Asthma essentials are a short list of tools that help you spot trouble early and know what to do: a written asthma action plan, a quick-relief inhaler you carry at all times, a spacer if you use a metered dose inhaler, a peak flow meter if your clinician advises one, and a plan for your triggers. Each item below comes from the NHLBI, the CDC, MedlinePlus or the American Lung Association. Your own doctor decides what fits you, so use this page as a checklist for your next visit.
1. A written asthma action plan
The NHLBI describes an asthma action plan as a written treatment plan. It covers the triggers to identify and avoid, how to recognize an asthma attack and what to do during one, which medicines to take and when, when to contact your provider or seek emergency care, and who to contact in an emergency. (NHLBI, Asthma treatment and action plan)
The American Lung Association describes it as an individualized worksheet with three zones. In the green zone you have no symptoms and keep taking your long-term control medicine even when you feel well. In the yellow zone you have symptoms, so you slow down, follow your plan and use your quick-relief medicine. In the red zone you have severe symptoms or a flare-up, and you follow your plan and get immediate medical care if symptoms do not improve. (American Lung Association, Create an asthma action plan) Your doctor builds the plan with you, including your medicines, so do not change your medicine on your own.
Ask for a written copy and keep it where you can find it. Our guide to how to treat moderate to severe asthma explains how an action plan fits with trigger control and knowing when to get help.
2. A quick-relief inhaler you carry at all times
The NHLBI says your healthcare provider will probably prescribe a quick-relief inhaler for you to carry at all times. (NHLBI) MedlinePlus says quick-relief medicines are what you take when you are coughing, wheezing, having trouble breathing or having an asthma attack. It advises you to tell your provider if you use quick-relief medicine twice a week or more to control your symptoms, because that may mean your asthma is not well controlled, and to bring enough medicine with you when you travel. (MedlinePlus, Asthma quick-relief drugs)
Know the emergency signs too. MedlinePlus says to go to the emergency room or call emergency medical services right away for symptoms such as severe shortness of breath at rest, extreme difficulty breathing, bluish color to the lips and face, severe chest pain, drowsiness or confusion, a rapid pulse, or a peak flow measurement of less than 50% of your personal best. (MedlinePlus, Asthma) Call 911 if you think you are having an emergency. See how to calm asthma without an inhaler for the first steps in a flare and when to call 911.
3. A spacer, if you use a metered dose inhaler
The American Lung Association describes a spacer as a plastic tube that attaches to a metered dose inhaler and creates space between your mouth and the medicine. A valved holding chamber is a type of spacer with a one-way valve. (American Lung Association, Valved holding chambers and spacers) MedlinePlus says that if you have a spacer, you should use it. (MedlinePlus, How to use an inhaler with a spacer) Its steps include:
- Shake the inhaler hard 10 to 15 times before each use, then connect it to the spacer.
- Breathe out fully, seal your lips around the spacer and keep your chin up.
- Breathe in slowly through your mouth as you press the inhaler once, and keep breathing in slowly and as deeply as you can.
- Hold your breath for about 10 seconds if you can, then breathe out slowly through pursed lips.
- If you use a quick-relief beta-agonist, wait about 1 to 2 minutes before the next puff.
Spacers attach to metered dose inhalers, so ask your clinician or pharmacist whether one works with your inhaler, and ask them to watch your technique. Details can differ between devices, so follow the instructions that come with yours.
4. A peak flow meter, if your clinician advises one
A peak flow meter measures how well you can push air out of your lungs. The American Lung Association says it may be most useful for people who are newly diagnosed and people with persistent asthma, and that you should discuss its use with your healthcare provider. (American Lung Association, Measuring your peak flow rate)
The NHLBI describes your personal best peak flow as the highest number you get over a 2-week period. Your later readings are compared with that number: 80 to 100 percent is the green zone, 50 to 79 percent is the yellow zone and less than 50 percent is the red zone. It advises measuring every morning on waking, before you take asthma medicine, and during symptoms taking your attack medicine first and then measuring. (NHLBI, Monitoring your asthma) Your clinician sets your own numbers and tells you what to do in each zone, so the plan you were given comes first.
5. A plan for your triggers and your flu vaccine
The CDC says to know your triggers and how to avoid them. It names secondhand smoke, dust mites, air pollution including wildfire smoke, cockroaches and other pests, pets with fur if you are allergic, and mold. It also lists infections such as flu, colds and RSV, allergies and pollen, certain chemicals and fragrances, weather changes, and exercise or strong emotions that cause very fast breathing. (CDC, Controlling asthma)
The CDC also says flu vaccination is especially important for people with asthma. (CDC, Flu and people with asthma) It recommends a flu vaccine every season for everyone 6 months and older, with rare exceptions. (CDC, Who needs a flu vaccine) Ask your doctor or pharmacist what is right for you.
Write down what sets off your symptoms and bring the list to your visit. Our guide to pulmonary rehab for severe asthma explains where rehab fits when asthma is not well controlled.
Questions to bring to your next asthma visit
- Do I have a written asthma action plan, and can I have a copy to keep with me?
- Which inhaler is my quick-relief inhaler, and how many puffs should I take?
- Would a spacer help with my inhaler, and can you watch my technique?
- Should I use a peak flow meter, and what is my personal best?
- What are my triggers, and which vaccines do you advise for me?
- How will I know if my asthma is not well controlled, and what should I do then?
For more ideas on getting the most from appointments, see how to advocate for yourself with asthma or COPD.
How Bloom helps with asthma essentials
Bloom Medical Group provides one-on-one virtual pulmonary rehab for moderate to severe asthma, live by video with a licensed respiratory therapist or clinical exercise physiologist. The program includes education on managing triggers and using your inhaler, and customized asthma action plans. Bloom works alongside your own doctor, who sets your treatment, and a referral from that doctor is needed to start. Read more about asthma rehab with a respiratory therapist.
Frequently asked questions
A written asthma action plan, a quick-relief inhaler you carry at all times, a spacer if you use a metered dose inhaler, a peak flow meter if your clinician advises one, and a plan for your triggers that includes flu vaccination. Your clinician decides which ones fit you.
The NHLBI says it describes the triggers to identify and avoid, how to recognize an asthma attack and what to do during one, which medicines to take and when, when to contact your provider or seek emergency care, and who to contact in an emergency.
MedlinePlus says that if you have a spacer, you should use it. Spacers attach to metered dose inhalers, so ask your clinician or pharmacist whether one works with your inhaler and whether your technique is right.
No. The American Lung Association says a peak flow meter may be most useful for people who are newly diagnosed and people with persistent asthma, and that its use should be discussed with your healthcare provider.
MedlinePlus says to tell your provider if you use quick-relief medicine twice a week or more to control your symptoms, because it may mean your asthma is not well controlled. Do not change your medicine on your own.
The CDC names secondhand smoke, dust mites, air pollution including wildfire smoke, cockroaches and other pests, pets with fur if you are allergic, and mold. Infections such as flu and colds, allergies and pollen, and weather changes can also set off symptoms.
Bloom provides one-on-one virtual pulmonary rehab for moderate to severe asthma, including education on triggers and inhaler use and customized asthma action plans. A referral from your own doctor is needed. You can call 1-866-972-8228 to check your plan.
Next step
Not sure whether rehab fits you? Take our free 2 minute lung health assessment.
Ready to find out if you qualify? Call Bloom Medical Group at 1-866-972-8228 or fill in the see if you qualify form. One-on-one virtual pulmonary rehab with licensed respiratory therapists and clinical exercise physiologists, billed to commercial insurance. Read how virtual pulmonary rehab at Bloom works.
This article is for education only and is not medical advice. Talk with your doctor about what is right for you.
Sources
- NHLBI. Asthma: Treatment and action plan
- American Lung Association. Create an Asthma Action Plan
- MedlinePlus. Asthma, quick-relief drugs
- MedlinePlus. Asthma (medical encyclopedia)
- American Lung Association. Valved Holding Chambers and Spacers
- MedlinePlus. How to use an inhaler, with spacer
- American Lung Association. Measuring Your Peak Flow Rate
- NHLBI. Monitoring Your Asthma (NIH Publication No. 20-HL-8119)
- CDC. Controlling Asthma
- CDC. Flu and People with Asthma
- CDC. Who Needs a Flu Vaccine
