Medicines up-to-date as of: July 2014

Paediatric Asthma Action Plan

Name: 
NHI: 

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Doctor:       (or enter your name): 
This plan issued:     
Expires and needs replacing on

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WELL - No cough or wheeze

happy smiley

  • No day or night time cough or wheeze
  • Play and behavior same as usual playing and behaviour

Comments:

Use Preventer medication:
Device:
Dose:
Frequency:
Use Controller medication:
Device:
Dose:
Frequency:
Before exercise:

 

Use Reliever:
Device:
Dose:
Frequency:
When required:
Before exercise:
MILD COUGH OR WHEEZE OR GETTING A COLD - Child not distressed

sad smiley

  • Increase in daytime cough and wheeze
  • Occasional cough at night
  • Cough or wheeze when excited or running
  • Using your blue puffer more
  • Go to see your doctor

Comments:

Continue using your Preventer:
Device:
Dose:
Frequency:

 

Continue using your Controller:
Device:
Dose:
Frequency:
Before exercise:

 

Use Reliever:
Device:
Dose:
Frequency:
When required:
Before exercise:
ASTHMA WORSE - Short of breath, Child becoming distressed

sick smiley

  • Frequent daytime cough and wheeze
  • Unable to play like other children
  • Slept very little due to asthma
  • Only able to sit quietly, no energy
  • Go to see your doctor

Comments:

Continue using your Preventer:
Device:
Dose:
Frequency:

 

Continue using your Controller:
Device:
Dose:
Frequency:

 

Use Reliever:
Device:
Dose:
Frequency:
When required:

 

Commence
Prednisolone: give dose once a day in the morning for 3 days.

 

Prednisone: Take once a day in the morning for 3 days.
EMERGENCY. Severe or sudden onset, child distressed. gasping for breath, pale, quiet, Finding it hard to speak. RELIEVER NOT WORKING
DIAL 111 for an AMBULANCE. Keep child calm and sit upright Give 6 puffs of reliever via
- child to take 6 breaths after each puff. Repeat treatment every 5 minutes until ambulance arrives.
We acknowledge the Royal Childrens Hospital Melbourne for sharing their idea for this plan.

Please note - copy to be retained in Clinical Records, sent to GP & Community Nurse or Educator if applicable

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