Under 5s asthma action plan

Under 5s asthma action plan Keep this plan safe and take it with you every time your child sees their GP or asthma nurse. If you re worried about your child s asthma don t put off asking for help or advice. Zone 1 Your child s asthma is under control if: They ve very few or no asthma symptoms during the day or night (wheezing, coughing, shortness of breath) They can do all the things they normally do without asthma symptoms Continue your child s usual medicines as prescribed. If your child has preventer medicine it should be taken every day, even when your child is feeling well. Reliever medicine should only be used if your child has asthma symptoms or as directed by your GP or asthma nurse. Other medicines: If your child is always in Zone 1 it may be possible to reduce (step down) their medicine but only after talking to their GP or asthma nurse. Zone 2 Your child s asthma is getting worse if any of these things happen: They need to use their reliever inhaler more than They ve been waking with asthma symptoms three times a week They ve got asthma symptoms when active They ve got a cold Continue your child s preventer medicines as instructed by your GP or asthma nurse below. Start using your child s reliever medicines as instructed by your GP or asthma nurse below. Other medicines: If your child is often in Zone 2 speak to your GP or asthma nurse as their usual medicines may need to be changed. When your child s asthma is back under control you ll be able to go back to Zone 1. 1

Zone 3 Your child s asthma is bad if any of these things happen: They re waking at night with asthma symptoms The effects of their reliever inhaler aren t lasting 3 4 hours or working within 15 minutes They re unable to do the things they normally do without getting symptoms Continue your child s preventer medicines as in Zone 2 and instructed below. Give your child their reliever medicine as follows: If your child has been given steroid tablets, start them as instructed and make an urgent appointment. Give prednisolone 5mg tablets all together straight away and then give the rest of the doses every morning for days or until your child has completely recovered. If your child s asthma is not back at Zone 1 when they ve finished their steroid tablets, make an urgent on-the-day or emergency appointment to see their GP. Your child may need to continue with steroid tablets until recovery (Zone 1). Zone 4 Your child is having an asthma attack if any of these things happen: Their reliever inhaler does not help or last They re very distressed by their asthma symptoms They re too breathless to talk, eat or drink Their lips are blue They re using tummy or neck muscles to breathe Get help immediately Call 999 or your GP urgently Give two puffs of their reliever inhaler (one puff at a time) every two minutes they can have up to ten puffs Give steroid tablets if you have them and did not use them in Zone 3 Asthma UK Helpline 0800 121 62 44 Visit www.asthma.org.uk Email info@asthma.org.uk Parent: Contact no: GP: Surgery contact no: Drug allergies: Asthma UK 2014 registered charity number in England and Wales 802364 and in Scotland SCO39322 HP2610114 2

My Asthma Plan Your asthma plan tells you when to take your asthma medicines. And what to do when your asthma gets worse. 1. My asthma medicines My best peak flow is My preventer inhaler is called and its colour is My asthma medicines I take puff/s of my preventer inhaler in the morning and puff/s at night. I do this every day even if I feel well. Other asthma medicines I take every day: 2. When my asthma gets worse I will know my asthma is getting worse if: I have a cough, wheeze, it is hard to breathe or my chest hurts, or I am waking up at night because of my asthma, or I am taking my reliever inhaler every day, or My peak flow is less than My reliever inhaier is called and its colour is. I take puff/s of my (colour) reliever inhaler when I wheeze or cough, my chest hurts or it s hard to breathe. Does playing, running or doing PE normally make it hard to breathe? If yes I take puff/s of my (colour) reliever inhaler beforehand. When this happens: I keep taking my preventer medicines as normal. And also take puff/s of my (colour) reliever inhaler every four hours. If I am not getting any better I should see my doctor or asthma nurse today. What asthma medicines do you take every day? What should you do when your asthma gets worse? Remember to take your inhaler with a spacer if you have one

3. What to do when I have an asthma attack I am having an asthma attack if: My asthma triggers: (Write down things that make your asthma worse so you can stay away from them.) My not helping, or (colour) reliever inhaler is I can t talk or walk easily, or I am breathing hard and fast, or I am coughing or wheezing alot, or My peak flow is below When this happens: I should take puffs of my (colour) reliever inhaler every two minutes (up to ten puffs) until I feel better. I need to see my asthma nurse every six months at least Date I got my asthma plan: I am feeling better, but I don t want this to happen again so I need to see my doctor or asthma nurse today. I still don t feel better and I have taken ten puffs. Now I need to call 999 straight away. If I am waiting longer than 15 minutes for an ambulance I should take another puffs of my (colour) reliever inhaler every two minutes (up to ten puffs). My next asthma review: Doctor s/asthma nurse contact details: 999 Where can I find out more? Asthma UK is dedicated to improving the health and well-being of the 5.4 million people in the UK with asthma including 1.1 million children. Asthma UK Adviceline Ask an asthma nurse specialist 0800 121 62 44 asthma.org.uk/adviceline Asthma UK website Read the latest independent advice and news on asthma asthma.org.uk kickasthma.org.uk Asthma UK Summit House, 70 Wilson Street, London EC2A 2DB T 020 7786 4900 F 020 7256 6075 Asthma UK Northern Ireland Ground floor, Unit 2 College House, City Link Business Park, Durham Street, Belfast BT12 4HQ ni@asthma.org.uk Asthma UK Cymru Eastgate House, 35 43 Newport Road, Cardiff CF24 0AB wales@asthma.org.uk Asthma UK Scotland 4 Queen Street, Edinburgh EH2 1JE scotland@asthma.org.uk 2012 Asthma UK Registered charity number in England 802364 and in Scotland SCO39322. First published 2010. Next review 2013 HP1580210

How to Treat your Wheeze/Asthma... Date:... Useful Websites: Asthma UK: www.asthma.org.uk Teenage Health Freak: www.teenagehealthfreak.com www.childhealthbucks.com Smoking even outdoors will make asthma worse National Smoking Helpline: 0800 022 4332 http://www.smokefree.nhs.uk

Treatment Plan once you are home Oral Soluble Prednisolone (Dose)... Length of treatment (in days)... Start date:... End date:... Salbutamol (Blue Reliever Inhaler) Dose... Start Date... Other Medication... This should be reduced using the Six Steps to reducing your inhaler usage guide below Steroids (Preventer Inhaler)... Dose... Start Date... Other Medication... A follow up review should be undertaken by your GP/nurse within the next... days. Spacers Always take your inhalers via a spacer as this is a much more effective way of getting medicines into the lungs Volumatic Smaller children (generally under 3 years) to use spacer with face mask Older children (generally over 3 years) to use spacer with mouth piece Aero Chamber Six Steps to reducing your salbutamol (Blue Reliever Inhaler) usage (If your child is sleeping and breathing comfortably you do not need to wake them to give them their inhalers overnight). One puff every five breaths using the spacer (Tidal Breathing) 1 Inhale 10 puffs every 4 hours for 24 hours 2 Then inhale 8 puffs every 4 hours for 24 hours 3 Then inhale 6 puffs every 6 hours for 24 hours 4 Then inhale 4 puffs every 6 hours for 24 hours 5 Then inhale 2 puffs every 6-8 hours for 24 hours 6 Then inhale 2 puffs as and when required If your child gets more wheezy or breathless, go back up a step and contact your GP as soon as possible When my asthma is back under control this is what I should do This is my Blue Reliever Inhaler. Reliever (Blue Inhaler) This is used to relieve the wheeze/cough and can be used before exercise if necessary - it is best used with a spacer. This helps me when I am coughing or wheezing by opening up and relaxing my lungs. If I am using this more frequently than normal, I should see my doctor or nurse to have my asthma checked. When my asthma is well controlled I should not need to use my blue inhaler regularly. Preventer Inhalers (Brown, Orange, Purple, Green or White) My Preventer Inhaler is... (colour) coloured inhalers and chambers. Top Tips This inhaler prevents my lungs becoming irritated and inflamed. I must use this every day even when I am well to keep my asthma under control. Spacer prescribed? YES NO Health Care Professional has checked technique? YES NO Organise a review with your GP or Asthma Nurse Keep your blue inhaler with you at all times Get a new inhaler when you start your last full one Ask your Health Care Professional how to use your inhaler and spacer properly and check your technique at every appointment If you run out, in an emergency a pharmacist may be able to supply salbutamol (there may be a charge for this) Avoid trigger factors for your asthma/wheeze eg. pollen/dust Remember to rinse your mouth out after using your preventer Wash your spacer monthly with warm soapy water, leaving it to drip dry Smoking even outdoors will make asthma worse

What do I do if my child is Wheezy / has Asthma? (traffic light advice) Life Threat Moderate Mild If your child: becomes unresponsive becomes blue is having severe difficulty breathing - using tummy muscles - ribs are sinking in unable to complete sentences is unable to take fluids and is getting tired is pale, drowsy, weak or quiet If your child is: having some difficulty in breathing / noisy breathing Mild wheeze and has breathlessness that is not responding to the usual reliever (blue inhaler) treatment Using their blue reliever inhaler more than 2 puffs every 4 hours Breathing more quickly than normal If your child is: Using their reliever more than usual but is not breathing quickly and is able to continue doing day to day activities and is able to talk in full sentences You need EMERGENCY help Ring 999 - you need help immediately If you have a blue inhaler use it now - 1 puff per minute via Spacer UNTIL AMBULANCE ARRIVES Nearest Hospitals (open 24 hours 7 days a week): Frimley Park, Surrey Hillingdon Hospital John Radcliffe, Oxford Milton Keynes Hospital Royal Berkshire, Reading Stoke Mandeville Hospital, Aylesbury Wexham Park Hospital, Slough You need to contact a nurse or doctor today Increase blue inhaler 10 puffs over 20 minutes and repeat every 4 hours via spacer and Please ring your GP surgery during the day or when your GP surgery is closed, please call NHS 111 by dialling 111. Needs doctor / nurse review over the next few days, unless deteriorating. Continue to use blue inhaler as required. Read this leaflet about how to help with your wheeze / Asthma symptom control. Warning signs that your asthma is not well controlled include: Waking up regularly to cough, feeling tight / wheezy during the night Early morning tightness wheeze or cough Frequently needing your blue inhaler Frequent exercise induced cough or wheeze Reassess and monitor your child regularly (symptoms may start or get worse in the evening ) - please follow traffic light advice above. REMEMBER ALWAYS HAVE YOUR BLUE INHALER AND SPACER WITH YOU IMPORTANT: ASTHMA/WHEEZE CAN BE LIFE THREATENING Produced by the Children and Young People Urgent Care Board Published August 2014 To be reviewed August 2015. This guidance is written in the following context: This document was arrived at after careful consideration of the evidence available including but not exclusively NICE Quality Standard for Asthma QS25- February 2013, BTS/SIGN Asthma Guidelines 2009, as applicable. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. The guidance does not, however, override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient in consultation with the patient and / or carer. www.chilternccg.nhs.uk www.aylesburyvaleccg.nhs.uk www.sloughccg.nhs.uk www.windsorascotmaidenheadccg.nhs.uk

If you have any concerns about managing your asthma, you can call an asthma nurse specialist on Asthma UK s Adviceline 0800 121 62 44 your asthma action plan If you use an asthma action plan you are four times less likely to have an asthma attack that requires emergency hospital treatment. Asthma UK has a range of resources to help with your asthma and a team of specialist asthma nurses if you need further advice. Asthma UK Adviceline 0800 121 62 44 info@asthma.org.uk Or visit our website www.asthma.org.uk Name Date 2013 Asthma UK registered charity number in England and Wales 802364 and in Scotland SCO39322 HP2230513 First published 2004; Last updated 2011; Last reviewed 2013; Next review 2016 Complete this with your asthma nurse or GP.

This is what I need to do to stay on top of my asthma: My asthma is getting worse if I notice any of these: I am having an asthma attack if any of these happen: My personal best peak flow is: My preventer inhaler (insert name/colour) I need to take my preventer inhaler every day even when I feel well. I take and puff(s) in the morning puff(s) at night. My reliever inhaler (insert name/colour) I take my reliever inhaler only if I need to. I take puff(s) of my reliever inhaler if any of these things happen: I m wheezing My chest feels tight I m finding it hard to breathe I m coughing Other medicines I take for my asthma every day: Contact number for GP/specialist asthma nurse: When you have good control over your asthma you should have no symptoms. If you have hay fever or a food allergy it s even more important to have good control of your asthma. 1 2 My symptoms are coming back (wheeze, tightness in my chest, feeling breathless, cough) I am waking up at night My symptoms are interfering with my usual day-to-day activities (eg at work, exercise) I am using my reliever inhaler a week or more My peak flow drops to below times This is what I can do straight away to get on top of my asthma: If I haven t been using my preventer inhaler, start using it regularly again or: Increase my preventer inhaler dose to until my symptoms have gone and my peak flow is back to normal. Take my reliever inhaler as needed (up to puffs every four hours). If I don t improve within 48 hours make an appointment to see my GP or asthma nurse. If I have been given prednisolone tablets (steroid tablets) to keep at home: Take (which is mg of prednisolone tablets x 5mg) immediately and again every morning for or until I am fully better. days Call my GP today and let them know I have started taking steroids and make an appointment to be seen within 24 hours. 1 My reliever inhaler is not helping or I need it more than every hours I find it difficult to walk or talk I find it difficult to breathe I m wheezing a lot or I have a very tight chest or I m coughing a lot My peak flow is below THIS IS AN EMERGENCY TAKE ACTION NOW Take two puffs of my reliever inhaler (one puff at a time) 2 Sit up and try to take slow, steady breaths If I don t start to feel better, take two puffs 3 of my reliever inhaler (one puff at a time) every two minutes. I can take up to ten puffs 4 5 6 If I don t feel better I should call 999 straight away. If an ambulance doesn t arrive within ten minutes, and I m still not feeling better, then I should repeat Step 3 Even if I feel better after this I should see my GP or asthma nurse for advice the same day If I have rescue prednisolone tablets, take 40mg (8 x 5mg) altogether Please note this asthma attack information is not designed for people who use the Symbicort SMART regime. If you use Symbicort SMART please speak to your GP or asthma nurse about this.