PA Asthma Action Plan 2007-2025 free printable template

Asthma Action Plan (To be completed by Doctor/Nurse) Name School Doctor/Nurse's Name Emergency Contact After Parent Asthma Severity: Asthma Triggers: Birth Date Parent/Guardian Doctor/Nurse's Office

How to fill out printable asthma action plan pdf form

How to fill out PA Asthma Action Plan

1. Start by entering the patient's name, date of birth, and contact information at the top of the form.
2. Fill out the patient's asthma triggers in the designated section to identify factors that may cause asthma symptoms.
3. Record the patient's current medications, including dosage and frequency, on the medication summary section.
4. Indicate the patient's asthma symptoms and their severity on the scale provided, ensuring to differentiate between mild, moderate, and severe symptoms.
5. Complete the action plan for different zones: Green (doing well), Yellow (caution), and Red (medical alert) to indicate the patient's status based on their symptoms.
6. Specify the steps to take in each zone, including when to use rescue medication and when to seek medical help.
7. Review the plan with the patient and their family to ensure understanding and compliance.
8. Keep a copy of the action plan for the patient's records and provide a copy to the patient and their caregivers.

Who needs PA Asthma Action Plan?

1. Patients diagnosed with asthma, including children and adults, who require a structured plan to manage their condition.
2. Caregivers and family members of asthma patients who need guidance on how to respond to asthma symptoms.
3. Healthcare providers who need to develop a comprehensive management strategy for their patients with asthma.

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Instructions and Help about capp action plan pdf

Do you have an asthma action plan an asthma action plan helps you to recognize when you or your child's asthma is getting worse and remind you what to do when this happens it also provides you with important information on when and how to get medical help quickly asthma Australia recommends that everyone with asthma has an asthma plan from their doctor this should include your personal medication plan and what to do if your asthma gets worse a copy of the plan should be given to carers for example child care workers school and preschool staff and relevant family members if you do not have an action plan see your doctor as soon as you can to have this completed if your symptoms are in the green zone it indicates that your asthma is reasonably well controlled, and you should carry on taking your medications as the doctor has prescribed if you are in this green zone you will notice that you are using your blue puffer less than three times a week and that doesn't include using it before you exercise if you notice that you are using your blue puffer more than three times a week, and you have started waking up wheezing or coughing during the night more than a couple of times a week your asthma may be getting worse if you look at the action plan your GP has given you will now be in the yellow section your doctor may give you extra medications to take to get this under control follow your plan and see your doctor if your symptoms don't improve if you are using your blue puffer every three to four hours and waking up every night or morning feeling very wheezy and your chest is tied then your asthma may be severe look at your plan and follow the directions your doctor has written for you in the orange section this may include starting some oral steroid tablets, or it may ask you to see your doctor straightaway if you are experiencing severe shortness of breath you are having difficulty speaking in sentences because of your breathing, and you don't seem to be getting much relief from your blue puffer you should follow the asthma first aid on the action plan and call triple o immediately please watch the section on asthma first aid it is extremely important to know what asthma first aid is and highly recommended that you watch the asthma first aid section and then read your action plan

People Also Ask about asthma plan word online

How do you write an asthma action plan?

Your asthma action plan will include your medicines and instructions for what to do when you are feeling well, what to do when you have asthma symptoms and what to do when your asthma symptoms are getting worse. It should include the names of your medicines, how much to take and when to take it.

What is the 4x4x4 rule for asthma?

Tell the operator that someone is having an asthma emergency. Keep giving the person 4 separate puffs, taking 4 breaths for each puff, every 4 minutes until emergency assistance arrives.

What is a Personalised asthma action plan for adults with asthma?

To know when and how they should change their medicines, adults with asthma can be given a written plan that is designed just for them. This is called a personalised asthma action plan (PAAP). The PAAP will tell people when they need to see their doctor and may include education on how they should manage their asthma.

Who can write an asthma plan?

An Asthma Action Plan is like an instruction manual for your asthma written by your doctor. Everyone with asthma should have an Asthma Action Plan, no matter how old you are or how mild your asthma might feel. It's your guide on how to manage your asthma and what to do if you do have a flare-up or asthma attack.

What is a Personalised asthma action plan?

A written personalised action plan (such as Asthma UK's asthma action plan) should be tailored to the person with asthma, enabling them to recognise when symptoms are worse. The plan should set out actions to be taken if asthma control deteriorates and who to contact. [

What is the best practice asthma action plan?

Your personal asthma action plan should include: a list of your usual asthma medicines, including doses. instructions on what to do when your asthma gets worse (including when to take extra doses or extra medicines, and when to contact a doctor or go to the emergency department) what to do in an asthma emergency.

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What is PA Asthma Action Plan?

The PA Asthma Action Plan is a written plan developed for individuals with asthma that outlines how to manage their condition, including daily management, handling worsening symptoms, and when to seek emergency care.

Who is required to file PA Asthma Action Plan?

Individuals diagnosed with asthma, especially those who experience moderate to severe symptoms or have frequent asthma attacks, are encouraged to file a PA Asthma Action Plan with their healthcare provider.

How to fill out PA Asthma Action Plan?

To fill out the PA Asthma Action Plan, individuals should work with their healthcare provider to document their asthma symptoms, peak flow measurements, triggers, prescribed medications, and action steps for daily management and emergencies.

What is the purpose of PA Asthma Action Plan?

The purpose of the PA Asthma Action Plan is to provide a clear and structured approach for individuals and caregivers to manage asthma effectively, minimize symptoms, prevent attacks, and improve overall health outcomes.

What information must be reported on PA Asthma Action Plan?

The PA Asthma Action Plan must include information such as personal information (name, date of birth), asthma triggers, medications (including dosage), peak flow zones, action steps based on symptoms, and emergency contact information.