This Asthma Action Workbook is an educational booklet where you can learn about asthma. It is not a treatment plan and should not be used in place of a doctor’s care.
How We Breathe
Match the words below to the body part and fill in the letters!
• Diaphragm (belly muscle)
• Bronchiole (small airways)
• Nose
• Alveoli (air sacs)
• Mouth
• Trachea (in throat)
• Bronchi (two large airways)
Asthma Attack!
Your lungs change on the inside.
Match the changes to the Asthma picture by drawing a line from the number to the picture.
A. Heart is trying to pump more blood and oxygen to the body
B. Lungs are clearing mucus
C. Lungs are trying to breathe in more oxygen
D. Swallowed mucus
E. Body wants more oxygen
F. Allergies
G. Air is trapped in lungs
H. Airways are tightening/swelling
Circle your Body Clue numbers, draw a line to connect them to why they happen, then connect the rest!
Answers can be found on the back cover.
Asthma Triggers
ALLERGENS
Animals
Certain Foods
Dust Mites
Feathers
Mold/mildew
Pollens
Medications
IRRITANTS
What starts your asthma or makes it worse? Check them below.
PHYSICAL
How to Deal With Triggers
Cigarette smoke
Pollution, dirty air
Dust
Fumes, strong smells
Car exhaust
Cleaners/paints
Exercise
Cold air
Emotions
Colds/flu
Sleep
Limit where pets can go in your house. Wash and groom your pets.
Ask others to not smoke around you or use strong fumes or perfumes near you.
Keep your windows closed and stay inside when pollen levels are high.
Use your inhaler before exercise and wear a scarf when it’s cold outside.
Practice Belly Breathing to stay calm. (See Page 5)
Wash your hands and cover your cough and sneeze to reduce the spread of germs. 1 2 3 4 5 6
How to Use a Metered Dose Inhaler (MDI) with a Spacer
Asthma Medicine - Inhaler & Spacer
How does my asthma medicine help me?
Circle the word that best fits the sentence.
1. Rescue Medicine - Albuterol: RELAX TIGHTEN UP
Helps to _____ my airway muscles in 3-5 minutes. This medicine can be taken 15 minutes before exercise. It is important for me to warm-up and cool down before and after exercise.
2. Control Medicine: REDUCING INCREASING
Helps prevent asthma attacks by ________the swelling and mucus in my airways. It is important to take this medicine every day at the same time of day and to rinse my mouth after each use. I should not swallow the water.
True or False?
Circle the correct answer.
3. An inhaler makes a spray of medicine which you breathe into your lungs.
TRUE FALSE
4. A spacer is added to your inhaler to get more medicine into your lungs.
TRUE FALSE
Take the cap off and shake inhaler.
To watch a video on spacers visit breathepa.org and click on YouTube 1 2 3 4 5 6 7 8
5 6 7 8
Answers can be found on the back cover.
Hold the inhaler upright. If the inhaler is new, not used often, or has been dropped, you should spray a dose (prime) into the air before using.
Plug the inhaler into the spacer.
Keep your chin straight and breathe out into the spacer.
With the spacer in your mouth, press down on the inhaler.
Breathe in slowly to the count of 5. The spacer should not whistle. Hold your breath to the count of 10 if you can, then exhalebreathe out into the spacer.
If your doctor says 2 puffs, wait 1 minute, shake inhaler and repeat steps 3-7 for puff 2. 1 2 3 4 Let’s Practice!
Understanding Your Peak Flow Meter (PFM)
A Peak Flow Meter (PFM) is a tool that measures how well air moves out of your lungs. During an asthma attack, your airways get tight. A Peak Flow Meter can tell if your airways are getting tight before you have any body clues. A Peak Flow Meter can also be used to detect exerciseinduced asthma.
How to use a Peak Flow Meter
Move the center red button down to zero.
Stand up.
Take a deep breath in.
Put the meter into your mouth with lips tight. Blow out all the air from your lungs as hard and fast as you can.
Write down your number in the chart to the right. If you cough or make a mistake, redo steps 1 - 5.
Day 1 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 2 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 3 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 4 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 5 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 1 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 2 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 3 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 4 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 5 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
7
Repeat steps 1 - 6 two more times. Your Personal Best Number (PBN) is the highest number after taking readings in this way for two weeks. Do reading once in the morning and once in the early afternoon each day. 1 2 3 4 5 6
Day 6 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 7 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 8 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 9 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 10 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 11 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 12 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 13 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 14 - Morning Reading
#1_____ #2_____ #3_____ PBN_____
Day 6 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 7 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 8 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 9 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 10 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 11 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 12 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 13 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Day 14 - Afternoon Reading
#1_____ #2_____ #3_____ PBN_____
Personal Best Number (PBN)
After taking readings for two weeks with your Peak Flow Meter, find the highest number. This is your Personal Best Number. Write it on the line in the box.
These readings should be taken when your asthma is doing well and under control.
Next, write your PBN next to the blue stars below to determine your Peak Flow Meter Zones. It is important to share and talk about this information with your doctor.
Example: Tommy’s PBN is 400. Tommy is in the Green Zone if his readings are above 320 L/min, in the Yellow Zone if his readings are between 200 and 320 L/min, and in the Red Zone if his reading is 200 L/Min or less.
WHAT’S YOUR
Green Zone?
PBN___ x .8 = ___ Green Zone Start
This is the starting point for your GREEN Zone.
If you get peak flow numbers at this point or above you are in your Green Zone. Have Fun!
WHAT’S YOUR
Yellow Zone?
Your yellow zone consists of all the numbers between the green zone and the red zone.
If you get between these two points, you are in your YELLOW Zone. Be careful and take action to get your asthma under control.
Your Personal Best Number (PBN) is:
WHAT’S YOUR
Red Zone?
PBN___ x .5 = ___
Red Zone Start
This is the starting point for your RED Zone.
If you get peak flow numbers at this point or below, you are in your Red Zone This is a medical emergency; take action immediately!
GREEN ZONE = Good to Go YELLOW ZONE = Caution RED ZONE = Medical Alert
How to Clean Your Spacer & Peak Flow Meter
1 2 3 4 5 6
7 8
Clean Spacer and Peak Flow Meter weekly.
The Spacer will pull apart in three pieces.
The Peak Flow Meter will pull apart in two pieces.
Soak both in warm soapy water for ten minutes.
Move the parts around in the soapy water.
Rinse well in warm water.
Air dry overnight. Do NOT dry with a towel.
Put both back together the next day. Both can be stored in a plastic bag.
What Do Asthma Classifications Mean to Me?
When you have asthma you may see a special doctor called a Pulmonologist or Allergist. This doctor will compare your asthma symptoms to a special chart. This chart will help the doctor decide what kind of asthma you have and what medicine you need.
Your doctor may ask you to do a special breathing test. This test is called spirometry, it measures how much and how fast you can breathe in and out. This test may be repeated as you grow up with asthma to see how you are doing.
Your doctor's goal is to control your asthma, which means you have no issues with playing at recess, sleeping in your bed or missing school.
There are four Asthma Classifications. Next time you visit your doctor, find out which asthma you have and circle it below:
INTERMITTENT
Albuterol (rescue) medication is taken as needed for symptoms/body clues.
For more information, breathepa.org,visit and click on YourUnderstanding SystemRespiratory and Peak Flow Meter.
MODERATE PERSISTENT
Daily long term control medication is necessary and Albuterol (rescue) medication as needed for symptoms/ body clues.
Belly Breathing
MILD PERSISTENT
One daily long-term control medication is necessary and Albuterol (rescue) medication as needed for symptoms/ body clues.
SEVERE PERSISTENT
Multiple long-term control medications and Albuterol (rescue) medication as needed for symptoms/body clues. Take oral corticosteroids, if needed.
Belly Breathing will help you stay calm and ease the tightness in your chest from air that is trapped:
• Slowly breathe in through your nose, filling your lungs while relaxing your stomach muscles.
• Next, blow out the air through pursed lips, while pulling in stomach muscles tightly.
• Relax and repeat.
• You can practice this while blowing bubbles.
What You’ve Learned About Your Asthma
Let’s Review!
DRAW a line from the asthma airway change to the letter.
Check here if you don’t know airway changes. Name:__________________________________ Answers
A. Muscles squeeze (this makes you wheeze)
B. Walls swell (this makes your chest feel tight)
C. Too much mucus (this makes you cough)
CHECK ALL boxes that are asthma triggers, then CIRCLE those that are YOURS.
CHECK ALL boxes that are Early Warning Signs/Clues of Asthma, then CIRCLE those that are YOURS.
CIRCLE the pictures showing ways to reduce, avoid or eliminate an asthma trigger.
Inhaler Exercise
Cigarette Smoke Pollen
Dogs, Cats
Broken Arm Fast Heartbeat
Belly Ache
Cough or Wheeze
Tired
CHECK the correct answers for each of the following questions.
1. What is your rescue medication called?
Flovent Albuterol
Advair
2. A second medication used daily to manage asthma is called?
Tylenol Controller
3. How often do you use a spacer with your inhaler?
Never Sometimes Most of the time Always
4. If you have exercise asthma, should you use your Albuterol before exercise or activity?
Yes No
Rate your confidence level in taking care of your asthma on your own. CIRCLE your choice of emoji for each question that shows how you feel.
1. Are you ok asking your doctor about your asthma?
5. Which picture shows the best way to use your inhaler?
Without a Spacer With a Spacer
2. Are you ok explaining how you feel before an asthma attack? (Early Warning Signs)
3. Are you ok using your inhaler/spacer on your own?
4. Are you ok telling someone you need help with your asthma?
6. Why is it important to use a spacer with your inhaler? More Medicine Reaches the Lungs
Side Effects
Asthma Action Plan
Encourage the child with asthma to take part in the completion of this form. Share completed form with School and Healthcare Provider.
Name: _________________________________________ Circle one: Male Female Age: _____ DOB: _____/_____/______
Form Completed By: Phone #: ( ) ________-_________ Date:
Parent-Caregiver: I give permission to the school nurse or other school personnel as designated to use this Asthma Action Plan and consent for the healthcare provider/health center, the school nurse, and Breathe PA to communicate the asthma management and medication administration for one year. I give permission for the child to carry and selfadminister the Rescue/Quick-reliever asthma inhaler.
Healthcare Provider: I authorize the written orders contained in this Asthma Action Plan. This child has demonstrated responsibility to carry and self-administer the Rescue/Quick-reliever asthma inhaler; and understands when to tell an adult if the symptoms are not improving.
School Nurse: This child has demonstrated responsibility to carry and self-administer the Rescue/Quick-reliever asthma inhaler; and understands when to tell an adult if the symptoms are not improving.
do YOU look, sound, or feel right before an asthma
It is rare to have an asthma attack without body clues that alert you.
attack?
Here is a list of Early Warning Signs. Put a check in the boxes of your signs and share this with those supporting you to help prevent a severe asthma attack!
List more here: _________________________________________________________________________
Trigger Checklist
How to Avoid, Reduce, or Eliminate
You may not be able to control everything around you that triggers your asthma. However, you can learn how to Avoid (stay away), Reduce (make less), or Eliminate (take away) most of the things that start up your asthma. Help those around you support your efforts by checking the boxes of your triggers.
List more here: _________________________________________________________________________
• Allergens – Pollution, animal dander, dust mites, and molds
• Irritants – Weather changes, strong odors (personal care products and air fresheners), and cigarette smoke
• Upper Respiratory Infections – Colds and flu can make asthma worse. Ask the doctor about a flu shot.
• Physical Exercise – Especially in extreme temperatures. This is known as EXERCISE-INDUCED ASTHMA (EIA).
Each child’s triggers can vary.
Reducing Triggers at Home
• Animal Dander – Remove dander by brushing, and washing pets. Keep pets from sleeping in beds.
• Dust Mites – Encase mattress and pillow in dust mite cover, limit number of stuffed animals in bed. Vacuum carpet weekly with bagless vacuum.
• Strong Odors – Limit use of air fresheners in home. Keep cigarette smoke outside.
• Mold – Clean noticeable mold, and keep exhaust fans running after showers to reduce moisture.
• Pollen – Close windows while cutting grass. Change clothes after being outside.
Use Albuterol 10-15 minutes before exercise. Albuterol is also called a “rescue” medication and can help up to four hours. Use warm-up and cooldown exercises to get ready for exercise.
Talk to your doctor about these and other recommendations. Small, simple changes can help reduce trigger exposures.
Early Warning Signs
Can possibly include:
• Wheezing
• Cough
• Chest tightness or pain in chest/back
• Shortness of breath/difficulty breathing
• Little energy for active play
Each child’s early warning signs can vary.
atAsthma Home
A Guide for Parents & Guardians
Asthma awareness in the home begins with knowing what makes the asthma worse, and how to reduce the trigger, understanding the signs of an attack and how to properly handle it. This quick reference guide can be removed and hung for easy access.
For more information programsregardingand educational videos please visit breathepa.org
ALERT!
Signs of a more serious episode:
• Immediately follow emergency procedures on Asthma Action Plan!
• Blue or gray-tinged lips/fingernails
• Child cannot talk in sentences
• Neck /chest muscles drawn in with breath
• Child is breathing fast (15 breaths or more/30 seconds)
• Lightheadedness
Early detection and treatment can lead to a less severe attack, preventing the need for emergency procedure.
Answer Key
Picture:
• From left to right, letters should be B, C, and A.
Triggers:
• Cigarette smoke
• Pollen
• Exercise
• Cats/dogs
Early Warning Signs:
• Belly ache
• Cough or wheeze
• Fast heartbeat
• Feeling tired
Reduce Triggers:
• Use “green” cleaning supplies
• Open or close window
• Use inhaler
• Wash pets
PAGE 7:
Top of Page:
1. Albuterol
2. Controller
3. Your answer should be “Always”
4. Yes
5. With a spacer
6. More medicine reaches the lungs, less side effects
About Breathe Pennsylvania
Breathe Pennsylvania’s mission is to empower western Pennsylvanians to breathe better and live healthier through education and awareness of lung health in our community.
Through our locally focused programs and services, we strive to equip the residents of Western Pennsylvania with the knowledge and tools they need to become advocates for their own lung health. Founded more than 100 years ago to help combat tuberculosis, we have a long and rich history of promoting respiratory health.
Today, our services have evolved to include lung health education and programs to the community. We help local residents who are living with respiratory ailments, such as asthma or COPD, provide information and resources to health care professionals, as well as offer preventative lung health and smoking cessation resources.
Breathe Pennsylvania assists anyone wishing to learn more about their lungs and how to keep them healthy.
