Managing Asthma with an Action Plan
It’s important to really understand the step wise progression from being in your good zone and managing your asthma, to starting to tip over the edge and needing to ratchet up the management a little bit to prevent it form becoming a more serious episode. We have Asthma Action Plans that we’ve adapted from the national model that the National Heart, Lung and Blood Institute created. The green zone is when you are doing well and the medicines are doing what they are supposed to be doing and are being taken every day. The yellow zone is when they are starting to get into a little bit of trouble and there are some signs that their lung function isn’t as good and they’re starting to show some signs of a cold, and describes some things that you start to do to adapt and change your management. We list how they change the medicines when they get into that yellow zone. The red zone explains what to do when they’re really bad and having many more symptoms and they need to use the medications more and when you need to contact the physician.
Shari Nethersole, MD, Pediatrician
Why clinicians like asthma action plans
Why clinicians like Asthma Action Plans As clinicians, we love that Asthma Action Plans* are written out in color so that families can stick it to their refrigerators. That way, if it’s Dad who’s in charge one day for giving meds and he’s not used to giving out the medication, he can see exactly what to do. We love that there are many copies of Asthma Action Plans, so if parents are divorced we can give a copy to each household, we can give one to the daycare, and one to the school nurse so that everyone knows this is what Suzie Q does when she’s feeling well and in her green zone, this is what needs to be done when she starts to get a cold and is in her yellow zone, and then if she is not getting better, to do what the red zone indicates, whether it be giving her Albuterol right away, or calling the doctor or calling if the Albuterol doesn’t work, or getting her to the nearest health care provider even if it means calling 911. The Asthma Action Plans are great devices, and help put Parents “in the driver’s seat” for their children’s asthma.
Beth Klements, MS, APRN, BC, Asthma Clinical Nurse Specialist, Pediatric Nurse Practitioner
Why other people like Asthma Action Plans
School nurses love Asthma Action Plans because when a child comes to them and is short of breath, they know exactly what they should do. Families like it to because it puts them in the driver’s seat: instead of having to call their health care office, over time they learn that if child gets a cold, they can look right to their Plan and know what to do, and maybe doing what the Plan says will be all they need to do to get back to their child’s green zone, or maybe they can call up their health care provider and say, “You know what? Suzie Q’s had a cold for a week and she’s been in her yellow zone for a couple days. I’ve been doing everything and she’s still not getting better. What do I do?” The Asthma Action Plans are a win win situation for everybody: the providers, the parents, and the school. So we really like everyone with asthma to have an Asthma Action Plan.
Beth Klements, MS, APRN, BC, Asthma Clinical Nurse Specialist, Pediatric Nurse Practitioner
We advise kids to have their asthma medicines at school
For most kids who have intermittent need for an asthma medicine, we advise them to have their asthma meds with them at school in the event that they develop symptoms. It varies a lot from kid to kid how much they will actually need to use their inhalers at school; sometimes it’s a safety measure. Most school nurses are really comfortable with asthma and know how to recognize the symptoms and when to give the medicines, so it’s never a bad idea to have the medicines at school. For some patients, having the school nurse give kids their meds on a regular basis is actually one of the best ways to ensure some level of compliance. For some of the kids we see who come from disorganized home settings and who need a twice a day asthma medicine who aren’t doing well with their asthma, it’s a good strategy to have at least one of their daily doses be delivered by the school nurse who can check it off on the calendar every day and make sure that it happens routinely. The school can be an ally in that way.
Hans Oettgen, MD, PhD, Associate Chief, Division of Immunology