General Tools – Asthma Action Plan
An Action Plan is a written, customized plan to help you take action to manage your asthma. 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. The Action Plan is based on changes in respiratory symptoms and peak flow numbers, and it specifically will:
Give you and your family information about when and how to use daily medications, emergency medications and your peak flow meter.
Help you decide when to call your healthcare provider and when to seek emergency medical care.
Serve as an easy place to keep your crisis intervention plan, self-management instructions or written guidelines.
Components of an Asthma Action Plan
Action Plans should be individualized. Your healthcare provider will develop an Action Plan specifically for you, and your action plan should include the following information:
1. Peak Flow Numbers and Peak Flow Zones
Peak flow numbers measure how well you are breathing. If your peak flow number drops, it means you are having trouble breathing. Peak flow zones can be used to signal you when your peak flow drops a certain percentage. Your healthcare provider will consider certain characteristics of your asthma and help you determine your zones.
2. Asthma Symptoms
Your action plan should tell you what to do when you experience asthma symptoms and when you need to increase treatments to manage asthma symptoms. Your plan will be based on the severity or seriousness of these symptoms.
3. Asthma Medications
Together with your healthcare provider, you will develop instructions about when to take asthma medications.
4. Emergency Telephone Numbers and Locations of Emergency Care
Your written action plan should include information about who to call and where to get emergency care. Your healthcare provider will be able to give you telephone numbers and locations for emergency care during the day or night. You should also include numbers of relatives, friends and other people who can help you in an emergency.
Specific Points to Clarify with Your Healthcare Provider
These are five points that your healthcare provider should specifically clarify for you for inclusion in your Action Plan.
• When should you call your healthcare provider?
• When should you seek emergency care?
• When is quick relief medicine not enough?
• When or if you should increase inhaled steroids?
• When or if you should start taking oral steroids?
Making Your Asthma Action Plan Work for You
Your Action Plan can help you manage your asthma symptoms. Here are tips to make sure it’s available and update for you to use:
Photocopy your written plan and give it to those who can assist you in using the plan, including your spouse or significant other, relatives and work personnel.
Keep a current action plan with you at all times for use in an emergency.
Review your action plan with your healthcare provider at least once a year. Changes in your personal best or baseline peak flow number or medications may mean your action plan also needs to be changed.
If you ever have questions or concerns about your Action Plan, please discuss them with your healthcare provider.
General Tools – Peak Flow Meter
A peak flow meter is a small, easy-to-use instrument that reveals how well your lungs are working. It does this by measuring your peak expiratory flow, which tells you how fast you can blow out air after a maximum inhalation. You use the peak flow meter to help you identify lung performance patterns, which give you information to prevent asthma episodes and develop your asthma management plan.
How it Works
First, you establish your “personal best,” or the highest number you regularly blow. This helps you see when you have changes with your asthma, because it gives you something to measure against. Once you know you personal best, you and your doctor establish treatment rules or “zones.”. You establish your personal best by recording the peak flow values for two weeks first thing in the morning before taking any medications and late afternoon when your asthma is under control..
If your peak flow is less than 80% of your personal best, you take your rescue medication, then wait 20 to 30 minutes and check your peak flow again.
If your peak flow is not back above 80%, report this to your doctor.
If your peak flow is back above 80%, recheck your peak flow about every 4 hours for a day or so. Call your doctor if you continue to need rescue medicine
If your peak flow is less than 60% consider this an emergency: Take your rescue medicine, and call your doctor or go to the emergency room right away.
How to Measure Your Expiratory Flow
Whenever you measure your flow, it is a good idea to write your peak flow numbers in a place where you can track them. Establish one central place to do this so you can more easily keep track of your numbers, such as in a peak flow sheet or Asthma Health Diary. Here’s how to regularly measure your expiratory flow:
Grab your peak flow recording sheet or health diary and a pen and record the date and time, along with any changes in how you feel, changes in your medicines, and/or anything you think may be making your asthma worse.
• Stand up or sit up straight.
• Slide the indicator to the base of the meter.
• Take in a deep breath.
• Place the mouthpiece in your mouth and seal your lips around it.
• Blow out as hard and fast as you can (one quick blow).
• Repeat that process 2 more times.
• Select the highest number of the 3 efforts.
• Record this number on your peak flow diary or on a graph.
When to Check Your Expiratory Flow
When the numbers do not change much from time to time: The peak flow number should be checked once a day (ideally in the morning when you wake up).
When you are doing well: Use the peak flow meter two times during the week and once on the weekend.
When you:
Begin to wake at night with asthma symptoms
Experience more daytime asthma symptoms
Have a respiratory infection (a cold)
You are sick or have asthma symptoms
Check your peak flow number at least twice a day (once in the morning and once in the evening)
When you need to use “rescue medicine”: This is medicine prescribed by your doctor to be used for quick relief of asthma symptoms. Check your peak flow before taking the rescue medicine, then check it again 20-30 minutes later.
Reporting Peak Flow Numbers to Your Doctor
Take your peak flow meter and your asthma health diary with you each time you visit with your doctor or nurse. If you have an Asthma Action Plan from your doctor, follow the plan for each peak flow zone, and compare your peak flow numbers to your personal best.
Signs Your Asthma is Getting Worse
Your peak flow meter is only an aide to you, so do not rely on your peak flow numbers alone when deciding whether to take your rescue medicine or call your doctor. In addition to measuring your peak flow on a daily basis, you should always look out for early warning signs of an asthma attack, which are:
• Runny, stuffy nose
• Fatigue
• Chin or throat itches
• Headache
• Moodiness
• Cough with activity or laughing
• Wheezing with activity
• Waking up at night or early morning with a cough or wheeze
• Faster breathing rate
• Irritability
General Tools – Peak Flow Zone Chart
The following shows an example of how these zones work. Your doctor can help you create a similar table for your own asthma.
Green: 80-100% of your personal best
• Your breathing is good.
• You do not have any early warning signs or asthma symptoms.
• Take all your medicines every day, as your doctor tells you.
• Take your inhaler before exercise, as your doctor tells you.
Yellow: Caution 60-80% of your personal best
• Runny, stuffy nose.
• Feel more tired.
• Chin or throat itches.
• Sneezing.
• Restless
• Red or pale face
• Coughing
• Dark circles under your eyes
• Use “rescue” medicine
• Recheck peak flows after 20-30 minutes
• Call your doctor, healthcare professional, or nurse care manager:
• if your peak flow is not back to the Green Zone
• if your peak flow drops into the Yellow Zone again in less that 4 hours.
Red: Danger Below 60% of your personal best
• Cough, more at night
• Wheezing
• Chest feels tight or hurts
• Breathing faster than normal
• Get out of breath easily
• Use your quick-relief medicine by inhaler or nebulizer right away!
• Call your doctor or 911 NOW
Article source: http://www.nationaljewish.org/healthinfo/conditions/asthma/lifestyle-management/tools/action-plan
Picture source: http://srxa.wordpress.com/2011/05/03/you-can-control-your-asthma-2
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