Maintaining good day-to-day asthma control is the key to keeping symptoms at bay and preventing asthma attacks. Having a written asthma action plan makes it easier for you to measure whether your child's asthma is under control — and it lets you know exactly what steps to take when it isn't. 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. Here's how to get started.
Creating an asthma action plan
Because asthma varies from person to person, you'll need to work with the doctor to develop a plan that's customized for your child. If your child is old enough, he or she may be able to help create and use the plan. Your child's action plan can help you and your child:
- Track asthma symptoms. The plan will help you keep tabs on asthma signs and symptoms such as coughing, wheezing and shortness of breath and when symptoms interfere with school, play, exercise or sleep. You'll also need to track how often your child uses a quick-relief inhaler (such as albuterol) to ease symptoms.
- Record peak flow readings. If your child is old enough to use one, he or she may have a peak flow meter. This simple hand-held device tests how well the lungs are working day-to-day. Low measurements indicate that the lungs aren't working as well as they should be. This is often the first sign that asthma's getting worse.
- Judge asthma control. The action plan will give you a system for making sense of the information you record. Many asthma plans use a "traffic light" system of green, yellow and red zones that correspond to worsening symptoms. This system can help you quickly determine asthma severity and identify signs of an asthma attack. Some asthma plans use a symptoms questionnaire called the Asthma Control Test (ACT) to measure asthma severity over the past month.
- Adjust medications. Your child's plan should say when you need to make medication adjustments based on the severity of symptoms. Asthma medications usually include long-term control medications such as inhaled corticosteroids and as-needed, quick-relief medications such as inhaled albuterol. Make sure you understand what medications to use when, how long to use them and what to expect.
- Recognize and treat an asthma attack. Tracking symptoms daily and adjusting treatment accordingly improves asthma control and reduces the risk of having an asthma attack. But if symptoms do start to get worse quickly, follow the action plan's instructions for using quick-relief medications or other steps to get your child's symptoms under control.
- Know when to seek emergency care. Some asthma attacks can't be managed at home. Use the action plan to recognize the signs of rapidly worsening asthma, such as trouble speaking, use of abdominal muscles to breathe or wide nostrils when breathing in. If your child uses a peak flow meter, the action plan will also tell you when low peak flow readings signal that your child's asthma attack has become an emergency.
- Help your child avoid asthma triggers. The action plan may have a place for you to list your child's asthma triggers and notes on how to avoid them. These vary from person to person — examples include cold air, pollen, dust mites, mold, pet dander, smoke and respiratory infections.
Creating your child's asthma plan
Because asthma varies from person to person, you'll need to work with the doctor to develop a plan that's customized for your child. If your child is older, he or she may benefit from helping create the plan and using it to monitor how well treatment is working. While formats vary, most action plans have clear instructions on how to:
- Manage your child's medications. Your plan should list your child's asthma medications and when to take them. Medications usually include daily control medications (such as inhaled corticosteroids) and as-needed, quick-relief (rescue) medications (such as inhaled albuterol). Make sure you know what medications you have on hand, where they are and how to use them. If your child has a nebulizer to administer medication in mist form, the asthma action plan should include instructions for when to use it.
- Track your child's long-term asthma control. Good overall asthma control is critical for preventing asthma flare-ups. If your child's asthma isn't under good long-term control, he or she is more likely to have bothersome symptoms and is at increased risk of an asthma attack. Signs of poorly controlled asthma mean you and your child need to meet with the doctor to review your child's asthma plan and make treatment changes. The Asthma Control Test (ACT) is a common way to measure how bothersome asthma symptoms have been over the past month. This test also tracks how often your child has needed to use a quick-relief (rescue) inhaler such as albuterol.
- Recognize and treat an asthma attack. When you're on the lookout for warning signs — such as coughing, wheezing or shortness of breath — you can take prompt action at the first sign of an asthma flare-up. Recognizing and treating an asthma flare-up before symptoms get bad is the best way to prevent a full-blown asthma attack. If your child does have an asthma attack, follow the action plan's instructions for using quick-relief medications and other steps to get asthma symptoms under control.
- Take action based on peak flow readings. If your child is old enough to use one, some doctors recommend a peak flow meter to help monitor how well your child's lungs are working. When your child's peak expiratory flow reading (PEF) is low, you'll need to increase or add medications according to the action plan. Often, low peak flow readings are the first sign of an asthma flare-up.
- Know when to seek emergency care. Some asthma attacks can't be managed at home. Use the action plan to recognize the signs of rapidly worsening asthma, such as difficulty speaking, using abdominal muscles to breathe or wide nostrils when breathing in. If your child uses a peak flow meter, the action plan will also tell you when low peak flow readings signal that your child's asthma attack has become an emergency.
- Help your child avoid asthma triggers. The action plan may have a place to list your child's asthma triggers and how to avoid them. These vary from person to person — examples include cold air, pollen, dust mites, mold, exercise, pet dander, smoke or respiratory infections.
Check out a sample plan
Print out this asthma action plan and take it to your child's next appointment. Ask the doctor to help you personalize the plan for your child. Or your child's doctor may already have a plan for you to use.
Sample asthma action plan for children 5 and older (PDF file requiring Adobe Reader).
Make sure caregivers know how to use the action plan
Once you and your child's doctor have developed an asthma action plan, keep it close at hand. Make sure your child and everyone who cares for him or her — including grandparents and baby sitters — know where to find it and what to do in case of worsening asthma symptoms. Give a copy of the plan to the school nurse and your child's teachers and coaches. Keep another copy in your wallet or purse, in case an asthma attack occurs away from home. As your child gets older, he or she can take more responsibility for using the plan to track and manage asthma.
Meet regularly with your child's doctor
Work with the doctor to adjust your child's asthma action plan on a regular basis. Asthma changes with age, so your child's treatment plan will need to change too.
- Make sure your child goes to every scheduled appointment. Review your child's asthma action plan at every doctor visit. Tell the doctor about any problems your child is having sticking with the plan. These checkups are also a good time to double check that you're tracking symptoms accurately and that your child is using asthma medications properly.
- If asthma isn't under control, see the doctor. If your child is following the action plan but symptoms still aren't under control, a treatment change may be needed. On the other hand, if your child's asthma is well controlled all of the time, the doctor may be able to reduce the amount of medication your child takes.
- Call the doctor if you have concerns. If you have any questions or you're simply concerned about your child's signs and symptoms, call your child's doctor or schedule an appointment.
Having asthma shouldn't mean that your child will miss school, be short of breath during sports or play, or wake up coughing at night. By carefully following a written plan, you and your child can keep asthma well controlled and minimize the disruptions it causes.