Asthma in children: Creating an asthma action plan

Help your child manage his or her asthma by planning ahead. Here's help creating an asthma action plan.

The key to keeping your child's asthma under control is daily monitoring and giving your child the right asthma medication at the right time. A written plan will make it easier for you and your child to take charge of asthma by helping you track symptoms to see if your child's asthma is under control — and knowing exactly what steps to take when it isn't.

An asthma attack can be a frightening experience for both you and your child. Using an asthma action plan can help you know what to do to prevent and treat asthma flare-ups.

What a written plan can do for you

Monitoring your child's asthma with a written plan is especially important if your child has moderate or severe asthma or has had serious asthma flare-ups (exacerbations). A written plan can help you and your child:

Quickly recognize early warning signs of an asthma attack
Know when to adjust asthma medications
Keep tabs on how well treatment is working
Know when to call a doctor or seek emergency help

Creating your child's asthma plan

Because asthma varies from person to person, you'll need to work with the doctor to develop a plan that's customized for your child. If your child is older, he or she may benefit from helping create the plan and using it to monitor how well treatment is working. While formats vary, most action plans have clear instructions on how to:

Manage your child's medications. Your plan should list your child's asthma medications and when to take them. Medications usually include daily control medications (such as inhaled corticosteroids) and as-needed, quick-relief (rescue) medications (such as inhaled albuterol). Make sure you know what medications you have on hand, where they are and how to use them. If your child has a nebulizer to administer medication in mist form, the asthma action plan should include instructions for when to use it.
Track your child's long-term asthma control. Good overall asthma control is critical for preventing asthma flare-ups. If your child's asthma isn't under good long-term control, he or she is more likely to have bothersome symptoms and is at increased risk of an asthma attack. Signs of poorly controlled asthma mean you and your child need to meet with the doctor to review your child's asthma plan and make treatment changes. The Asthma Control Test (ACT) is a common way to measure how bothersome asthma symptoms have been over the past month. This test also tracks how often your child has needed to use a quick-relief (rescue) inhaler such as albuterol.
Recognize and treat an asthma attack. When you're on the lookout for warning signs — such as coughing, wheezing or shortness of breath — you can take prompt action at the first sign of an asthma flare-up. Recognizing and treating an asthma flare-up before symptoms get bad is the best way to prevent a full-blown asthma attack. If your child does have an asthma attack, follow the action plan's instructions for using quick-relief medications and other steps to get asthma symptoms under control.
Take action based on peak flow readings. If your child is old enough to use one, some doctors recommend a peak flow meter to help monitor how well your child's lungs are working. When your child's peak expiratory flow reading (PEF) is low, you'll need to increase or add medications according to the action plan. Often, low peak flow readings are the first sign of an asthma flare-up.
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 difficulty speaking, using 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 to list your child's asthma triggers and how to avoid them. These vary from person to person — examples include cold air, pollen, dust mites, mold, exercise, pet dander, smoke or respiratory infections.

Check out a sample plan

The asthma action plan that follows is an example of a plan to use. Print the plan and take it to your child's next appointment. Ask the doctor to help you personalize the plan for your child.

Sample Asthma Action Plan for Children 5 and Older (PDF file requiring Adobe Reader).

Keep the action plan within reach

Once you and your child's doctor have developed a written asthma plan, keep it handy in case of an asthma flare-up. Make sure your child and everyone who cares for him or her — including grandparents and baby sitters — know where to find it and what to do in case of worsening asthma symptoms. Give a copy of the plan to the school nurse and your child's teachers and coaches. Keep another copy in your wallet or purse, in case an asthma attack occurs away from home.

As your child gets older, he or she can take more responsibility for monitoring and managing asthma. By the time your child is a teen, he or she may be able to take a key role in using the action plan to monitor symptoms and adjust treatment.

Meet regularly with your child's doctor

Work with the doctor to adjust the asthma action plan on a regular basis. Asthma changes with age, so treatment plans need to change too.

Make sure your child goes to every scheduled doctor's appointment and brings along the current asthma plan.
Review your child's asthma plan at every doctor visit. Tell the doctor about any problems your child is having sticking with the plan.
If you have any questions or if you're simply concerned about your child's signs and symptoms, call your child's doctor or schedule an appointment.

Having asthma shouldn't mean your child will miss school, be short of breath during sports or play, or wake up coughing at night. By carefully following a written plan, you and your child can keep asthma well controlled — and minimize the disruptions caused by asthma flare-ups.