The Minnesota Department of Health's pediatric plan gives families green, yellow and red zone steps based on symptoms and peak flow (80-100%, 50-79% and below 50% of personal best). The provider's signature authorizes school or daycare staff to give the listed medicines, and the same page records whether the child may carry a quick-relief inhaler. Spanish and adult versions are available.
The child's physician, NP or PA fills in the zones and medicines and signs, authorizing administration and confirming whether the child can self-administer quick-relief medicine. The parent or guardian signs consent and circles whether the child may carry the inhaler at school.
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Yes. MDH posts the child plan in English and Spanish (Plan De Accion Para Asma, para el niño), and adult versions in both languages. For patients on a single combination inhaler for maintenance and relief, MDH also links a SMART therapy asthma action plan from the Allergy and Asthma Network.
Yes. The plan states that it provides authorization for administering the medicines it describes, and the MD, NP or PA signature covers that authorization. The parent's signed consent may supplement the school or daycare's consent form, allowing the child's medicine to be given at school or daycare.