Do you have a written asthma action plan from your doctor or respiratory specialist? Managing asthma can be confusing, especially if you or your child are newly diagnosed. With young children it can sometimes be quite hard to judge what to do next if it seems like their asthma is getting worse. Can you give more of their reliever? At what point should you go to the doctor or the hospital? So often asthma seems to get worse in the middle of the night, making these decisions even more difficult. If you have asthma, or care for someone who does, a written asthma action plan can be a really valuable tool to take some of the stress out of managing asthma flares.
What is an asthma action plan?
An asthma action plan is a written guide prepared by the doctor who manages your (or your child’s) asthma. It sets out instructions to follow based on how well your asthma is controlled.
(Asthma action plans are different to a discharge plan that you might get after being released from a hospital admission for asthma. Discharge plans are detailed instructions on what to do in the days immediately after you leave hospital, and are temporary. An asthma action plan is something to use all of the time in managing your asthma.)
What should be included in a written asthma plan?
Your plan should include clear instructions about your asthma medications and what you should do if your asthma symptoms get worse.
When you are well
Your asthma plan should set out what to do when you feel well and your asthma is well controlled. It should list:
- your reliever medication, and how often to use it; and
- your preventer medication(s) (if any) and how often to use it.
When you are not well
Asthma plans should also set out what to do if you are not well and have some asthma symptoms. This could be that you need your reliever more often or you are having some asthma symptoms overnight. Or, if your or your child’s asthma is exacerbated by colds and viruses, the plan may include instructions to increase your medications while you have those cold symptoms. We have had asthma plans that have included instructions to take more puffs of reliever medication at a time and to increase some asthma preventer medications during colds and viruses.
When asthma symptoms are getting worse
Importantly, your asthma plan should set our clearly what to do if you asthma symptoms are getting worse. As well as how to tell if they are getting worse. You might be using your reliever often but it isn’t lasting more than 3 hours before you need to take more. Or you may notice your breathing or coughing getting worse. Your plan should include clear instructions on the signs to look for and:
- how much reliever to take and how often;
- any additional medications to take (for example, your plan might include taking a dose of oral steroids like prednisolone); and
- when to seek a medical review by your doctor.
Finally, your action plan should make it clear what to do in an asthma emergency. This includes the danger signs, when to call an ambulance and what to do while you wait for help (asthma first aid).
Other useful things to include are your emergency contact’s name and phone number.
Do adults need an asthma action plan?
Written asthma action plans are particularly helpful for managing asthma in young children. They may not be able to tell you exactly how they are feeling and won’t know if they are getting sick enough to need more medication or to see a doctor. But they are also just as helpful for adults. We too can have doubts about how unwell we really are and if we really need to escalate our asthma care.
Young children cannot usually manage spirometry tests of use peak flow meters reliably. However, an asthma action plan for a teenager or adult might include instructions on how to monitor if your asthma is getting worse by using peak flow measurements. I have a written plan which records my normal peak flow reading, and then gives a range of peak flow readings that match the instructions for “not well” and “asthma symptoms getting worse”.
Benefits of having a written plan to manage your asthma
Having a written plan to manage asthma is a really good idea for both children and adults.
The National Asthma Council of Australia believes states on its website that written asthma action plans are “one of the most effective asthma interventions available“, with the benefits including less absences from school or work, reduced hospital admissions, less visits to doctors and emergency, reduced use of reliever medications and even improved lung function.1
There are also some really practical benefits.
If you have a young child with asthma, you have no doubt spent many nights perched over the end of their bed watching them breathe and wondering if you need to wake them to give them more reliever medication. Or if they need to go to urgent care in the middle of the night or can wait until the morning. Having a written plan from your doctor can give you practical guidance about what to do and relieve stress and anxiety for parents and carers.
For children, childcare, early learning and schools will usually require you to provide a copy of your child’s asthma action plan together with their medication and spacer. You can also give copies to anyone who looks after your child so they know what to do when you aren’t there.
Even for adults, it is a great idea to carry a copy of your written action plan with you with your asthma medications. This lets anyone know in an emergency that you have asthma and what medications you are taking as well as helping you remember what to do.
Examples of asthma action plans
An asthma action plan prepared by your doctor will be unique to you. Your asthma medications may be different to someone else’s, and your asthma severity, triggers and signs of worsening asthma may vary.
Some plans are designed only for specific types of asthma medication.
Individual plans also take into account other factors including your language, culture and how well you can manage your asthma symptoms on your own.
This is what one of our very first personalised asthma action plans for a young child looked like. (This is provided for illustration only – do not use for your child). This was prepared by a doctor at our local hospital and had pictures of each asthma medication prescribed by our doctor:
We’ve also had plans that have been as simple as a letter from our child’s respiratory specialist.
However, I personally find the plans which include clear steps and colour coding to be far easier for to follow. The traffic light system of green (for well), orange (for unwell) and red (asthma getting worse or an asthma emergency) is very effective. My own plan includes peak flow readings for each step, like in this colour-coded template from Asthma Australia:
The links at the end of this post have more examples of asthma action plans and templates.
References and more information
If you don’t already have a written asthma action plan, ask your doctor at your next asthma review appointment. And if you do have a written plan, make sure it is reviewed regularly. This should be at least every 12 months, or 6 months for children, and whenever you change medications.
You can find more information about written asthma plans from asthma organisations including the following resources we’ve referred to in this post:
- 1National Asthma Council of Australia, Asthma Action Plans;
- National Asthma Council of Australia, Asthma Action Plan Library;
- Asthma Australia, Asthma Action Plan;
- CDC Asthma Action Plans (USA);
- Asthma + Lung UK, Your asthma action plan (UK).
For more practical tips about managing your asthma, you might be interested in our posts about using asthma spacers and thunderstorm asthma. You might also like to read about the benefits and limitations of using a pulse oximeters for asthma management as part of your asthma plan.
*Disclaimer: Allergy Spot does not provide medical advice. You should always consult a suitably qualified medical practitioner in respect of your own medical conditions, symptoms or concerns. See our Website Terms for more details.