This two-page plan from the National Heart, Lung, and Blood Institute gives a patient written instructions for daily asthma care and flare-ups. The clinician fills in controller and quick-relief medicines, doses and peak flow ranges for green, yellow and red zones, plus danger signs that call for emergency care. It was updated in December 2020 to align with the 2020 Focused Updates to the Asthma Management Guidelines.
The patient's physician or other health care provider completes the front page with the patient: name, doctor, date, phone numbers, medicines, doses and peak flow numbers. The patient or family checks off known triggers on the back page, which has no signature line.
Enter the patient's name, the doctor's name and the date the plan was written, then the doctor's phone number and the hospital or emergency department number. These numbers are what the patient reaches for in the yellow and red zones, so fill both in. The date tells the patient, family and school which version of the plan is current.
The green zone describes no cough, wheeze, chest tightness or shortness of breath day or night, and doing usual activities. If a peak flow meter is used, enter the value for 80 percent or more of personal best and the personal best itself. List each daily medicine with how much to take and when, then name the medicine for the before-exercise line, printed as 2 or 4 puffs 5 minutes before exercise.
Symptoms include cough, wheeze, chest tightness or shortness of breath, waking at night, or doing some but not all usual activities, or a peak flow of 50 to 79 percent of best. Enter the quick-relief medicine, number of puffs, how often it can be repeated and the maximum doses, or nebulizer once, while green zone medicines continue. If not back in green after 1 hour, enter the next quick-relief dose, the oral steroid in mg per day for 3 to 10 days, and the hours within which to call the doctor.
The red zone covers being very short of breath, quick-relief medicines not helping, not being able to do usual activities, or symptoms the same or worse after 24 hours in the yellow zone, or a peak flow under 50 percent of best. Enter the quick-relief medicine with number of puffs or nebulizer and the oral steroid dose in mg. The plan then tells the patient to call the doctor now and go to the hospital or call an ambulance if still in the red zone after 15 minutes and the doctor hasn't been reached.
Trouble walking and talking due to shortness of breath, or blue lips or fingernails, call for taking the quick-relief medicine and going to the hospital or calling for an ambulance now. Fill in the number of puffs, the quick-relief medicine name and the emergency phone line, since this box is meant to be acted on without further thought.
The back page lists allergens (dust mites, cockroaches and rodents, animal dander, indoor mold, pollen and outdoor mold), irritants (tobacco smoke, smoke, strong odors and sprays, vacuum cleaning) and other factors (sulfites, cold air, other medicines). The patient checks the triggers known to worsen their asthma and asks the doctor to help identify others. The page notes that tips work better combined and that the provider can help choose which ones fit.
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Asthma Action Plan
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Sources for this guide
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NHLBI lists the December 2020 Asthma Action Plan in English only, as a two-page fillable PDF. The template is widely re-hosted by state asthma programs, so check that any copy you hand out is the 2020 version, which carries publication number 20-HL-5251 and reflects the 2020 Focused Updates to the Asthma Management Guidelines.
Each zone has a blank for peak flow based on the patient's personal best: 80 percent or more in green, 50 to 79 percent in yellow, and less than 50 percent in red. NHLBI asks providers to write the numbers for each zone, the medicines to take and the steps to follow. If no meter is used, the symptom lists define the zones.
No. The plan has fields for the patient's name, the doctor, the date and phone numbers but no signature line or parent consent section. NHLBI presents it as a worksheet the patient completes with the health care provider to record how to monitor asthma and how to treat changing symptoms or attacks.
In the green zone, below the daily medicines table, the plan has a line for a medicine to take before exercise, printed as 2 or 4 puffs 5 minutes before exercise. The clinician writes in the medicine name so the patient knows which inhaler to use ahead of physical activity.