Asthma action plan: Signs only

GREEN ZONE: I'm Doing Well

I have no cough, wheeze, chest tightness, or shortness of breath during the day or night. I can do my usual activities. I take these drugs every day:

DRUG:_________________________ HOW MUCH & WHEN:_________________________

DRUG:_________________________ HOW MUCH & WHEN:_________________________

DRUG:_________________________ HOW MUCH & WHEN:_________________________

Additional instructions:

YELLOW ZONE: My Asthma Is Getting Worse

I have coughing, or wheezing, or chest tightness, or shortness of breath, or waking at night due to asthma. Or, I can do some -- but not all -- of my usual activities.

I add this quick relief drug (and keep taking my GREEN ZONE drugs):

DRUG:_________________________ HOW MUCH & WHEN:_________________________

Additional instructions:

RED ZONE: Medical Alert!

I am very short of breath, or quick-relief drugs have not helped, or I cannot do usual activities, or symptoms are the same/worse after 24 hours in the yellow zone.

DRUG:_________________________ HOW MUCH & WHEN:_________________________

After taking this drug, call the doctor NOW! Go to the hospital or call 911 for an ambulance if still in the red zone after 15 minutes AND I have not reached my doctor.

DANGER SIGNS:

• Trouble walking and talking due to shortness of breath.
• Lips or fingernails are blue.

Take 4 or 6 puffs of quick relief medicine and go to the hospital/call an ambulance!