Simply put, an asthma action plan provides the person with asthma andor their carer clear instructions on what to do when symptoms of asthma appear. This child has the knowledge and skills to selfadminister quickrelief medicine at school or daycare with approval of the school nurse. Asthma exacerbation management childrens hospital colorado. With a written asthma action plan, its easier for you to measure whether your childs asthma is under control and it lets you know exactly what steps to take when it isnt. Here is a sample asthma action plan you can use for students in school. A written asthma action plan encourages selfmanagement of asthma.
Providing this asthma education at the time of diagnosis and reinforcing it at all subsequent visits lead to better outcomes in terms of achieving the goals of asthma therapy, namely few symptoms, no limits on activity, rare exacerbations, and normal lung function. Allergens animal dander some people are allergic to the flakes of skin or dried saliva from animals with fur or feathers. Asthma action plan national heart, lung, and blood institute. Assess asthma control to determine if therapy should be adjusted see page 6. Asthma resources for professionals childrens hospital.
Illinois department of public health asthma action plan. Asthma action plan, for children 6 years or older, continued doctor doctors phone number. They can also reduce asthma attacks and prevent loss of lung function. Our goals include improving diagnoses, management and prevention of asthma by stimulating research, and providing evidencebased educational resources for worldwide use. The principles of pediatric asthma management are generally accepted. Using an asthma action plan can help you stay active with fewer asthma problems. If you cannot contact your doctor, go directly to the emergency room. Make an appointment with your asthma care provider within two days of an er. A list of the persons triggers and how to avoid them, instructions for taking asthma medicine, information on what to do during an asthma episode, instructions on when to call a doctor, and. Summer can be a fun time to do many outdoor activities. Community health worker pediatric asthma home visiting program program summary.
Keeping your child symptomfree at home is also very important, so at the breathing institute, we make aaps a priority during outpatient visits, as well. For students to carry their inhaler in school, your health care provider must check off approval at the bottom of the pacnj asthma treatment plan. This test will provide a score that may help your doctor determine if your childs asthma treatment plan is working or if it might be time for a change. Connecticut department of health asthma action plans in pdf and word formats.
Instructions for appropriate use of asthma medications. Merely noting the symptoms would not help to cure this disease if you do not know what actually you should take note of. Patientcentered asthma care minnesota department of health. This asthma action plan provides authorization for the administration of medicine described in the aap. This brochure provides an asthma action plan that will help you learn the steps to selfmanage your asthma so you can live a life as symptomfree as possible. Pediatric asthma in a nutshell american academy of. Asthma action plan for adults american lung association. Provider instructions for asthma action plan children ages 05 determine the level of asthma severity see table 1 fill in medications fill in medications appropriate to that level see table 1 and include instructions, such as shake well before using use with spacer, and rinse mouth after using. The colors of a traffic light will help you use your asthma medicines.
International consensus on icon pediatric asthma n. Pacnj asthma treatment plan the pediatric adult asthma. Together, you can modify it as needed so that you always know when a change in your symptoms means something serious. Apr, 2020 the goal of asthma selfmanagement is to achieve better health through controlling and preventing asthma attacks.
Review your childs asthma symptoms and peak flow zones with the camp nursecounselor. Differentiate asthma from other conditions that cause wheezing and cough. Services as meeting the requirements of the new jersey law. Cough, wheeze, chest tightness, or shortness of breath, or. The guide provides parents and caregivers the information they need to improve their childrens quality of life. Every person with asthma needs to have a personalized asthma action plan. Yellow zone caution continue with green zone medicine and add quickrelief medicine. Green zone doing well breathing is good no coughing, wheezing, chest tightness, or shortness of breath during the day or night, and able to do usual activities work, play, and exercise, and peak flow is more than. Weve made great progress since making aaps a priority. What actions to take when you are or your child is having symptoms of asthma or a low peak flow meter reading. Children with asthma have swollen inflammation, sensitive airways that lead to episodes of trouble breathing. Feel free to download and print this pdf for your patients. Perform skin or blood allergy tests for all patients with persistent asthma. Assess asthma severity to initiate treatment see page 5.
Identify commonly used asthma medications, their mechanism of action, and their adverse effect profile. If you or your child has asthma that requires daily treatment, it is important to have an asthma action plan. I consent to communication between the prescribing health care provider or clinic, the school nurse, the school medical advisor and school. Many people with asthma are allergic to the dried droppings and remains of cockroaches. Yes no if child refusesis unable to selftreat, an adult must give medicine. Asthma resources for professionals childrens hospital of. Asthma action plan for children age 15 child health bc. Name asthma action plan, for children 6 years or older.
Asthma action plan for children age 618 child health bc. Pediatric asthma action plan personal best peak flow. Following your plan is a big step toward controlling the disease so you can live the life you want. Explains green, yellow, and red zones in an action plan. If you would like more information on illinois asthma program, please contact the illinois department of public health at 2177823300. An asthma action plan, sometimes called asthma management plan, is a form used to keep track of medications, remind you what your peak flow is, and indicate what steps to take if you find yourself having an asthma attack. Using an asthma action plan is especially important if your child has moderate to severe asthma or has had a serious asthma attack in the past. Yes no if child refusesis unable to selftreat, an adult must give medicine important reminder anaphylaxis is a potentially lifethreating, severe allergic reaction. An individualized asthma action plan indicates the steps that must be taken to keep your asthma from getting worse. Assess asthma control at every visit by selfadministered standardized test or verbal history. Pediatric documentation templates overview when documenting a visit in an electronic health record ehr, having templates for acute and chronic conditions can assist providers by increasing the efficiency with which a visit is documented and enhancing adherence to clinical guidelines for those conditions. Discharge plan controller for persistent asthma oral steroids home bronchodilator therapy every 4 hours for 72 hours or until completing oral steroids finalize and document asthma action plan and asthma education during phase 3 place orders for relabel of asthma medications for home use and.
An asthma management plan is a special plan that the doctor will make. Work with your health care provider to create a plan for your child. Asthma action plans respiratory health association. Merely noting the symptoms would not help to cure this disease. Iggy and the inhalers includes comic books, trading cards, videos, and stickers for kids with asthma.
It can help you make quick decisions in case you are not able to think clearly during an attack. Download the printable version of the summer fun action plan pdf. Work with your doctor to make an asthma action plan what is a pdf document. In the early part of 2003, the leadership of the indiana department of health and the indiana department of environmental management invited people and organizations to form the. The pacnj asthma treatment plan is the only written plan. This asthma action plan outlines steps for you to selfmanage asthma when you start having more symptoms. Yearly percentage of asthma action plans distributed to outpatients. My asthma action plan childrens healthcare of atlanta. Asthma is getting worse cough, wheeze, chest tightness, or shortness of breath, or waking at night due to asthma, or can do some, but not all, usual activitiesorpeak flow. This colourful my asthma plan is designed especially for children age from six to 11. Asthma action plans division of disease prevention mecdc. Asthma action plan caring for kids canadian paediatric society.
Indiana asthma plan 5 a strategic plan for addressing asthma in indiana indiana asthma plan is the product of almost 20 months of planning. Download the printable school asthma action plan pdf. Tell the camp nursecounselor that your child has asthma. Allergy and anaphylaxis emergency plan childs name. Signs of an asthma episode or asthma attack when to seek emergency care.
Childhood asthma control test for children 4 to 11 years old. Pediatric documentation templates ahrq digital healthcare. I give permission for the medicines listed in the action plan to be administered in school by the nurse or other school staff as appropriate. The pediatricadult asthma coalition of new jersey is sponsored by the american lung association of the midatlantic. Asthma action plans division of disease prevention. Yes no if yes, higher chance severe reaction child has had anaphylaxis. Here is an easytoread guide for parents of children with asthma. Perform spirometry at baseline and at least every 1 to 2 years for patients 5 years of age. These tools for asthma control were created following the evidencebased guidelines. Before taking this form to your health care provider, complete the top left section with. Your healthcare provider might also change your usual asthma treatment according to the level of asthma control over time.
Aug 28, 2019 with a written asthma action plan, its easier for you to measure whether your childs asthma is under control and it lets you know exactly what steps to take when it isnt. By following the steps written in the general action plan, you can help your child perform normal, daytoday activities without experiencing alarming episodes or symptoms of asthma. Pediatric asthma action plan 115 years mild intermittent symptoms persistent symptoms or moderate or severe. Here are the basic guidelines to remember when formulating an asthma action plan. Pediatricadult asthma coalition of new jersey asthma action plans in. Assessing asthma control monitoring symptoms taking medicines as directed avoiding known asthma triggers asthma action plans an asthma action plan is a tool to help selfmanage asthma and is developed with the patient, caregiver and doctor. If you are interested in talking with our certified pediatric asthma educators to learn how to better control your childs asthma, please call the pediatric asthma program of cape fear valley at 910 6153185 to make an appointment. Studies show that following a written asthma action plan can lead to fewer asthma attacks and better disease management. Asthma treatment plan student parent instructions the pacnj asthma treatment plan is designed to help everyone understand the steps necessary for the individual student to achieve the goal of controlled asthma. Develop your own asthma action plan to help you control your childs asthma, establish goals. Send a supply of daily medicines and medicines to treat an asthma attack, including a quickrelief inhaler and spacer. Accurately assess asthma severity and level of control and develop a comprehensive treatment plan. This could include teachers, school nurses, and after school care staff.
Global initiative for asthma global initiative for. For almost 20 years, the community asthma prevention program has focused on fighting disparities in asthma through strong community ties, high performingcollaborations and partnerships, community health workers, integration of healthcare services and tailored environmental interventions to increase the effectiveness of care for people with asthma. The goal of asthma selfmanagement is to achieve better health through controlling and preventing asthma attacks. For more information contact the asthma society of canada at. It lists the medicines your child needs to take every day to stay well, what to do if their asthma gets worse, and what to do in an asthma attack. With the help of your doctor complete this action plan to ensure a safe funfilled summer. This plan will help you know what to do when asthma is in control and when asthma symptoms start to act up.
Mar 01, 2016 providing this asthma education at the time of diagnosis and reinforcing it at all subsequent visits lead to better outcomes in terms of achieving the goals of asthma therapy, namely few symptoms, no limits on activity, rare exacerbations, and normal lung function. Asthma action plans also tell school and other caregivers about your childs asthma. Identify barriers to good asthma control and how to. Pediatric asthma action plan from iggy and the inhalers asthma information for kids patient education package. The global initiative for asthma gina strives to increase awareness of asthma among health professionals, health authorities, and the general public. Diagnosis and management 2015, translated action plans available in chinese and punjabi, and fillable pdf. Date hospitalemergency department phone number green zone doing well no cough, wheeze, chest tightness, or shortness of breath during the day or night can do usual activities and, if a peak flow meter is used, peak flow. My asthma action plan times per day every day take only noas needed see below starting in yellow zone or before excercise times per day every day times per day every day 2 puffs 46 puffs 1 nebulizer treatment gargle or rinse mouth after use special instructions when i am doing well be careful ask for help asthma triggers check all that. An asthma action plan is a written plan that tells you what asthma medicine to take every day and how to treat an asthma attack. Oct, 2014 pediatric asthma action plan from iggy and the inhalers asthma information for kids patient education package.