Asthma action plans are usually broken down into three levels, which help identify the severity of an asthma attack and coordinate the appropriate level of response. Each attack plan will differ slightly based on an individual’s specific condition as well as physician recommendations. Individuals should work closely with their physicians when they are creating their plans.

One of the most useful methods asthmatic individuals can use to evaluate themselves is a home peak flow meter. This device measures the peak airflow from a person’s lungs. By comparing the results of a peak flow meter against earlier results (achieved under normal conditions) an individual can determine whether they are having an attack, and determine how severe it is.

The three sections of an asthmatic individual’s action plan should include all of the following information, with data specified to each individual:

• Green zone. This level indicates good control. Individuals at this level should be able to produce 80 percent or better of their best peak flow results. There are generally no symptoms associated with this level (e.g., coughing, wheezing), and individuals should be able to carry out their usual activities. Individuals should also be able to sleep normally without symptoms wakening them. People in this zone should continue with their regular asthma treatment.
  
  This section should clearly lay out all daily asthma medications, as well as when they should be taken, and the proper dosage for each. Any special instructions for medication use should be explained here in detail. The locations of all medications and the local pharmacy’s contact information should also be noted in this section.
  
  It is a good idea to make a note of any personal triggers that might lead to an attack. While these are likely to vary by individual, some are common to many people with asthma (e.g., exercise, dust, tobacco smoke). Recording these triggers can help an individual to avoid them.
  
  
• Yellow zone. This level indicates that a person's asthma is getting worse and that they should be cautious. Individuals at this level should be able to produce between 50 and 80 percent of their best peak flow results. This zone often involves some types of asthma symptoms, particularly with activity or at night. Though symptoms often vary by individual, these may include (and should be noted in the plan):
  
  
• • Coughing
  • Wheezing
  • Chest pain or tightness
  • Shortness of breath
    
  
  Other factors that may place a patient in the yellow zone include:
  
  
  • Exposure to a known asthma trigger
  • Early signs of a cold
   
  Individuals in this zone are usually experiencing some sort of asthma exacerbation, and will probably be unable to carry out all of their usual activities. They should take any quick–relief medications recommended by their physician (e.g., short–acting bronchodilators) in addition to continuing with their regular medications. The quick–relief medications, dosages and instructions should be completely noted in this section of the action plan.
  
  The yellow zone should also note instructions for individuals whose peak flow returns to the green zone and whose symptoms diminish. After a yellow zone episode, many physicians recommend continuing with regular quick–relief medications for several days or temporarily increasing the dosage of some regular medications. A physician may also recommend adding a new type of medication. Individuals developing their plans should discuss this situation with their physician.
   
  Individuals who fail to improve despite the use of medication should contact their physician.
  
  
• Red zone. This zone is considered an emergency medical alert. Individuals in this zone will only be able to produce less than 50 percent of their best peak flow.  Anyone who remains in the red zone for more than 15 minutes should go directly to the hospital or call for an ambulance. Symptoms of this condition include (and should be noted on the plan):
  
  
• • Extreme Shortness of breath
  • No response to quick–relief medications
  • Inability to carry out usual activities
  • Yellow zone symptoms that persist longer than 24 hours or get worse
    
    
  Anyone who displays the following symptoms should go immediately to the hospital or call for an ambulance (do not wait 15 minutes):
  
  
• • Shortness of breath that results in difficulty walking or talking
    
    
  • Blue lips or fingernails (cyanosis)
    
    
  • Sucking in of the skin between the ribs when breathing
    
    

Individuals at this level usually need to take additional medication, such as an increased dose of a short–acting bronchodilator and/or an oral corticosteroid. A physician should help an individual fill in drug and dosage information for this section. 

• Patient’s name
  
  
• Name and phone number of an emergency contact (typically a nearby family member or friend)
  
  
• Emergency room phone number
  
  
• Closest hospital phone number and location
  
  
• Physician’s name and phone number (both daytime and nighttime/weekend numbers)

Individuals should discuss their asthma action plans with their physician at least once a year to make sure they contain up–to–date information. Plans may need to be changed as a patient’s baseline (personal best) peak flow number changes or their medications are altered. Parents of asthmatic children should routinely update the plans on file with schools and other caregivers.