NHS FORTH VALLEY
Asthma Action Plan
Short-term
All patients 5 years and over
Your asthma symptoms have been getting worse and you may have
had to attend your GP surgery, accident and emergency or even
been admitted to hospital.
This is a short-term management plan to help you manage your
asthma symptoms until it is under control again.
You will be given a longer-term asthma plan by your asthma
nurse/GP when your symptoms have improved.
Name
Date Completed
Best Peak Flow
(not recommended in children under 5 years)
Peak Flow
Your peak flow following emergency treatment:
Treatment following exacerbation (indicated by a ‘x’):
Name(s)
Dose
Preventer
Reliever
Other inhaled treatment
Other asthma
medication
(if prescribed)
Oral steroids (if
prescribed)
Other medication

Record your peak flow morning and night time. Continue until you are
reviewed at your asthma clinic.

If you have received emergency treatment for your asthma, contact your
asthma nurse or GP the next working day.

If you have been discharged from hospital you should contact your asthma
nurse or GP the next working day.
When your asthma is getting worse…

Your peak flow is below:
hospital)

You become short of breath, cough, wheeze and need to use your reliever
more often or find your inhaler is less effective

Seek medical advice that day.
(80% of your peak flow on discharge from
Emergency Plan
The following is an emergency plan which should be followed if you
experience a severe asthma attack:
A severe asthma attack can cause any of the following symptoms:
For adults and older children





Your chest feels tight and wheezy
You cannot talk in full sentences
You do not get relief from your reliever inhaler
Your peak flow is below
(60% of your peak flow on discharge from
hospital)
You are unable to record your peak flow
For a young child
 Too breathless to drink
 Colour becomes blue over the lips and tongue
 Appears exhausted
 Too breathless to cry
 The chest pulls in with every breath or there is a grunt with every breath
What should you do next:


Take
x 5mg prednisolone tablets (if available)
Emergency reliever treatment – use nebulised reliever (if available) once only
or 10 puffs of your reliever (one puff at a time) through a spacer once only
You may repeat your emergency reliever treatment whilst waiting for
medical help if you have not felt any improvements after 15-20 minutes

Record your peak flow

Dial 999 for an ambulance