Asthma Action Plan For Children When Well When Unwell Danger Signs every 3 hours more than or more often for one or more every ½ hour, OR
• Blue lips, OR
• Difficulty speaking or feeding Frightened OR
• Exhausted What should I do? What should I do? What should I do? What should I do? Preventer/Combined Give .………………………………. Keep giving………………………. CALL AN AMBULANCE on 000 Medication: Up to 3 - 4 hourly as needed: as needed. …………………. …. puffs/tablets (under 6 years old) Start Oral Steroid if prescribed: ………………………………………. …… times a day everyday …………………….… mg (……ml) (6 years or older) 4 puffs every 4 minutes Reliever: And see a doctor or come into hospital AS SOON AS POSSIBLE Use a spacer if available
continue same dose as usual, OR ………………………… …. puffs ………………………….…. puffs …… times a day until better
Dr name:…………………………………. Ph:………………….
Patient name:………………………………………………………………
Next Dr’s Appointment:……………………………………………………
Take this plan with you when you next visit your doctor EXTRA MEDICINE TO TAKE AFTER GOING HOME: FOLLOW-UP (please tick which) Date:……………………….
GP follow up in ……………. days/weeks
Prednisolone: ………….mg (.ml) once a day for ……………. days
Outpatient Clinic ………. weeks
Asthma Liaison Nurse …. weeks ……………………….……. ……… puffs ……………….… times a day for …………. days
Other: ………………………………………………………………………………………….…….
Consultant rooms ……………. weeks
. …………………………………………………………………………………………………………….
RETURN to hospital or see a doctor as soon as possible if your child:
• Starts working harder to breath (sucking in around tummy, ribs or neck with breathing) OR • Starts needing their reliever puffer more than every 3 hours Call an AMBULANCE if your child has any one of the following:
• Needs their reliever puffer more than every ½ hour, OR
• Has difficult speaking or feeding due to breathlessness, OR
• Is blue at the lips, OR
• Is frightened or exhausted
While waiting for the ambulance give your child their Relieverpuffer 4 puffs every 4 minutes (use a spacer if available) IS YOUR CHILDS’ ASTHMA UNDER CONTROL?
Does your child have any of the following symptoms when they seem well? • NIGHT TIME or EARLY MORNING wheeze, chest tightness or cough?
• Wheeze, chest tightness or cough with EXERCISE? RELIEVER 2 days a week, or more, to relieve asthma symptoms (not including before sport)?
• MISSING SCHOOL because of their asthma?
Answer yes, to any one of these? Then your child should see their family doctor, to look at ways to get their asthma under better control. www.healthnetworks.health.wa.gov.au (08) 9489 2800 [email protected] Developed by the Acute Respiratory (Paediatric) Working Group of the WA Child and Youth Health Network and Respiratory Health Network. Dec 2007 REVISION: Dec 2009
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