Your Child and Asthma - Controlling Asthma

Living with Asthma

How to Control Asthma

Green, Yellow, and Red Zone Management Plans
(If your child is an Infant or a Toddler see below)

Your child's asthma does not stay the same all the time. Some times it will be better and sometimes it will be worse. Working with your doctor, you can have a plan for when your child is well (green zone), is having a mild flare-up (yellow zone), or is starting to have a severe flare-up (red zone). By checking your child's peak flow daily, you can decide if she/he is in the green, yellow, or red zone.
Ask your doctor for a written green, yellow, and red zone self-management plan for your child.

Green zone (asthma is well-controlled)

Measured peak flow is over 80% of your child's personal best peak flow rate. In the green zone your child has no asthma symptoms. There is no coughing or wheezing.
Your child should be in the green zone all the time. Take the daily preventive medicine suggested by your doctor.

Be sure to write down your child's green zone range and your child's green zone plan.

Yellow zone (caution: a flare-up is starting)

Measured peak flow is between 50% and 80% of the personal best peak flow rate. Your child may have mild asthma symptoms such as occasional coughing or wheezing. Some people may notice a runny nose, itchy eyes, or a scratchy throat. Sometimes there are no symptoms, but the peak flow rate is decreased. A mild flare-up has started.

Start the yellow zone plan that you and your doctor have agreed on. This may include starting symptom relieving (bronchodilator) medicine as well as giving more preventive (in haled anti-inflammatory) medicine.
If your child is stuck in the yellow zone over 24 hours, call your doctor or advice nurse.

If your child is usually in the yellow zone twice a week or more, your child's asthma is not controlled. Contact your doctor or advice nurse.

Be sure to write down your child's yellow zone range and your child's yellow zone plan.

Red zone (danger - a flare-up is in progress):
Measured peak flow is below 50% of your child's personal best peak flow rate. There may be persistent coughing, wheezing, chest tightness, or fast breathing. A severe flare-up has begun.

Start the red zone plan suggested by your doctor.
Call your doctor or advice nurse. You will need to see your provider.

A red zone plan usually includes starting flare-up reversing medication (an oral corticosteroid such as prednisone) and giving a higher dose of symptom relieving (bronchodilator) medicine. Usually 2 to 5 days of oral corticosteroids are needed to clear up the inflammation of the bronchial tubes.

Be sure to write down your child's red zone range and your child's red zone plan

Infants and Toddlers
Green, Yellow and Red Zone Management Plans

You cannot measure a peak flow for an infant or toddler. By counting the breathing rate and watching for symptoms, you can find the early clues to an asthma flare-up.

The breathing rate is the number of breaths in one minute. Count the number of times the chest rises and falls in one minute, or place a moistened finger under your child's nose so you can feel the air with each breath. Then count the number of breaths in 1 minute.

Count the breathing rate when your child is resting or asleep. A child will normally breathe faster when active or excited.

Ask your doctor for a written green, yellow, and red zone self-management plan for your infant or toddler.

Green zone (asthma is well-controlled):
There is no coughing and no wheezing. Your child's breathing rate at rest is normal. Normal breathing rates at rest:
20 - 40 breaths per minute for an infant less than 1 year
18- 30 breaths per minute for a child 1 to 4 years
16 - 25 breaths per minute for a child 5 to 8 years
In the green zone, take the daily preventive medicine suggested by your doctor.

Yellow zone (caution - a flare-up is starting):
There may be an occasional cough or wheeze. Your child's breathing rate at rest may be slightly faster than normal.

Yellow zone plans may include starting symptom relieving (bronchodilator) medicine and increasing preventive (inhaled anti-inflammatory) medicine.

If your child remains in the yellow zone over 24 hours, or if your child is usually in the yellow zone twice a week or more, call your doctor or advice nurse. A clinic visit may be needed.

Red zone (danger - a flare-up is in progress):
Your child may have a persistent cough, persistent wheeze, or may wake up sever al times a night due to coughing and wheezing. Breathing out may take longer than breathing in. There may be sucking in of the skin between the ribs or below the chest. The breathing rate may be faster than normal.

Breathing rates that suggest a moderate to severe asthma flare-up:
Over 50 breaths per minute for an infant less than 1 year
Over 40 breaths per minute for a toddler
Over 30 breaths per minute for a school age child

Red zone plans usually include increasing symptom relieving (bronchodilator) medication and starting flare-up reversing (oral corticosteroid) medication.
If your child is in the red zone, call your doctor or advice nurse. You will need to see your provider.

Danger Signs
If your child has any of these danger signs, call your doctor or advice nurse NOW. Your child needs medical attention IMMEDIATELY!

Wheezing when breathing in as well as when breathing out
Sucking in of the skin below the chest, between the ribs, and at the base of the neck
Nostrils widening with each breath
Difficulty walking or talking
Very rapid breathing
Lips or fingernails turn blue (if this happens, bring your child to the emergency room immediately)

Introduction
Understanding Asthma
Treatment of Asthma
Living with Asthma

Site design by Green Island Graphics

		How to Control Asthma

		Green, Yellow, and Red Zone Management Plans (If your child is an Infant or a Toddler see below) Your child's asthma does not stay the same all the time. Some times it will be better and sometimes it will be worse. Working with your doctor, you can have a plan for when your child is well (green zone), is having a mild flare-up (yellow zone), or is starting to have a severe flare-up (red zone). By checking your child's peak flow daily, you can decide if she/he is in the green, yellow, or red zone. Ask your doctor for a written green, yellow, and red zone self-management plan for your child. Green zone (asthma is well-controlled) Measured peak flow is over 80% of your child's personal best peak flow rate. In the green zone your child has no asthma symptoms. There is no coughing or wheezing. Your child should be in the green zone all the time. Take the daily preventive medicine suggested by your doctor. Be sure to write down your child's green zone range and your child's green zone plan. Yellow zone (caution: a flare-up is starting) Measured peak flow is between 50% and 80% of the personal best peak flow rate. Your child may have mild asthma symptoms such as occasional coughing or wheezing. Some people may notice a runny nose, itchy eyes, or a scratchy throat. Sometimes there are no symptoms, but the peak flow rate is decreased. A mild flare-up has started. Start the yellow zone plan that you and your doctor have agreed on. This may include starting symptom relieving (bronchodilator) medicine as well as giving more preventive (in haled anti-inflammatory) medicine. If your child is stuck in the yellow zone over 24 hours, call your doctor or advice nurse. If your child is usually in the yellow zone twice a week or more, your child's asthma is not controlled. Contact your doctor or advice nurse. Be sure to write down your child's yellow zone range and your child's yellow zone plan. Red zone (danger - a flare-up is in progress): Measured peak flow is below 50% of your child's personal best peak flow rate. There may be persistent coughing, wheezing, chest tightness, or fast breathing. A severe flare-up has begun. Start the red zone plan suggested by your doctor. Call your doctor or advice nurse. You will need to see your provider. A red zone plan usually includes starting flare-up reversing medication (an oral corticosteroid such as prednisone) and giving a higher dose of symptom relieving (bronchodilator) medicine. Usually 2 to 5 days of oral corticosteroids are needed to clear up the inflammation of the bronchial tubes. Be sure to write down your child's red zone range and your child's red zone plan Infants and Toddlers Green, Yellow and Red Zone Management Plans You cannot measure a peak flow for an infant or toddler. By counting the breathing rate and watching for symptoms, you can find the early clues to an asthma flare-up. The breathing rate is the number of breaths in one minute. Count the number of times the chest rises and falls in one minute, or place a moistened finger under your child's nose so you can feel the air with each breath. Then count the number of breaths in 1 minute. Count the breathing rate when your child is resting or asleep. A child will normally breathe faster when active or excited. Ask your doctor for a written green, yellow, and red zone self-management plan for your infant or toddler. Green zone (asthma is well-controlled): There is no coughing and no wheezing. Your child's breathing rate at rest is normal. Normal breathing rates at rest: 20 - 40 breaths per minute for an infant less than 1 year 18- 30 breaths per minute for a child 1 to 4 years 16 - 25 breaths per minute for a child 5 to 8 years In the green zone, take the daily preventive medicine suggested by your doctor. Yellow zone (caution - a flare-up is starting): There may be an occasional cough or wheeze. Your child's breathing rate at rest may be slightly faster than normal. Yellow zone plans may include starting symptom relieving (bronchodilator) medicine and increasing preventive (inhaled anti-inflammatory) medicine. If your child remains in the yellow zone over 24 hours, or if your child is usually in the yellow zone twice a week or more, call your doctor or advice nurse. A clinic visit may be needed. Red zone (danger - a flare-up is in progress): Your child may have a persistent cough, persistent wheeze, or may wake up sever al times a night due to coughing and wheezing. Breathing out may take longer than breathing in. There may be sucking in of the skin between the ribs or below the chest. The breathing rate may be faster than normal. Breathing rates that suggest a moderate to severe asthma flare-up: Over 50 breaths per minute for an infant less than 1 year Over 40 breaths per minute for a toddler Over 30 breaths per minute for a school age child Red zone plans usually include increasing symptom relieving (bronchodilator) medication and starting flare-up reversing (oral corticosteroid) medication. If your child is in the red zone, call your doctor or advice nurse. You will need to see your provider. Danger Signs If your child has any of these danger signs, call your doctor or advice nurse NOW. Your child needs medical attention IMMEDIATELY! Wheezing when breathing in as well as when breathing out Sucking in of the skin below the chest, between the ribs, and at the base of the neck Nostrils widening with each breath Difficulty walking or talking Very rapid breathing Lips or fingernails turn blue (if this happens, bring your child to the emergency room immediately)

		Introduction Understanding Asthma Treatment of Asthma Living with Asthma Site design by Green Island Graphics