Under 5s asthma action plan

Keep this plan safe and take it with you every time your child sees their GP or asthma nurse. If you’re worried about your child’s asthma don’t put off asking for help or advice.

Zone 1Your child’s asthma is under control if:

• They’ve very few or no asthma symptoms during the day or night (wheezing, coughing, shortness of breath)• They can do all the things they normally do without asthma symptoms

Continue your child’s usual medicines as prescribed.

Name:

Dose & time:

If your child has preventer medicine it should be taken every day, even when your child is feeling well.

Action Reliever medicine should only be used if your child has asthma symptoms or as directed by your GP or asthma nurse.

Other medicines:

If your child is always in Zone 1 it may be possible to reduce (step down) their medicine but only after talking to their GP or asthma nurse.

1

Name:

Dose & time:

Action

Name:

Dose & time:

Name:

Dose & time:

Zone 2Your child’s asthma is getting worse if any of these things happen:

They need to use their reliever inhaler more than three times a week • They’ve got asthma symptoms when active

• They’ve got a cold

• They’ve been waking with asthma symptoms

Continue your child’s preventer medicines as instructed by your GP or asthma nurse below.

Name:

Dose & time:

Name:

Dose & time:

Action

Start using your child’s reliever medicines as instructed by your GP or asthma nurse below.

If your child is often in Zone 2 speak to your GP or asthma nurse as their usual medicines may need to be changed. When your child’s asthma is back under control you’ll be able to go back to Zone 1.

Name:

Dose & time:

Name:

Dose & time:

Action

Other medicines:

•

Zone 3Your child’s asthma is bad if any of these things happen:

• They’re waking at night with asthma symptoms

The effects of their reliever inhaler aren’t lasting 3–4 hours or working within 15 minutes

They’re unable to do the things they normally do without getting symptoms

Continue your child’s preventer medicines as in Zone 2 and instructed below.

Action Give your child their reliever medicine as follows:

Action If your child has been given steroid tablets, start them as instructed and make an urgent appointment.

Give ______ prednisolone 5mg tablets all together straight away and then give the rest of the doses every morning

for ______ days or until your child has completely recovered.

If your child’s asthma is not back at Zone 1 when they’ve finished their steroid tablets, make an urgent ‘on-the-day’ or emergency appointment to see their GP. Your child may need to continue with steroid tablets until recovery (Zone 1).

Name:

Dose & time:

Name:

Dose & time:

Action

Zone 4Your child is having an asthma attack if any of these things happen:

• Their reliever inhaler does not help or last

• They’re very distressed by their asthma symptoms

• They’re too breathless to talk, eat or drink

• They’re using tummy or neck muscles to breathe

• Their lips are blue

Action Get help immediately

• Call 999 or your GP urgently

Give two puffs of their reliever inhaler (one puff at a time) every two minutes – they can have up to ten puffs

Give steroid tablets if you have them and did not use them in Zone 3

© Asthma UK 2014 registered charity number in England and Wales 802364 and in Scotland SCO39322 HP2610114

2

Name:

Parent:

Contact no:

GP:

Surgery contact no:

Drug allergies:

•

•

Asthma UK Helpline 0800 121 62 44

Email info@asthma.org.uk

Visit www.asthma.org.uk

•

•

My Asthma Plan

My asthma medicines

•Mybestpeakflowis

•Mypreventerinhaleriscalled anditscolouris

OtherasthmamedicinesItakeeveryday:

Doesplaying,runningordoingPEnormallymakeithardtobreathe?

IfyesItake puff/sofmy(colour)relieverinhalerbeforehand.

1. My asthma medicines

Your asthma plan tells you when to take your asthma medicines.

And what to do when your asthma gets worse.

Name:

What asthma medicines do you take every day?

Remember to take your inhaler with a spacer if you have one

2. When my asthma gets worse

When this happens:Ikeeptakingmypreventermedicinesasnormal.

I will know my asthma is getting worse if:

• Ihaveacough,wheeze,itishardtobreatheormychesthurts,or

• Iamwakingupatnightbecauseofmy asthma,or

• Iamtakingmyrelieverinhalereveryday,or

•Mypeakflowislessthan

And alsotakepuff/sofmy(colour)relieverinhalereveryfourhours.

If I am not getting any better I should see my doctor or asthma

nurse today.

What should you do when your asthma gets worse?

• MyrelieverinhaIeriscalledanditscolouris.Itakepuff/sofmy(colour)relieverinhalerwhenIwheezeorcough,mychesthurtsorit’shardtobreathe.

• Itakepuff/sofmypreventerinhaler inthemorningandpuff/satnight. IdothiseverydayevenifIfeelwell.

I still don’t feel better and

I have taken ten puffs.Now

Ineedtocall999straight

away.IfIamwaitinglonger

than15minutesforan

ambulanceIshouldtake

anotherpuffsofmy

(colour)

relieverinhalereverytwo

minutes(uptotenpuffs).

I am feeling better, butIdon’twantthistohappenagainsoIneedtoseemydoctororasthmanursetoday.

I am having an asthma attack if:

• My(colour)relieverinhalerisnothelping,or

• Ican’ttalkorwalkeasily,or

• Iambreathinghardandfast,or

• Iamcoughingorwheezingalot,or

•Mypeakflowisbelow

When this happens:Ishouldtakepuffsofmy(colour)relieverinhalereverytwominutes(uptotenpuffs)untilIfeelbetter.

3. What to do when I have an asthma attack

999

My asthma triggers:

Doctor’s/asthma nurse contact details:

Date I got my asthma plan:

I need to see my asthma nurse every six months at least

My next asthma review:

(Writedownthingsthatmakeyourasthmaworsesoyoucanstayawayfromthem.)

©2012AsthmaUKRegisteredcharitynumberinEngland802364andinScotlandSCO39322.Firstpublished2010.Nextreview2013 HP1580210

Where can I find out more?AsthmaUKisdedicatedtoimprovingthehealthandwell-beingofthe5.4millionpeopleintheUKwithasthmaincluding1.1millionchildren.

Asthma UK AdvicelineAskanasthmanursespecialist

08001216244asthma.org.uk/adviceline

Asthma UK websiteReadthelatestindependentadviceandnewsonasthmaasthma.org.ukkickasthma.org.uk

Asthma UKSummitHouse,70WilsonStreet,LondonEC2A2DBT02077864900F02072566075

Asthma UKNorthern IrelandGroundfloor,Unit2CollegeHouse,CityLinkBusinessPark,DurhamStreet,BelfastBT124HQni@asthma.org.uk

Asthma UK CymruEastgateHouse,35–43NewportRoad,CardiffCF240ABwales@asthma.org.uk

Asthma UK Scotland4QueenStreet,EdinburghEH21JEscotland@asthma.org.uk

Name: ...................................................................

Date: ...................................

Smoking even outdoors will make asthma worseNational Smoking Helpline: 0800 022 4332

http://www.smokefree.nhs.uk

How to Treat yourWheeze/Asthma

Useful Websites:

Asthma UK: www.asthma.org.uk

Teenage Health Freak: www.teenagehealthfreak.com

www.childhealthbucks.com

Spacers

One puff every five breaths using the spacer (Tidal Breathing)

Aero ChamberVolumatic

Treatment Plan once you are homeOral Soluble Prednisolone (Dose) ...............................................................................

Length of treatment (in days) ..............................................................................................

Start date: ..................................................... End date: ......................................................

Salbutamol (Blue Reliever Inhaler)

Dose.................................................. Start Date....................... ..........................................

Other Medication ................................................................................................................This should be reduced using the Six Steps to reducing your inhaler usage guide below

Steroids (Preventer Inhaler) ......................................................................................Dose.................................................. Start Date.................................................................

Other Medication ..........................................................................................................

A follow up review should be undertaken by your GP/nurse within the next .................... days.

Always take your inhalers via a spacer as this is a much more effective way of getting medicines into the lungs● Smaller children (generally under 3 years)

to use spacer with face mask● Older children (generally over 3 years) to

use spacer with mouth piece

This is my Blue Reliever Inhaler.

This is used to relieve the wheeze/cough and can be used before exercise if necessary - it is best used with a spacer.

This helps me when I am coughing or wheezing by opening up and relaxing my lungs.

If I am using this more frequently than normal, I should see my doctor or nurse to have my asthma checked.

When my asthma is well controlled I should not need to use my blue inhaler regularly.

Reliever (Blue Inhaler)

Preventer Inhalers (Brown, Orange, Purple, Green or White)

My Preventer Inhaler is ..................... (colour)

This inhaler prevents my lungs becoming irritated and inflamed.

I must use this every day even when I am well to keep my asthma under control.

Spacer prescribed? YES NO

Health Care Professional has checked technique?

YES NO

● Organise a review with your GP or Asthma Nurse

● Keep your blue inhaler with you at all times

● Get a new inhaler when you start your last full one

● Ask your Health Care Professional how to use your inhaler and spacer properly and check your technique at every appointment

● If you run out, in an emergency a pharmacist may be able to supply salbutamol (there may be a charge for this)

● Avoid trigger factors for your asthma/wheeze eg. pollen/dust

● Remember to rinse your mouth out after using your preventer

● Wash your spacer monthly with warm soapy water, leaving it to drip dry

● Smoking even outdoors will make asthma worse

When my asthma is back under control this is what I should do

If your child gets more wheezy or breathless, go back up a step and contact your GP as soon as possible

(If your child is sleeping and breathing comfortably you do not need to wake them to give them their inhalers overnight).

1 Inhale 10 puffs every 4 hours for 24 hours

2 Then inhale 8 puffs every 4 hours for 24 hours

3 Then inhale 6 puffs every 6 hours for 24 hours

4 Then inhale 4 puffs every 6 hours for 24 hours

5 Then inhale 2 puffs every 6-8 hours for 24 hours

6 Then inhale 2 puffs as and when required

GIVING YOUR INHALER Steps 1-3 needs to be followed for each puff e.g. if asked to give 2 puffs; repeat the whole process twice. You may be given different coloured inhalers or chambers. The process is the same for all colours. Below are some examples of different coloured inhalers and chambers.

Top TipsSix Steps to reducing your salbutamol (Blue Reliever Inhaler) usage

Reassess and monitor your child regularly (symptoms may start or get worse in the evening ) - please follow traffic light advice above.

REMEMBER ALWAYS HAVE YOUR BLUE INHALER AND SPACER WITH YOUIMPORTANT: ASTHMA/WHEEZE CAN BE LIFE THREATENING

LIFE THREAT

If your child:● becomes unresponsive● becomes blue● is having severe difficulty breathing - using tummy muscles - ribs are sinking in● unable to complete sentences● is unable to take fluids and is

getting tired ● is pale, drowsy, weak or quiet

MODERATE

If your child is:● having some difficulty in breathing /

noisy breathing● Mild wheeze and has breathless-

ness that is not responding to the usual reliever (blue inhaler) treatment

● Using their blue reliever inhaler – more than 2 puffs every 4 hours

● Breathing more quickly than normal

You need to contact a nurse or doctor today

Increase blue inhaler 10 puffs over 20 min-utes and repeat every 4 hours via spacer and

Please ring your GP surgery during the day or when your GP surgery is closed, please call NHS 111 by dialling 111.

MILD

If your child is:Using their reliever more than usual but is not breathing quickly and is able to continue doing day to day activities and is able to talk in full sentences

Needs doctor / nurse review over the next few days, unless deteriorating. Continue to use blue inhaler as required. Read this leaflet about how to help with your wheeze / Asthma symptom control.

What do I do if my child is Wheezy / has Asthma? (traffic light advice)

Warning signs that your asthma is not well controlled include:● Waking up regularly to cough, feeling tight / wheezy during the night ● Early morning tightness wheeze or cough● Frequently needing your blue inhaler● Frequent exercise induced cough or wheeze

You need EMERGENCY helpRing 999 - you need help immediately

If you have a blue inhaler use it now - 1 puff per minute via Spacer

UNTIL AMBULANCE ARRIVES

Nearest Hospitals (open 24 hours 7 days a week):

▲▲

▲

Frimley Park, SurreyHillingdon HospitalJohn Radcliffe, OxfordMilton Keynes Hospital

Royal Berkshire, ReadingStoke Mandeville Hospital, AylesburyWexham Park Hospital, Slough

Produced by the Children and Young People Urgent Care Board

Published August 2014 To be reviewed August 2015. This guidance is written in the following context:

This document was arrived at after careful consideration of the evidence available including but not exclusively NICE Quality Standard for Asthma QS25- February 2013, BTS/SIGN Asthma Guidelines 2009, as applicable. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. The guidance does not, however, override the

individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient in consultation with the patient and / or carer.

www.chilternccg.nhs.uk www.aylesburyvaleccg.nhs.uk www.sloughccg.nhs.uk www.windsorascotmaidenheadccg.nhs.uk

If you use an

asthma acti

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four times le

ss likely

to have an asth

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that r

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emergency

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your asthma action plan

Name Date

Complete this with your asthma nurse or GP.

Asthma UK has a range of resources to help with your asthma and a team of specialist asthma nurses if you need further advice.

Asthma UK Adviceline 0800 121 62 44

info@asthma.org.uk Or visit our websitewww.asthma.org.uk

© 2013 Asthma UK registered charity number in England and Wales 802364 and in Scotland SCO39322HP2230513 First published 2004; Last updated 2011; Last reviewed 2013; Next review 2016

If you have any concerns about managing your asthma, you can call an asthma nurse specialist on Asthma UK’s Adviceline 0800 121 62 44

When you have good control over your asthma you should have no symptoms. If you have hay fever or a food allergy it’s even more important to have good control of your asthma.

My asthma is getting worse if I notice any of these:

This is what I need to do to stay on top of my asthma:

My symptoms are coming back (wheeze, tightness in my chest, feeling breathless, cough)

I am waking up at night

My symptoms are interfering with my usual day-to-day activities (eg at work, exercise)

I am using my reliever inhaler times a week or more

My peak flow drops to below

My reliever inhaler is not helping or I need it more than every hours

I find it difficult to walk or talk

I find it difficult to breathe

I’m wheezing a lot or I have a very tight chest or I’m coughing a lot

My peak flow is below

1 If I haven’t been using my preventer inhaler, start using it regularly again or:

Increasemypreventerinhalerdoseto until my symptoms have gone and my peak flow is back to normal.

Takemyrelieverinhalerasneeded(upto puffseveryfourhours).

If I don’t improve within 48 hours make an appointment to see my GP or asthma nurse.

2 If I have been given prednisolone tablets (steroid tablets) to keep at home:

Take mgofprednisolonetablets

(whichis x5mg)immediately

andagaineverymorningfor daysoruntilIamfullybetter.

Call my GP today and let them know I have started taking steroids and make an appointment to be seen within 24 hours.

This is what I can do straight away to get on top of my asthma:

I am having an asthma attack if any of these happen:

THIS IS AN EMERGENCY TAKE ACTION NOW

1 Take two puffs of my reliever inhaler (one puff at a time)

2 Sit up and try to take slow, steady breaths

3 If I don’t start to feel better, take two puffs of my reliever inhaler (one puff at a time) every two minutes. I can take up to ten puffs

4 If I don’t feel better I should call 999 straight away. If an ambulance doesn’t arrive within ten minutes, and I’m still not feeling better, then I should repeat Step 3

5 Even if I feel better after this I should see my GP or asthma nurse for advice the same day

6 If I have rescue prednisolone tablets, take 40mg (8 x 5mg) altogether

Contact number for GP/specialist asthma nurse:

My personal best peak flow is:

My preventer inhaler    (insert name/colour)I need to take my preventer inhaler every day even when I feel well.

Itake puff(s)inthemorning

and puff(s)atnight.

My reliever inhaler  (insert name/colour)I take my reliever inhaler only if I need to.

Itake puff(s)ofmyrelieverinhalerifanyofthesethingshappen: I’mwheezing Mychestfeelstight I’mfindingithardtobreathe I’mcoughing

Other medicines I take for my asthma every day:

Please note this asthma attack information is not designed for people who use the Symbicort SMART regime. If you use Symbicort SMART please speak to your GP or asthma nurse about this.