ASTHMA ACTION PLAN

Take this ASTHMA ACTION PLAN with you when you visit your doctor

ACTION PLAN FOR DOCTOR’S CONTACT DETAILS EMERGENCY CONTACT DETAILS

Name Name Name

Phone Phone Phone

Next asthma check-up due Relationship

WHEN WELL Asthma under control (almost no symptoms) ALWAYS CARRY YOUR RELIEVER WITH YOU

Peak flow* (if used) above:

Your preventer is:..................................................................................................................... OTHER INSTRUCTIONS
(NAME & STRENGTH)
(e.g. other medicines, trigger avoidance, what to do before exercise)
Take............................. puffs/tablets..................................................... times every day
 Use a spacer with your inhaler .........................................................................................................................................................

Your reliever is:.........................................................................................................................

(NAME) .........................................................................................................................................................

Take............................. puffs........................................................................................................
.........................................................................................................................................................
When: You have symptoms like wheezing, coughing or shortness of breath
 Use a spacer with your inhaler .........................................................................................................................................................

Asthma getting worse (needing more reliever than usual, having more symptoms than usual,
WHEN NOT WELL waking up with asthma, asthma is interfering with usual activities)

Peak flow* (if used) between and

Keep taking preventer:..........................................................................................................
(NAME & STRENGTH)
OTHER INSTRUCTIONS  Contact your doctor
Take............................. puffs/tablets.................................................... times every day (e.g. other medicines, when to stop taking extra medicines)

...........................................................................................................................................................
...........................................................................................................................................................
 Use a spacer with your inhaler

Your reliever is:......................................................................................................................... ...........................................................................................................................................................

(NAME)

Take............................. puffs........................................................................................................ ...........................................................................................................................................................

........................................................................................................................................................... ...........................................................................................................................................................
 Use a spacer with your inhaler

Severe asthma flare-up/attack (needing reliever again within 3 hours,

IF SYMPTOMS WORSEN increasing difficulty breathing, waking often at night with asthma symptoms)
Peak flow* (if used) between and
Keep taking preventer:..........................................................................................................
(NAME & STRENGTH)
OTHER INSTRUCTIONS  Contact your doctor today
Take............................. puffs/tablets..................................................... times every day (e.g. other medicines, when to stop taking extra medicines)
Prednisolone/prednisone:
...........................................................................................................................................................
 Use a spacer with your inhaler Take................................................................ each morning for................................ days
Your reliever is:.........................................................................................................................
(NAME) ...........................................................................................................................................................

Take............................. puffs.......................................................................................................
...........................................................................................................................................................

...........................................................................................................................................................
...........................................................................................................................................................
 Use a spacer with your inhaler

Asthma emergency (severe breathing problems, symptoms get

DANGER SIGNS worse very quickly, reliever has little or no effect)

Peak flow (if used) below:

DIAL 000 FOR Call an ambulance immediately

Say that this is an asthma emergency

AMBULANCE Keep taking reliever as often as needed

 Use your adrenaline autoinjector (EpiPen or Anapen)
nationalasthma.org.au
* Peak flow not recommended for children under 12 years.
ASTHMA ACTION PLAN
WHAT TO LOOK OUT FOR

WHEN THIS MEANS:

WELL • you have no night-time wheezing, coughing or chest tightness
• you only occasionally have wheezing, coughing or chest tightness during the day
• you need reliever medication only occasionally or before exercise
• you can do your usual activities without getting asthma symptoms

THIS MEANS ANY ONE OF THESE:

WHEN • you have night-time wheezing, coughing or chest tightness
NOT WELL • you have morning asthma symptoms when you wake up
• you need to take your reliever more than usual
• your asthma is interfering with your usual activities
THIS IS AN ASTHMA FLARE-UP

IF
THIS MEANS:
SYMPTOMS
• you have increasing wheezing, cough, chest tightness or shortness of breath
GET WORSE
• you are waking often at night with asthma symptoms
• you need to use your reliever again within 3 hours
THIS IS A SEVERE ASTHMA ATTACK (SEVERE FLARE-UP)

THIS MEANS:
DANGER • your symptoms get worse very quickly
SIGNS • you have severe shortness of breath, can’t speak comfortably or lips look blue DIAL 000 FOR
• you get little or no relief from your reliever inhaler
CALL AN AMBULANCE IMMEDIATELY: DIAL 000
AMBULANCE
SAY THIS IS AN ASTHMA EMERGENCY

PREVENTERS RELIEVERS
Your preventer medicine reduces inflammation, Your reliever medicine works quickly to make
swelling and mucus in the airways of your lungs. breathing easier by making the airways wider.
ASTHMA Preventers need to be taken every day, even when
Always carry your reliever with you – it is essential
MEDICINES you are well.
for first aid. Do not use your preventer inhaler for
Some preventer inhalers contain 2 medicines to quick relief of asthma symptoms unless your doctor
help control your asthma (combination inhalers). has told you to do this.

To order more Asthma Action Plans visit the National Asthma Council website.
A range of action plans are available on the website –
please use the one that best suits your patient.
nationalasthma.org.au
National Asthma Council Australia retained editorial control. © 2023