Create a personalized asthma action plan with your healthcare provider. Call our friendly helpline nurses mondayfriday, 9am5pm 0300 222 5800. Created with a patient, parent and doctor, an action plan can be an essential reference for a childs school, day care center, babysitter, coach, grandparent and anyone else that helps take care of the child. Pacnj asthma treatment plan the pediatric adult asthma. You can also talk about your action plan with a certified asthma educator or certified respiratory educator, a healthcare professional with special training in asthma management. 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. Ask your childs doctor for a written asthma action plan.
Ask your doctor to fill out an asthma action plan for you. May 27, 2014 asthma action plan steps john bottrell health professional may 27, 2014 most asthma experts recommend every asthmatic have an asthma action plan, sometimes called an asthma management plan. Yes no if child refusesis unable to selftreat, an adult must give medicine important reminder anaphylaxis is a potentially lifethreating, severe allergic reaction. Always use the asthma action plan language for example, those sound. Assess asthma control at every visit by selfadministered standardized test or verbal history. The goal of asthma selfmanagement is to achieve better health through controlling and preventing asthma attacks. If you do not have a written asthma action plan, take the form below to your doctor and have them fill it out for you. 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. 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. Three things happen in the airways of the lungs during an asthma attack.
In order for the asthma action plan to be effective, it must be taught. I should continue using my normal medications as directed by my doctor, and remeasure my peak flow every weeks months. Asthma action plan asthma severity see reverse side asthma triggers identified things that make your asthma worse. 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. Asthma action plan for children ages 5 and younger handling asthma flareups is easier and less stressful for you and your child when you have a plan. Asthma action plan blue cross blue shield association. Asthma action plan national heart, lung, and blood institute.
Asthma clinical pathway emergency childrens hospital of. Download the asthma action plan for children ages 5 and younger pdf. The asthma action plan chosen should be appropriate for the persons age, treatment regimen, asthma severity, culture, language, literacy level, and ability to selfmanage. The pacnj asthma treatment plan is the only written plan. Action plan from asthma action plan from the us national institutes of health pdf. Connect with us 1200 first street, ne, washington, dc 20002 phone. My asthma action plan childrens healthcare of atlanta. Massachusetts asthma action plan personal best peak flow. Georgia school health resource manual 20 nurseresourcesschoolnursesmediachoadocuments. A written asthma action plan encourages selfmanagement of asthma. Bring asthma action plan and all medicines to all doctors appointments. Always use the asthma action plan language for example, those sound like yellow zone symptoms or did you start your yellow zone quick relief medications. Take this to your doctor here is your asthma action plan.
An asthma action plan is a written series of steps and management. Clinical pathways home emergency icu inpatient outpatient specialty care primary care. My asthma action plan name date doctor doctors phone number symptoms my breathing is normal. Asthma action plan and informational materials asthma clinical guideline tool. 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. Asthma action plan for younger children en espanol asthma action plan for older children en espanol. Asthma action plan for older children childrens healthcare of atlanta. Services as meeting the requirements of the new jersey law. Number of children aged 1 month to 21 years with an asthma diagnosis and a documented asthma action plan in past 12 months denominator. This brief assessment tool offers guidance in determining how well an asthma action plan is working for a student.
Perform skin or blood allergy tests for all patients with persistent asthma. Weve improved by paying close attention to the data, educating our providers and team members, and continuing to work to get better. 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. Electronic, fillable pdf versions of asthma action plans click below to open forms. Our library includes some of the many different written asthma action plans available. To download straight to your computer, right click and choose save target as. With consistent implementation of the action plan, many patients are able to eliminate some or in rare instances, all of the medications needed for asthma control. If your child doesnt have an asthma action plan, talk to his doctor about getting one. School nurse resources childrens healthcare of atlanta. Direct members to the childrens concussion page to download toolkit and view webinars.
Fill it in with your doctor so you can answer these questions. Take the asthma control test periodically and share the results with your healthcare provider to help assess if your asthma symptoms are well controlled. You can use it as a strategy to identify when your asthma may be flaring up and how to manage your asthma when it gets out of control. Mckesson population health management tool, which will. Simply giving a patient and family a written asthma action plan is not enough. If provided as part of a well check up if a 99212 is billed in addition to the well code, a copay. Apr, 2020 minnesota department of healths interactive asthma action plan is a computerbased program that uses information entered by the healthcare provider to create a personalized plan for each patient. Take a class to learn more about how to manage asthma. Electronic, fillable pdf versions of asthma action plans. Share the plan with childsschool, childcare center and others who care for your child.
Allergens animal dander some people are allergic to the flakes of skin or dried saliva from animals with fur or feathers. Get to know this document, the cornerstone of personalized treatment for anyone with a food allergy. 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. The colors of a traffic light will help you use your asthma medicines. A copy of the plan should be with your childs school, day care center, babysitter, coach, grandparent and anyone else that helps take care of your child. Asthma action plan english georgia department of public. An asthma action plan may be provided at a well checkup as part of anticipatory guidance or at an acute care visit for an exacerbation. Asthma action plan library national asthma council australia. Many people with asthma are allergic to the dried droppings and remains of cockroaches. Asthma action plan program primer kids health first. If student stays in red zone, begin emergency plan.
Every person with asthma needs to have a personalized asthma action plan. All children with asthma need an asthma action plan. Asthma action plans national asthma council australia. An asthma action plan allows you and your healthcare provider to create a personalized program for managing your asthma.
Consistent follow up with us as well as compliance with the medications at home ensure the best success. Need help speaking with your healthcare provider about your. This asthma action plan matches specific symptoms to actions that will help your child manage his or her asthma. I need to see my asthma nurse every six months parents get the most from your childs action plan make it easy for you and your family to find it when you need it take a photo and keep it on your mobile and your childs mobile if they have one stick a copy on your fridge door share your.
Your asthma action plan fill this in with your gp or nurse the stepbystep guide that helps you stay on top of your asthma name and date. 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. If student improves to yellow zone, send student to doctor or contact doctor. For more information contact the asthma society of canada at. Asthma action plan, for children 6 years or older, continued doctor doctors phone number. English pdf spanish pdf asthma triggers at home and in the workplace. Name asthma action plan, for children 6 years or older. It will help them understand how to recognize and handle an asthma attack. Number of children aged 1 month 21 years with asthma diagnosis. Clinical guideline for the diagnosis, evaluation, and management of adults and children with asthma 2011 pdf asthma action plan. Here are some tips to help effectively teach your patients and families to use their asthma action plan.