An asthma action plan (or management plan) is a written plan that you develop with your child's doctor to help control your child's asthma.

The goal of an asthma action plan is to reduce or prevent flare-ups and emergency department visits through day-to-day management. Having a written step-by-step plan in place provides clear instructions so you and your child can:

• avoid triggers
• identify early symptoms of a flare-up and treat them to prevent the flare-up from getting worse
• know how to manage a full-blown flare-up
• know when to seek emergency care

Experts recommend using a written plan as part of asthma treatment. Following a written asthma action plan can help your child do normal everyday activities without having asthma symptoms.

Action Plans Are Unique

Each person's experience with asthma is different, so each action plan will be, too. A key part of any action plan will detail what needs to be done during a flare-up. If your child attends school, this may include permission for him or her to take rescue medication at school. The action plan should also clearly state when to seek emergency care.

The Zone System

Although they can be organized in a number of ways, many action plans use the "zone system," which is based on the red, yellow, and green colors of a traffic light. This is the same color system used on peak flow meters. Action plans use symptoms, peak flow readings, or both to help you determine the zone your child is in:

• The green zone, or safety zone, explains how to manage asthma on a daily basis, when a child is feeling good.
• The yellow zone, or caution zone, explains how to look for signs that asthma is getting worse. It also instructs you on which medications to add to bring your child's asthma back under control.
• The red zone, or danger zone, explains what to do when a flare-up is severe.

The color system makes it easy for kids and parents to quickly figure out which instructions apply to a child's peak flow meter reading. Your child's "personal best" peak flow reading is an important measurement to include on the plan so that you'll have something to compare the new numbers to.

Asthma action plans may also include:

• emergency phone numbers and locations of emergency care facilities
• a list of triggers and how to avoid them
• steps your child should take before exercising
• a list of early flare-up symptoms to watch for and what to do when they occur
• the names and dosages of all your child's medications and when and how they should be used

It's valuable to have all of this information in one place so that you — as well as your child's teachers, relatives, and caregivers — can respond properly, even in stressful situations.

Putting the Plan to Good Use

Your child's action plan will be most effective if you make yourself familiar with it before your child has a flare-up. Follow the advice within it to avoid flare-ups.

Familiarize your child with the plan and answer any questions. Older kids should know which steps they can take themselves and when they should seek help.

The action plan should go everywhere your child goes. Keep a copy at home in a well-known spot and give one to the school nurse, teachers, and anyone else who cares for your child. Offer to discuss the plan so they won't be hesitant about following it.

Also, revise the plan whenever dosages for your child's medicines change. Review the plan with your doctor at least every 6 months or more frequently if symptoms occur more often than they used to.

The plan also might need to be updated if your child doesn't seem to require rescue medications as often. Any time the action plan is changed, provide new copies to anyone who has one.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: October 2010