My Asthma Action Plan
Topic Overview
My name:__________________ |
Doctor's name: ___________________ |
Doctor's phone: _______________ |
Controller medicine |
How much? |
How often? |
Other instructions |
---|---|---|---|
Quick-relief medicine |
How much? |
How often? |
Other instructions |
---|---|---|---|
GREEN ZONE This is where I want to be! |
YELLOW ZONE My asthma is getting worse. |
RED ZONE Danger! |
---|---|---|
Symptoms
|
Symptoms
|
Symptoms
|
Peak flow (if I use a peak flow meter)
|
Peak flow (if I use a peak flow meter)
|
Peak flow (if I use a peak flow meter)
|
Actions
|
Actions
|
Actions
EMERGENCY: If it's hard to walk or talk because of shortness of breath or if my lips or fingertips are blue, I need to CALL 911 or go to the hospital for help right away. |
Current as of: June 9, 2019
Author: Healthwise Staff
Medical Review:E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Rohit K. Katial, MD - Allergy and Immunology