includes instructions on daily management of your asthma and how to manage worsening symptoms.

Part One: You

This section should have your full name, date the action plan was developed and emergency contact details. It should list the names and phone numbers of your doctor, allergist or asthma specialist (this may be a pulmonologist, allergist or immunologist). If you use a peak flow meter, write down your personal best peak air flow. You may also list your triggers.

Part Two: The Three Zones

The asthma scale is based on three “zones”:

1. The green zone means you’re doing well. You are not coughing, wheezing, having trouble breathing or feeling tightness in your chest. You can work and exercise at your normal level and are sleeping well. Your peak flow meter, if you use one, should be at or above 80 percent of your personal best peak flow.
   

   This zone includes instructions for your daily asthma control and maintenance medications by name, how much to take and when to take them. When your asthma is in this zone, continue to take your medications as usual.
   

2. The yellow zone means you’re getting worse. It may be hard to breathe, or you may be coughing, wheezing or have a tight chest. Your usual activities may be setting off your symptoms. You may wake at night with symptoms. Your peak flow might register at 50 to less than 80 percent of your personal best.
   

   This zone should instruct you to continue your green zone medicines and add your quick-relief/rescue medicines, as prescribed by your doctor. This zone includes these medicines by name, how much to take and when and how often to take them.

   The yellow zone also includes information about whether you need to add or increase medication or call your doctor. Your action plan should include a time frame (most often it’s if you’re not back in the green zone after an hour) and instructions on actions to take if you stay in the yellow zone. Even if you return to the green zone within the specified time, your plan should tell you if there are changes to make to your regimen — or if you need to call your doctor.

3. The red zone means a medical alert. Get immediate help! Your peak flow is below 50 percent of your personal best. Symptoms may be one or more of the following: extreme shortness of breath or working harder to breathe; inability to perform usual activities, or asthma medicine that isn’t working anymore. Your plan will advise to use your quick-relief/rescue medicines until you get help. It will also tell you if you need to do anything differently with other medications and whom to call. If you can’t reach anyone by phone right away, seek emergency medical care IMMEDIATELY.

Don’t wait — call 911 if you can’t walk or talk due to shortness of breath, your symptoms are severe and worsening or if your lips or fingernails are blue or gray!

Keep copies of your plan at home and work. Review it with your doctor regularly. If the action plan is for your child who has asthma, make sure to share it with care providers, school nurses and coaches.

With an asthma action plan, you may be able to breathe easier in more ways than one.

By Ginny Greene, Contributing Editor

Sources
National Heart, Lung, and Blood Institute. Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Accessed: January 15, 2016.
Centers for Disease Control and Prevention. Asthma. Asthma action plan. Accessed: January 15, 2016.
American Academy of Allergy Asthma and Immunology. Asthma action plan. Accessed: January 15, 2016.

Last Updated: January 15, 2016