An asthma action plan is a written plan that helps you manage sudden increases in your or your child's asthma symptoms (acute asthma episodes). It tells you what medication you need to use, based on the severity of the episode, and when you should call a health professional or seek emergency treatment.

Your action plan is based on zones of asthma severity defined by symptoms and your personal best peak expiratory flow (PEF), which is your highest peak flow recorded over a 2- to 3-week period when your asthma is under control. Personal best is never taken during an acute asthma episode. If you do not know your personal best, talk to your health professional.

• Green zone. Green means go. You are in the green zone of the asthma action plan if your peak expiratory flow is 80% to 100% of your personal best measurement. You want to be in the green zone every day. You should have no asthma symptoms when you are in the green zone, and you do not need quick-relief treatment.
• Yellow zone. Yellow means caution. You are in the yellow zone of your asthma action plan if your peak expiratory flow is 50% to less than 80% of your personal best measurement. You may not have symptoms, or they may be mild to moderate and may keep you from your usual activities or disturb your sleep. Your action plan should state which quick-relief medications you need to take, how much to take, and when to take them.
• Red zone. Red means STOP. You are in the red zone of your asthma action plan if your peak expiratory flow is less than 50% of your personal best measurement. Your symptoms may be severe, and you may have extreme shortness of breath and coughing. If your symptoms and peak expiratory flow are in the red zone, seek medical help immediately by calling 911. While you are seeking emergency help, follow your action plan and take your medications as directed. You may need emergency treatment or admission to a hospital.

The best strategy in avoiding and treating acute asthma episodes is being able to recognize an episode and know what to do. Talk to your health professional about:

• Your triggers. Asthma triggers are substances that can cause an episode, such as pollen or cigarette smoke. Avoiding your triggers can help decrease your risk of an episode and reduce its severity.
• Your symptoms. These generally include a drop in your peak expiratory flow (PEF) and increased and more severe coughing, wheezing, shortness of breath, and tightness in your chest. The symptoms may vary between people.
• Which quick-relief medications you need to take and how to give them to yourself.
• How to evaluate whether your quick-relief medications are working.
• When emergency care is necessary. If you have a large drop in PEF, your quick-relief medications are not working, or you are very short of breath, you may need emergency care. Your health professional will help you determine these signs.
• A possible pregnancy. If you are pregnant, you may have other options for asthma medications. During an episode, your health professional may also ask that you monitor your fetus's activity by noting a change in fetal kicks.

You and your health professional will work together to create an asthma action plan. You then follow your action plan when you notice a change in your asthma symptoms or PEF. An asthma action plan will help you make quick decisions about treatment so that you can avoid more serious episodes and get better.

Why is an asthma action plan important?

A review of research on asthma action plans reports that plans based on personal peak expiratory flow and the use of inhaled and pill-form corticosteroids improved the outcome of episodes. If you do not follow your action plan or do not use the medications it specifies, you may have a worse or longer acute asthma episode. You may have to seek emergency care or go to the hospital.

Things to Consider

It is important to treat acute asthma episodes quickly. If you do not improve soon after treatment for an episode, contact a health professional.

You may need to see a specialist (allergist or pulmonologist) if you have:

• Unusual symptoms, or there are problems deciding whether you have asthma.
• Other medical conditions that make it hard to treat asthma.
• Need for additional education or difficulty following your daily asthma treatment and action plans.
• Not met the goals of treatment after 3 to 6 months of therapy.
• Had a life-threatening asthma episode.

Other reasons to see a specialist include:

• Having severe persistent asthma.
• Needing to take continuous oral corticosteroid medications or high-dose inhaled corticosteroids or having had more than two treatments with oral corticosteroids in 1 year.
• Having asthma because of your workplace (occupational asthma).
• Needing skin testing for allergy.
• Thinking about starting treatment with allergy shots (immunotherapy).

If you or a loved one suffers from asthma that is not well controlled, please contact us for a personalized asthma action plan today!