Orlando F. Mills, MD, MPH

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Asthma Decision Guide and Action Plan

Asthma symptoms can appear at work, at home, or play. Some common asthma triggers to avoid include:

  1. Animal dander from fur or feathers
  2. Dust mites
  3. Cockroaches
  4. Indoor and outdoor mold
  5. Pollen
  6. Tobacco smoke
  7. Smoke, strong odors, sprays
  8. Vacuum cleaning
  9. Sulfites in food and beverages


There are two purposes of this:

  1. To provide general education to you about asthma
  2. To give you an Action Plan for your asthma based upon how you are doing.


Your asthma can cause symptoms including cough, shortness of breath, chest tightness, chest congestion or wheezing.  If you do experience these symptoms, it may be difficult for you to do your usual activities.

Here is how you can rate your asthma:
  1. First, ask yourself if you are having asthma symptoms.  Is your answer no, some, or yes?
  2. Next, ask if your symptoms are interfering with your usual activities.  Is your answer no, some, or yes?
  3. Finally, check your Peak flow and see how you did compared to your best peak flow.  Are you 80% or more, 50-79%, or below 50%?
You may also notice a decrease in your Peak Flow if your asthma is getting worse.
Peak flow meters measure how fast you can breath out. This tells us how well your asthma is doing.  Check Peak Flow at least weekly and record the Peak Flow number on paper.  You can obtain a Peak Flow meter at a pharmacy or the internet for approximately $15-30. 

Answer to 1           Answer to 2           Peak Flow           Asthma Rating
No                           No                           >80%                       Green
Somewhat               Somewhat               50-79%                    Yellow
Yes                          Yes                         <50%                        Red 
Based upon the asthma rating this is what you need to do.  See below to learn about rescue and maintenance medicines for asthma.


Green Zone

  1. Continue your usual medicines.
  2. Check your Peak flow weekly


Yellow Zone

  1. Take your rescue medicine 4 times a day
  2. Take your maintenance medicine twice a day.
  3. Call the office to be seen in the next 3 days


Red Zone

  1. Continue rescue medicine 4 times a day.
  2. Take maintenance medicine twice a day.
  3. Start prednisone 40mg a day
  4. Call the office that day or the next day to be seen

Call 911 or go to the Emergency Room if you believe you can not go on like this.

Rescue Medicine - designed to bring immediate relief of asthma, but the relief may only last a few hours.  These are needed when you have asthma symptoms. 

1.  proair

2.  proventil

3.  ventolin

4.  duoneb

5.  xopenex

Maintenance medicine - designed to keep you as symptom free as possible for the long term and should be taken every day unless you are told by a physician you no longer need it.
  1. advair
  2. flovent
  3. qvar
  4. symbicort
  5. Others

Using a Spray Inhaler

Without a spacer

  1. Take off the cap.
  2. Shake the inhaler.
  3. Stand up.
  4. Breathe out.
  5. Put inhaler in or just in front of your mouth.
  6. As you start to breathe in, push down on top of inhaler & keep breathing in slowly.
  7. Hold your breath for 3 seconds.
  8. Breathe out.


With a spacer

(Holding chamber to make it easier to use a spray inhaler.)

  1. Put the open end of the spacer in your mouth.
  2. Spray the asthma medicine into the spacer one time.
  3. Take a deep breath and hold it for 3 seconds.
  4. Breathe out into the spacer.
  5. Breathe in again, but do not spray the medicine again

For more information, visit the trusted websites below: