Treatment Overview

An
asthma action plan is a written plan that tells you
how to treat your asthma on a daily basis. The plan also helps you deal with
sudden increases in your or your child’s asthma symptoms (asthma attacks). You need to treat the
inflammation in your lungs to minimize the long-term
effects of asthma. The plan tells you what medicine is needed every day, what
steps to take for an asthma attack (based on its severity), and when you should
call a doctor or seek emergency treatment.

You and your doctor
make the asthma action plan. In general, the plan includes:

  • When to take the medicines you need daily to control airway
    inflammation.
  • What medicine to take and
    what steps to follow to deal with an asthma attack.

The asthma action plan also may contain:

  • Treatment goals, which include your personal goals about your
    asthma.
  • How to measure your
    peak expiratory flow (PEF) with a
    peak flow meter.
  • An
    asthma diary where you can keep track of your symptoms and triggers. You can also use the diary to record other things that help you manage asthma.

Your action plan is based on zones defined by your symptoms or your peak flow, or both. There are three zones: green, yellow, and red. Your action plan tells you what to do when you are in each zone. If your doctor recommends that you record PEF as part of your plan, then you will first need to find out your personal best
PEF
. This is your highest peak
flow recorded over a 2- to 3-week period when your asthma is under control.

  • 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. To figure 80% of your personal best peak flow,
    multiply your best flow by 0.80. For example, if your personal best flow is
    400, multiplying by 0.80 gives you 320.
  • Yellow zone. Yellow means Caution. You are in the
    yellow zone of your asthma action plan if your peak expiratory flow is 50% to
    79% of your personal best measurement. You may not have any symptoms, but your
    lung function is reduced. When you have symptoms, they may be mild to moderate. They may keep you from your usual activities or disturb your sleep. You may be short of breath or have chest tightness. You might also cough or wheeze. Your
    action plan should state which quick-relief medicines you need to take, how
    much to take, and when to take them. To figure 50% of your personal best peak
    flow, multiply your best flow by 0.50. For example, if your personal best flow
    is 400, multiplying by 0.50 gives you 200.
  • Red zone. Red means DANGER. 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 or peak expiratory
    flow, or both, are in the red zone, seek medical help immediately. While you are seeking
    emergency help, follow your action plan and take your medicines as directed.
    You may need emergency treatment or admission to a hospital.

The best strategy for avoiding and treating asthma
attacks is being able to recognize an attack and know what to do. Talk with your
doctor about:

  • Your triggers. Asthma
    triggers are substances that can cause an attack, such
    as pollen or cigarette smoke. Avoiding your triggers can help reduce your risk
    of an attack and reduce its severity.
  • Your symptoms. In general these include a drop in your peak
    expiratory flow (PEF) and more severe coughing, wheezing,
    shortness of breath, and tightness in your chest. The symptoms may vary from
    one person to another.
  • Which quick-relief medicines you need to
    take and how to take them.
  • How to evaluate whether your
    quick-relief medicines are working.
  • When emergency care is
    needed. If you have a large drop in PEF, your quick-relief medicines are
    not working, or you are very short of breath, you may need emergency care. Your
    doctor will help you learn about these signs.
  • A possible pregnancy.
    If you are pregnant, you may have other options for asthma medicines. During an
    attack, your doctor may also ask that you monitor your fetus’s activity by
    noting a change in fetal kicks.

See an example of an
asthma action plan (What is a PDF document?).

What To Expect After Treatment

If you are in your green zone, keep taking daily controller medicine if you
have it. You do not need quick-relief treatment.

If your symptoms
are mild or moderate (in the yellow zone), treat them at home using the
medicines specified in your asthma action plan. You can expect some relief of
your asthma symptoms. Seek medical help if the symptoms do not go away soon
after you take the prescribed medicine or if the symptoms become worse.

If your symptoms are severe (in the red zone), seek medical help
immediately. While you are seeking emergency help, follow your action plan and
take your medicines as directed. You may need emergency room treatment or
admission to the hospital. After a severe asthma attack, you may need a short
treatment using corticosteroids by mouth to bring your symptoms under
control.

Why It Is Done

You and your doctor will work together
to create an asthma action plan. Your action plan tells you what medicine you
need to take every day and what to do if you notice a change in your asthma
symptoms or your PEF, or both. This helps you make quick decisions about treatment so that
you can avoid more serious attacks and get better.

How Well It Works

Studies show that using an asthma action plan based on symptoms or on peak expiratory flow can control asthma flare-ups.

Risks

If you do not follow your action plan or do not
use the medicines it specifies, you may have a worse or longer asthma attack.
You may have to seek emergency care or go to the hospital.

What To Think About

It is important to treat asthma
attacks quickly, especially in children. Babies and small children need to be
watched closely during asthma attacks. And caregivers should seek medical help
early during an attack. Your child’s symptoms do not always show the severity
of the attack. If your child does not improve soon after treatment for an
attack, talk with your doctor.

  • During asthma attacks, stay calm and soothe
    your child. This may help him or her relax and breathe more
    easily.
  • Don’t underestimate or overestimate how severe your
    child’s asthma is. It often is hard to assess a baby’s or small child’s
    breathing difficulty. Seek medical care early for babies and small children
    with asthma symptoms.

Asthma attacks cannot be controlled by drinking large
amounts of liquids or taking non-prescription medicines such as antihistamines
or cold remedies. But if you have asthma, you can take antihistamines for other
problems, such as colds. Antihistamines will not make your asthma symptoms
worse.

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

Other Works Consulted

  • Kessler K (2010). Relationship between the use of asthma action plans and asthma exacerbations in children with asthma: A systematic review. Journal of Asthma and Allergy Educators, 2(1): 11-21. DOI: 10.1177/2150129710388415. Accessed January 12, 2015.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Rohit K Katial, MD – Allergy and Immunology

Current as ofMarch 25, 2017