Asthma Awareness: Your ‘Asthma Action Plan’

Today is my final guest blog in this series on asthma. I am deeply grateful to for inviting me and to all the readers for viewing my posts. I hope you have found them helpful.

Do you have an “asthma action plan” in place for your child? Due to the chronic nature of asthma, it is imperative to pay attention to the progression of symptoms, and one of the best ways to do so is by building an asthma action plan around your “peak flow,” preparing you to successfully deal with asthma when things go awry. “Peak flow” is a measurement of your lung function and can be taken with a “peak flow meter,” a small hand-held device that you can use pretty much anywhere. Taking in a deep breath and then blowing out into the device as hard as you can gives a number – your peak flow. Usually children as young as 5 years can do this maneuver. Measuring peak flow a number of times when you are well gives you your child’s personal best number.

Most current action plans are developed around the traffic signal structure of green, yellow and red zones, each based upon the asthma symptoms present and the current peak flow measurement. The green zone corresponds to 80-100% of this number, yellow 50-80% and red, less than 50%. For example, if 200 is your child’s personal best, green corresponds to 160-200, yellow to 100-160 and red, less than 100. Since the peak flow is effort-dependent, it may be falsely low if your child is tired and unable to give a good effort, so you’ll want to consider the level of other symptoms, as well.

So, what should you watch out for in each zone, and how should you react?

  • In the green zone, your child is experiencing no acute asthma symptoms, peak flow is 80-100% of his or her best, and no action – other than continuing current medications – is necessary.
  • In the yellow zone, peak flow is at 50-80%, and you may see coughing and wheezing, nighttime symptoms, or tightness in the chest. Your action steps in the yellow zone need to be discussed ahead of time with your physician. Usually you will need to provide your child with rescue medication several times a day. Additionally, I recommend parents contact me at this stage, because complementary treatment and medications such as prednisone may be needed. (I have some parents keep a small supply of prednisone at home to begin if their child continues in the yellow zone for longer than a day. The goal is always to nip problems in the bud, before symptoms worsen.
  • In the red zone, serious symptoms are present such as breathing hard and fast, being unable to talk easily, blue color or duskiness of the lips, skin or fingernails among other things. During this stage, rescue medicines providing no relief. Peak flow is less than 50% of best. This is a medical emergency. It is time to get to a doctor or hospital. Calling 911 to get help is probably the best action.


While this is the basic structure of an asthma action plan, Beating Asthma: Seven Simple Principles offers a more detailed discussion. I also recommend discussing an asthma action plan directly with your family physician.

Thanks again for joining me this week! I truly hope that the topics covered will help you take ownership of your child’s asthma and plan ahead to prepare for (and avoid!) tough times. Be empowered to beat asthma. You can do this. The quality of life will improve for your child and yourself!

I wish you and your family easy breathing!

Published on: May 18, 2012
About the Author
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Dr. Stephen Apaliski is a practicing asthma and allergy specialist in Texas and author of the book Beating Asthma: Seven Simple Principles, which can be found in paperback on CreateSpace, through his website,

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