Because asthma varies over time (sometimes symptoms are absent, sometimes symptoms are minimal, and at other times, asthma symptoms are bad), asthma action plans are very important. When a child has an asthma action plan, he or his parents and care givers are able to increase or decrease his treatment based on his symptoms with the guidance of that plan. Studies indicate that when children with asthma have an asthma action plan, they and their parents are better able to manage the ups and downs of their asthma.
So, what exactly is an asthma action plan? Think of it as a brief owner’s manual for people with asthma. First, all owners’ manuals (like the one you have for your car) tell you what to do under normal operating conditions. Similarly, your child’s asthma action plan tells you what to do when your child’s asthma is well controlled – those times when your child has no symptoms. The green zone is the zone your child is in when his asthma shows “normal operating conditions.”
When things are not going well, an asthma action plan, just like an owner’s manual, also tells you how bad the problem is and helps you to figure out what to do about the problem. By using the asthma action plan when your child has symptoms, you can determine whether your child is in the yellow zone or the red zone. This distinction is important, because the things that you need to do to get your child back into the green zone will vary depending on whether your child is in the yellow zone or the red zone.
The asthma action plan helps you to figure out what to do about the problem that has moved your child into the yellow or red zone. The plan helps guide you to know whether the asthma is bad enough that you need to get professional help from a clinician rather than trying to fix the problem on your own. This is similar to your car and its owner’s manual, because that manual tells you that some problems need to be handled by a professional mechanic rather than solved by you.
Below is a blank example of a Massachusetts Asthma Action Plan form, which the pediatrics department at Harvard Vanguard Medical Associates uses. The medication details specific to your child would be inserted into the three columns on the right in each zone:
Whether your child is in the yellow or red zone, you will use rescue medicine to give quick relief from symptoms (an example of a rescue medicine – sometimes called a quick relief medicine – is albuterol; brand names of albuterol include ProAire, Ventolin and Proventil or Xopenex). Your child’s clinician may also instruct you to add or to increase your child’s controller medicine(s) when your child is in the yellow zone and also give you specific instruction for when your child is in the red zone. The instructions for medicine use differ in the yellow zone compared to the red zone.
It is very important to note that if your child is in the yellow zone and you give the rescue medicine recommended in the yellow zone part of the action plan, yet your child does not get better, this moves your child into the red zone and you must act according to red zone instructions. Notice that the first item in the red zone is “Medicine is not helping.” If your child fails to respond to the yellow zone medicine, it means that your child is in the red zone.
If you don’t have an asthma action plan for your child, ask your clinician to give you one. Be sure to give a copy to your school, your childcare help and your child’s coaches and afterschool caregivers. Be prepared to manage your child’s asthma and asthma attacks with the aid of an asthma action plan, and make sure others who help care for your child also have a copy so they know what to do, too!