Developing an Asthma Action Plan

By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last Reviewed: May 2016. | Last updated: March 2023

If you have a written asthma action plan (AAA) and know how to monitor your symptoms, you are less likely to visit the emergency department or be hospitalized.¹ You will miss fewer days of work or school. You will wake up less often because of asthma symptoms.

An AAA tells you what to do if your symptoms start to get worse. Your action plan should be individualized based on the medications you take, your best peak flow measurement, and your medical history. You and your health care provider can work together to develop the plan.

What is an asthma action plan?

There are two basic parts to an AAA.² First, your plan should describe how to manage your asthma on a daily basis. It will say which control medications to take every day. It may have recommendations on ways to manage triggers.

The second part describes how to recognize worsening asthma symptoms. It will say which peak flow measurements are signs of worsening asthma (if you measure your peak flow). The action plan will have instructions on which medications to take. It will say who to call based on how severe the flare up is.

What are the zones of an asthma action plan?

Asthma action plans have three zones. The zones correspond to the colors of a traffic light: green, yellow, red (Table).² If you use a peak flow meter, your action plan will be based on your personal best peak expiratory flow (abbreviated PEF). You can also monitor based on symptoms. In this case, your action plan will list the signs and symptoms of worsening asthma.

It is not necessary to go to the emergency department every time your symptoms get worse. Your action plan can help you decide what kind of medical care you need.

Table 1: Asthma Action Plan

Zone

PEF (percentage of personal best)

Symptoms

Actions

Green

80% to 100%

You feel well. You have no asthma symptoms, even when you are active.

Your asthma is under control. Continue taking your daily medications.

Yellow Caution

50% to 80% (measure a few times)

You have symptoms such as: wheeze, cough, tight chest, shortness of breath. Your symptoms wake you up at night and limit you from some activities.

Use your rescue inhaler. Call your doctor to talk about making changes to your medications.

Red Danger

Less than 50%

It is getting harder and harder to breathe. You cannont sleep. Your symptoms prevent you from normal activities.

Take your rescue inhaler right away. Call your doctor or emergency department, or go right to the emergency department.

National Heart, Lung, and Blood Institute. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma - Full Report 2007. Accessed 11/12/14 at: http://www.nhlbi.nih.gov/files/docs/guidelines/asthgdln.pdf

Who should have a copy of the AAA?

If your child has asthma, be sure that other caregivers have a copy of the asthma action plan. This can include babysitters or daycare staff. Your child’s school, camps, or sports coach should have a copy of the action plan.

What if my health care provider did not give me an AAA?

The National Heart, Lung, and Blood Institute recommends that providers give their patients an asthma action plan.² Action plans are especially important for people with moderate or severe asthma or poorly controlled asthma, and people who have had a severe asthma attack. Unfortunately, this is an area where many providers do not follow the guidelines.³ One estimate is that only about one-third of people with asthma have written asthma action plans.⁴

If your provider does not bring up an asthma action plan, you should feel comfortable asking for one. You can bring in a blank action plan and work with your provider to fill it in. The National Heart, Lung, and Blood Institute has a blank asthma action plan available online.