Respiratory - Maintenance and Reliever Therapy (MART) Asthma Action Plan

Name:

Date:

Your Respiratory Specialist Nurse is:

Name:

Telephone Number:

Personal best or predicted peak flow:
 

Green

• I have no cough, wheeze, shortness of breath or chest tightness
• My asthma symptoms do not wake me up at night and have not interfered with my usual activities or exercise
• My peak flow is between _____ and _____ (80-100%) of my personal best

Action

My MART inhaler is called _______________________________________     

I need to take my MART inhaler everyday even when I feel well

I take _____ puff(s) in the morning

I take _____ puff(s) at night

I take my MART inhaler as my reliever inhaler if I get asthma symptoms.

As a reliever, I can take maximum 6 puffs on one occasion and maximum of 12 puffs in one day (including my morning and night puffs)

My other asthma medications:
 

Orange

My asthma is getting worse if I’m experiencing any of these:

• My symptoms are getting worse (wheeze, tight chest, feeling breathless, cough)
• My symptoms are waking me up at night
• My symptoms are affecting my day-to-day life (working, being active, socialising)

Action

I should take my asthma medications including inhalers daily/as prescribed

Take one puff of MART reliever when needed up to a maximum of 12 puffs in one day and 6 puffs on one occasion.

Measure peak flow more frequently

However, if my asthma symptoms are still getting worse and I am worried

Or I am using the maximum daily dose of your MART inhaler and my symptoms are not improving

Or I am regularly using extra doses of my MART inhaler most days as advised by my healthcare professional

Or My peak flow is between _____ L/min (50-80% of my personal best)

I will likely need steroids (Prednisolone) from my GP or from my rescue pack if my peak flow is _____ (70% or below of best/ predicted

Red

I am having an asthma attack if I’m experiencing any of the following:

• My MART inhaler is not helping
• 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 dropping further or below _____ <40% of my personal best

Action

THIS IS AN EMERGENCY – ACT NOW
Follow the 5 steps below. If you are worried or not improving at any stage, CALL 999 for an ambulance.

1. Sit upright and try to stay calm.
2. Take slow steady breaths
3. Take ONE puff of my MART inhaler every 1 to 3 minutes (Max 6 puffs)
4. Call 999 if my symptoms do not improve after 10 minutes
5. Repeat step 3 if my symptoms do not improve after 10 minutes

Further Information

Get more advice and support from Asthma UK

Speak to a specialist Nurse about managing your asthma
Tel: 0300 222 5800 (Monday to Friday 9am – 5pm)

Get news, advice and download information www.asthma.org.uk