Asthma action plan managing asthma national jewish health. I should continue using my normal medications as directed by my doctor, and remeasure my peak flow every weeks months. Create a personalized asthma action plan with your healthcare provider. This plan will help you know what to do when asthma is in control and when asthma symptoms start to act up. Pdf asthma action plancpg version with self management tips. An asthma management plan is a special plan that the doctor will make. Name asthma action plan, for children 6 years or older. Our library includes some of the many different written asthma action plans available. It can help you make quick decisions in case you are not. Work with your health care provider to create a plan for your child. Asthma action plan provider iinstructions at iinitial ppresentation, ddetermine tthe llevel oof aasthma sseverity level of severity is determined by both impairment and risk and is assigned to the most severe category in which any feature occurs. If you cannot contact your doctor, go directly to the emergency room. Asthma action plan library national asthma council australia. 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.
Take the asthma control test periodically and share the results with your healthcare provider to help assess if your asthma symptoms are well controlled. How to keep your asthma under control asthma is a chronic disease. To download straight to your computer, right click and choose save target as. Asthma action plan for older children childrens healthcare of atlanta. An asthma action plan should have information that details the course of action when such asthma aggravations occur. Category asthma action plans national asthma council. If i am not back in the green zone within one hour, then i should. The card has sections for information about a medication plan and a list of your childs signs and symptoms. Complete the asthma action plan smartform by clicking on the appropriate medications and directions for each zone. Work with your health care provider to create a plan that works for you. To download straight to your computer, right click and choose save target.
Many people with asthma are allergic to the dried droppings and remains of cockroaches. The asthma action plan chosen should be appropriate for the persons age, treatment regimen, asthma severity, culture, language, literacy level, and ability to selfmanage. Many written asthma action plans are available, as different action plans suit different people. Use this to develop your personal asthma action plan with your doctor and caregivers. When your childs asthma is under control, they will have. Take these medicines and get help from a doctor now. Allergens animal dander some people are allergic to the flakes of skin or dried saliva from animals with fur or feathers. Date hospitalemergency 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. Here is a sample asthma action plan you can use for students in school. Asthma action plan, for children 6 years or older, continued doctor doctors phone number. Peak flow from to peak flow from to peak flow from to massachusetts asthma action plan. You will need to scroll down to see all of the zones and options. Electronic, fillable pdf versions of asthma action plans ramp.
An asthma action plan is a written, customized plan to help you take action to manage your asthma. Read our tips on getting the best from a childs asthma action plan. Asthma action plans by national asthma council australia. My asthma action plan name date doctor doctors phone number symptoms my breathing is normal. The downloadable pdf below provides a worksheet of the zones in the asthma action plan. Regional asthma management program website writeable pdf asthma action plans in english, spanish, chinese, vietnamese. 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. Waking at night due to asthma usual activities may be limited yellow zone peak flow range 6080% of my personal best monitor your symptoms or check peak flows 2 times daily c if you use your quick relief inhaler or awaken more than 2 times per week due to asthma, your asthma may be out of control. Danger take these medicines and call your doctor now. All individuals with asthma should have an asthma action plan. Cough, wheeze, chest tightness, or shortness of breath, or. Ambulatory workflow bulletin creating an asthma action plan. An asthma action plan should include some basic details, to begin with.
Take a photograph of it and keep it on your phone you. Your school needs to know if your child has asthma. For more information contact the asthma society of canada at. My asthma is not well controlled if i answer yes to. It has sections for asthma triggers, daily medicines and emergency directions. Call our friendly helpline nurses mondayfriday, 9am5pm 0300 222 5800. Be sure to include the three zones created by the national institutes of healthexternal icon in your plan. Your goal is to prevent and control your asthma attacks. And, it helps you know what to do when you have symptoms. Make an appointment with your asthma care provider within two days of an er. Everyone with asthma needs his or her own asthma action plan. Developing an asthma action plan why consider an asthma action plan. Asthma action plan in word and pdf formats toggle navigation. Using a written asthma action plan makes it easier for you to measure whether your asthma is under control and it lets you know exactly what.
Yellow zone i have asthma symptoms i need to either increase my controller medication, or add on a different controller 1. 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. Asthma action plans are written documents developed by you and your health care provider, listing customized steps to prevent and handle an asthma episode. Maintaining good daytoday asthma control is the key to keeping symptoms at bay and preventing asthma attacks. Need help speaking with your healthcare provider about your. This could include teachers, school nurses, and after school care staff. If you know what to watch for and what steps to take, you will be able to make timely and appropriate decisions about managing your condition help prevent your asthma from getting worse. 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. Learn about asthma triggers, treatment options, and more. If no improvement in hours, call or visit your doctor. Asthma action plans respiratory health association. This asthma action plan is adapted from the asthma action plan created by the national institutes of health. Electronic, fillable pdf versions of asthma action plans.
It also has steps on how to handle asthma and allergy emergencies. 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. Asthma action plan library our library includes some of the many different written asthma action plans available. Asthma action plans asthma initiative of michigan aim. Check all items that trigger your asthma and things that could. The asthma action plan is a written, individualized plan that shows your daily treatment, such as what kind of medicines to take and when to take them. The asthma action plan chosen should be appropriate for the persons age, educational status, language and culture. Every person living with asthma should have an asthma action plan. Asthma action plans also tell school and other caregivers about your childs asthma. Minnesota department of healths interactive asthma action plan is a computerbased program that uses information entered by the healthcare provider to create a personalized plan for each patient. I use my asthma action plan to take action early this is the best way to get my asthma well controlled. Pdf asthma action plan cpg version with self management tips. Use poison baits, powders, gels, or paste for example, boric acid.
If a spray is used to kill roaches, stay out of the room until the odor. Select the one that is best for you, print a copy and fill in the information requested. Electronic, fillable pdf versions of asthma action plans click below to open forms. Ambulatory workflow bulletin creating an asthma action. Increase to day, for days, or until you are back in the green zone. With a written asthma action plan, its easier for you to measure whether your childs asthma is under control and it lets you know exactly what steps to take when it isnt. The student asthma action card is a great tool to give to your childs school about asthma management. Using an asthma action plan is especially important if your child has moderate to severe asthma or has had a serious asthma attack in the past. Asthma action plan provider instructions at initial presentation, determine the level of asthma severity l level of severity is determined by both impairment and risk and is assigned to the most severe category in which any feature occurs. Asthma action plan national heart, lung, and blood institute. You will work with your doctor to develop an asthma action plan tailored to. A printable version of the children asthma action plan and discharge plan from the asthma model of care keywords. As anyone who has asthma knows, ones breathing can be fine one day and very difficult the next.
1324 688 1175 94 1388 129 498 1270 1190 528 60 589 964 528 1422 780 981 179 923 1002 262 989 33 1317 844 1368 558 315 119 67 860 1412 243 528 435 503 511 1345 482 1217 998 147 867