A written action plan for asthma management

A written action plan tells you exactly which of your asthma medicines you should take when, and what to do if your symptoms get worse.

The Zones Method is an excellent, written plan that you and your doctor could develop to ensure that you obtain the best possible treatment and control of your asthma. It guides you to individualise and optimise your treatment.

Discuss the below sample plan with your doctor and read our article on peak expiratory flow rate. You’ll have to use a peak-flow meter to check how you’re doing.

Green: 80 - 100% of your personal best 

  • Your breathing is good.
  • You don’t have any early warning signs of asthma symptoms.

PLUS, you’re taking all your medicines every day, as your doctor tells you.

AND you use your inhaler before exercise, as prescribed.

The Green Zone is where you should always be. Your asthma is controlled.

Yellow: Caution – 60 - 80% of your personal best 

  • You have a runny, stuffy nose.
  • You feel tired.
  • Your chin or throat itches.
  • You’re sneezing.
  • Your chest feels slightly tight.
  • You’re coughing.
  • You have dark circles under your eyes.

Steps to achieve control:

  • Use your rescue medicine.
  • Recheck your peak flow after 20-30 minutes.
  • Call your doctor, nurse or counsellor if your peak flow isn’t back up to the Green Zone or if it drops into the Yellow Zone again in less than 4 hours.

The Yellow Zone signifies "caution" – you should adjust your treatment.

Red: Danger – below 60% of your personal best

  • You’re coughing.
  • You’re wheezing.
  • Your chest feels very tight or hurts.
  • You’re breathing faster than normal (more than 30 breaths/minute).
  • You’re unable to speak in sentences.
  • You feel anxious.
  • Your pulse rate is higher than 120/minute.
  • You’re pale and your mouth and fingernails are blue-grey in colour.
  • You get out of breath easily.

Steps to achieve control:

  • Use your quick-relief medicine by inhaler or nebuliser right away.

The Red Zone signifies "danger" – you should immediately contact your doctor or emergency services.

Reviewed by independent healthcare consultant Prof Praneet Valodia and pulmonologist Prof Elvis Irusen, Head of the Division of Pulmonology at the Faculty of Medicine and Health Sciences, Stellenbosch University. October 2018.

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