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Asthma Control Plan

Name of Patient ........................................ Prepared by Dr. .........................................

This plan will help a patient control his asthma and know what to do if he has an asthma episode. Keeping a patient’s asthma under control will help to :

  • Be active without having asthma symptoms. This includes being active in exercise and sports.
  • Sleep through the night without having asthma symptoms.
  • Prevent asthma episodes (attacks).
  • Have the best possible peak flow number - lungs that work well.
  • Avoid side effects from medicines.

Advice for patients:

Here are three ways to control asthma:

  • Follow your medicine plan

- Follow your Green Zone plan every day to prevent asthma symptoms from starting.

- Recognize your symptoms of an asthma episode. Act quickly to stop them.

- Follow the Yellow Zone plan to stop asthma symptoms and to keep an asthma episode from getting serious.

- Follow the Red Zone plan to take care of a serious episode. This is an emergency plan!

  • Whenever possible, stay away from things that bring on your asthma symptoms. For this follow “Asthma Trigger Control Plan” to reduce the number of things in your home, workplace, or classroom that bother your asthma.
  • See your doctor regularly. Talk about this plan with your doctor when you visit him/her. Your doctor will mark (check) on the plan what you should do. Follow the symptoms and action steps in these three zones to help you control your asthma
Green Zone: All clear  o Take these medicines.
This is where you should be every day.
 Name of medicine How much to take When to take it
 
_______________		  _______________  _______________
 
_______________		  _______________  _______________
     

 
Peak flow 
_______________		  

(80-100% of personal value)

  o Follow your “Asthma
Trigger Control Plan” to avoid things that bring on  your asthma.
No symptoms of an asthma episode.You are able to do your usual activities and sleep
without having symptoms. 		 
 o Take
__________________________ before exercise or (Name of medicine) strenuous
physical activity.
Yellow Zone: Caution  o Take these medicines.
This is where you
should take action to get asthma under control.
 Name of medicine How much to take When to take it
  _______________  _______________  _______________
  _______________  _______________  _______________
     

 
Peak flow 
_______________		  

(50-80% of personal value)

  o Follow your “Asthma
Trigger Control Plan” to avoid things that bring on  your asthma.
Symptoms of an
asthma episode. You may be coughing, wheezing, feeling short of breath, or
feeling like your chest is tight. These symptoms may keep you from your
usual activities or keep you from sleeping.		  
 o Take
__________________________ before exercise or (Name of medicine) strenuous
physical activity.
 
Red Zone: Medical
Alert		  o Take these
medicines.
This is an
emergency! Get help.Your asthma symptoms are serious.
 Name of
medicine		 How much to take When to take it
 
_______________		  _______________  _______________
 
_______________		  _______________  _______________
     

 
Peak flow 
_______________		  

(Below 50% of personal value)

  o Next , call the
doctor to ask about what you should do next. tell him/her this is an
emergency.
You may be
coughing, very short of breath, and/or the skin between you ribs and your
neck may be pulled in tight. You may have trouble walking or talking . You
may not be wheezing because air con not move out of your ariways.		  
 But, see the doctor
RIGHT AWAY or go to the hospital if any of these things are happening :
• Lips or fingernails
are blue.
• You/your child is
struggling to breathe.
• You/your child do
not feeling better 20 to 30 minutes after taking the extra medicine and
your peak flow is still under__________________________________ (50% of
personal best)
• Six hours after you
take the extra medicine, if you still need inhaled b2-agonist medicine
every 1 to 3 hours and your peak flow is under ____________________ (70%
of personal best)
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  • Misconception about Asthma

    There are some common concerns about Asthma prevailing in the society. In majority of cases, these are misconceptions or baseless fears. For optimum control of asthma, these points should be dealt with proper care. Otherwise the management plan may go in vain. It the physicians responsibility to eradicate such worries, if present, from the patient’s mind. Some common concerns and suggested clinicians responses are listed below. Model answers to some frequently asked questions (FAQs) are also given. These will help the physician to deal with such situations more confidently.

  • Hospital Based Care of Asthma

    Management of Asthma Attacks :

    Hospital-Based Care

    Initial Assessment:

    History, Physical examination (auscultation, use of accessory muscles, heart rate, respiratory rate) and Investigations (PEF or FEV1, Oxygen saturation SaO2, arterial blood gas analysis and other tests)

    Initial Treatment:

    • Inhaled short-acting b2-agonist, usually by nebulization, one dose every 20 minutes for 1 hour
    • Oxygen to achieve O2 saturation >90% (95% in children)
  • Use of Peak Flow Meter

    A peak flow meter is a device that measures how well air moves out of a patient's lungs. During an asthma episode, the airways of the lungs begin to narrow slowly. The peak flow meter can be used to find out if there is narrowing in the airways, hours - even days - before the patient has any symptoms of asthma. By taking the medicine early (before symptoms), your patient may be able to stop the episode quickly and avoid a serious episode of asthma. So its role in preventing severe asthma attack is very important.

    The peak flow meter can also be used to help you:

  • Use and Care of Nebulizer

    A nebulizer is a device driven by a compressed air machine. It allows your patient to take asthma medicine in the form of a mist (wet aerosol). It consists of a cup, a mouthpiece attached to a T-shaped part or a mask, and thin plastic tubing to connect to the compressed air machine. It is used mostly by three types of patients:

    • Young children under age 5.
    • Patients who have problems using metered dose inhalers.
    • Patients with severe asthma

    A nebulizer helps make sure that patients get the required amount of medicine

  • Investigation of Asthma

    Why we investigate asthma patients?

    • For classification and assessment of severity
    • For diagnosis of concomitant illness
    • For exclusion of other causes of cough, wheeze dyspnoea or chest tightness

    What are the investigations for asthma?

    We should do four basic investigations of all patients.

    1. Blood for TC, DC, ESR,
    Hb% and : 

  • Home Management of Asthma

    Why management at home ?

    Since asthma is a chronic disease, it can be and should be managed at home up to a certain level. If home management plan is applied intelligently and skillfully, most asthmatics can lead symptom free normal life, avoid hospitalization thereby cutting down the financial expenditure significantly. All patients of asthma, except those with acute exacerbation, should be treated at home.

    What are the components of home management plan ?

  • Prevention of Asthma

    How to prevent asthma?

    Development of asthma has two distinct bases: Hereditary and Environmental. For the prevention of the development of asthma we should manipulate these two factors. Regarding hereditary factors, we have yet nothing to do practically. Genetic engineering is a future probability. What we can do is to manipulate the environmental factors. Effort should be concentrated on primary prevention of asthma.

    What is primary prevention?