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So, you have a mild cough and wheezing. It’s been a while since this happened. What’s the plan?

Every day many of the 25 million people in the U.S. with asthma will need to act on their asthma symptoms.  So, where’s the plan?  An Asthma Action Plan is the best tool to have available to guide you stepwise through an asthma flare.  The “plan” should NOT be just “go to the ER!”  Most asthma attacks have early warning signs and if asthma is recognized early, the intervention may prevent the need for that ER visit and prednisone.  In Montana, only 25% of people with asthma have a Written Asthma Action Plan and only 78% of people with asthma have not been taught how to respond to an asthma attack. For more information on asthma in Montana, go to:

What’s the Asthma Action Plan?  It’s like a stoplight…Green, Yellow, and Red.

Green Zone: your breathing is fine with no cough or shortness of breath.  Peak flow reading is normal. You are taking your regular daily controller medications at the prescribed doses.

Yellow Zone: you are having mild cough or cold.  You notice mild wheezing, chest tightness or shortness of breath.  You are waking up at night with difficulty breathing or having exercise-related symptoms. Your peak flow reading is more than 50% but less than 80% of your personal best.   At this point, a change and likely an increase in medication is started to decrease symptoms and improve lung function in hopes of avoiding dropping into the RED zone.

Red Zone:  You are breathing hard and fast.  The asthma inhaler does not seem to be working.  You are having trouble talking or walking due to difficulty breathing.  Your peak flow is less than half (50%) of what it should be.  This is an emergency!  You should take additional quick-relief medications, call your doctor and prepare yourself to leave for the emergency room.

What are early warning signs of an asthma attack?

This may be different for each individual, but try to remember what happened hours to days before your last asthma flare.  How did you feel?  What early symptoms did you have?

  • Frequent cough, especially at night
  • Lower peak flow meter readings
  • Losing your breath easily or shortness of breath
  • Feeling very tired, fatigued or weak when exercising
  • Wheezing or coughing during or after exercise
  • Feeling tired, easily upset, grouchy, or moody
  • Signs of a cold or allergies (sneezing, runny nose, nasal congestion, sore throat, headache)
  • Trouble sleeping with nighttime asthma

The National Asthma Guidelines called EPR-3 (Expert Panel Report-3rd revision) recommends a written asthma action plan for all patients with asthma.  If you don’t have one…ask for one!  If you want to read for yourself the National Asthma Guidelines go to:

Your allergist/asthma specialist can develop a plan that works just for you!  Don’t leave home without it!

This educational information does not take the place of your physician’s advice.



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