Why Every Child Needs a Written Plan
An asthma inhaler in the backpack is helpful—but a custom, written Asthma Action Plan (AAP) tells parents, coaches, and school nurses exactly when to use it, how much, and what to do next if breathing worsens. The National Heart, Lung, and Blood Institute (NHLBI) reports that kids who follow a plan miss 40 percent fewer school days and cut ER visits in half compared with those who rely on “as‑needed” rescue puffs alone .
Three‑Zone Asthma Plan at a Glance
Zone | Symptoms | Peak Flow* | What to Do |
Green (Controlled) | No cough, sleeps well, plays without breathlessness | 80–100 % personal best | Daily controller: inhaled steroid + spacer |
Yellow (Caution) | First child asthma flare signs: cough, mild wheeze, can speak full sentences | 50–79 % | 2 puffs albuterol every 4–6 hrs, recheck peak flow |
Red (Danger) | Fast breaths, nostril flare, can’t speak 4 words, ribs pull in | < 50 % | Give rescue inhaler; if no relief in 15 min, repeat and call 911 |
*Peak‑flow meters are recommended for kids ≥ 5 yrs—blow out fast after full inhale, record highest of three tries.
A printable NHLBI Asthma Plan template opens in a new tab for quick downloads during clinic visits.
Spotting Early Flare Signs Before They Escalate
- Night cough more than twice a week
- Activity cut‑backs—child opts out of recess tag
- Short‑acting inhaler use > 2 days a week
- Chest tightness reports (“my shirt feels small”)
- Slight dip in peak‑flow into yellow zone even without wheeze
Logging these in a phone note helps prove patterns at your next well‑child exam.
Medications by Zone—Who, What, When
Class | Examples | Green | Yellow | Red |
Inhaled corticosteroid | Fluticasone, Budesonide | 1–2 puffs AM & PM | Continue | Continue |
Leukotriene blocker | Montelukast | Bedtime chew tab | Continue | Continue |
SABA (rescue) | Albuterol, Levalbuterol | None | 2 puffs q4–6 hrs | 4–6 puffs, start EMS if no relief |
Oral steroid burst | Prednisolone 1–2 mg/kg/day × 3–5 days | — | If no green return in 24 hrs | Start immediately, doctor call |
Never skip the daily controller even during quiet months; it keeps airway swelling low so triggers spark fewer Yellow days.
Building the Plan: Five Simple Steps
- Know the baseline. Two‑week peak‑flow log + symptom diary = personal “best” number.
- List all triggers. Pollen, pet dander, viral colds, exercise—write them on the plan.
- Color‑code meds. Green label on steroid inhaler, yellow tape on rescue—easy in dim gym lighting.
- Share copies. Upload PDF to the school nurse portal; hand hard copy to PE coach, babysitter, and grandparents.
- Review every six months. Growth spurts change dosing; controller strength may need an update.
download our editable Asthma Action Plan (PDF lives under Resources).
School & Sports Coordination
Texas laws allow kids to self‑carry rescue inhalers with a physician form. Give the coach a two‑puff pre‑exercise order if exercise triggers cough. Include:
- Warm‑up pause rule: if coughing during drills, rest 10 min and re‑measure peak flow.
- Buddy system: teammate alerts staff if red‑zone signs appear.
- Locker spare: store second inhaler with spacer and mask in nurse’s office.
Myth‑Busting Corner
Myth 1: “If there’s no wheeze, it’s not asthma.”
Reality: Cough alone can mark flares—especially at night.
Myth 2: “Steroid inhalers stunt growth.”
Reality: Low‑dose ICS may slow growth 0.4 cm in year one, but uncontrolled asthma stunts more via sleep loss and activity limits.
Myth 3: “Only cold air exercise triggers attacks.”
Reality: Hot, humid, pollen‑laden air is equally potent; use pre‑exercise albuterol regardless of season.
For detailed evidence, see the Global Initiative for Asthma (GINA) 2025 report (opens new tab).
Sample 7‑Day Symptom & Peak‑Flow Tracker
Day | Morning PF % | Daytime Symptoms | Night Wakings | Inhaler Uses |
Mon | 95 | None | 0 | 0 |
Tue | 90 | Mild cough after PE | 0 | 2 pre‑PE |
Wed | 78 | Wheeze in art class | 1 | 4 |
Thu | 85 | None | 0 | 0 |
Fri | 92 | Soccer cough resolved | 0 | 2 pre‑game |
Sat | 96 | — | 0 | 0 |
Sun | 95 | — | 0 | 0 |
Bring this sheet to adjustments visits—trend beats memory.
Trigger‑Proofing Your Home
- Wash bedding weekly > 130 °F to kill dust‑mite eggs.
- HEPA vacuum living areas twice a week—especially carpets.
- No scented candles or sprays; switch to LED candles.
- Pet dander plan: pets out of bedroom + HEPA purifier.
- Mold patrol: run bathroom fan 20 min after showers; fix leaks within 24 hrs.
EPA’s Indoor Air Quality DIY checklist offers step‑by‑step action items (new tab).
Emergency Drill: What Teens Should Memorize
- Rescue dose – “4 puffs albuterol with spacer.”
- Call threshold – “If breathing still hard after 15 min, dial 911.”
- Address – school or practice field address for EMS.
- ICE contact – parent cell stored under ASTHMA MOM or ASTHMA DAD.
Practice monthly; muscle memory beats panic.
External Resources Worth Bookmarking
- “Asthma and Schools” – American Lung Association guide for educators.
- “Peak Flow Meter How‑To” – Mayo Clinic step‑by‑step video.
Both open in new tabs so you can keep this plan open.
Breath by Breath, Plan by Plan
A polished Asthma Action Plan turns chaos into clear steps—empowering your child to manage flares confidently and keeping family life on schedule.
Time for a Tune‑Up?
Schedule an asthma control review—we’ll adjust doses, update the plan, and print school forms on the spot.