Creating an asthma action plan

Because people experience asthma differently, you'll need to work with the doctor to make a customized plan for your child. Children who are old enough to understand why you're setting up the plan may be able to help create it. An action plan can help you and your child:

• Track symptoms. The plan will help you keep tabs on signs and symptoms such as coughing, wheezing and shortness of breath. You can also note 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 (ProAir HFA, Proventil HFA, others), 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, along with 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 keep notes on how to avoid them. Asthma triggers vary from person to person — examples include cold air, pollen, dust mites, mold, pet dander, smoke and respiratory infections.