Asthma Action Plans for Adults and Children

An Asthma Action Plan is a personalised written guide that helps you recognise worsening asthma and take the right steps to keep it under control.
It’s a tool for both day-to-day management and emergency response.

Why have one?

Reduces the risk of hospital visits.
Helps spot early signs of flare-ups.
Gives clear instructions to family, carers, or school staff.

What it includes

Daily management — which preventer and reliever medicines to take and when.
Symptom zones —
- Green: Well controlled. Continue usual medicines.
- Yellow: Increasing symptoms (e.g., coughing, wheezing). Step up reliever use as directed.
- Red: Severe symptoms (difficulty speaking, blueness, rapid breathing) — seek urgent help.
Emergency contacts — your doctor, local emergency services.

The 4x4x4 Rule (Ventolin/reliever in an emergency)

If someone is having a severe asthma attack and doesn’t have immediate access to their doctor or hospital:

Sit the person upright. Stay calm and reassure them.
Give 4 puffs of a reliever inhaler (e.g., Ventolin/salbutamol), one puff at a time, with 4 breaths after each puff (via spacer if available).
Wait 4 minutes.
If there is no improvement, repeat the cycle (4 puffs, 4 breaths, 4 minutes).
If symptoms are still severe, call emergency services immediately. Continue the 4x4x4 cycle until help arrives.

For children

Provide a copy of the plan to school staff, coaches, and babysitters.
Review the plan at least once a year or after any hospital visit.
Teach children (age-appropriate) how to recognise yellow/red zone symptoms and when to ask for help.

FAQ

Q: Can I overdose on Ventolin if I follow the 4x4x4 rule?
A: Reliever inhalers like Ventolin (salbutamol) are generally safe when used in emergencies. The danger of not treating an asthma attack is far greater than the risk of taking extra puffs. Always follow your written Asthma Action Plan or your doctor’s advice.

Q: Should I still call an ambulance if symptoms improve after using Ventolin?
A: Yes — asthma attacks can flare up again quickly. Even if symptoms ease, you should still seek urgent medical review to make sure the attack is fully under control.

Q: When should I contact my doctor?
A: Any time you enter the yellow zone (increasing cough, wheeze, or breathlessness), if you need your reliever more often than usual, or after any red zone emergency. Regular follow-up with your doctor helps keep asthma controlled and reduces the chance of severe attacks.

⚠️ Asthma can be life-threatening.
Never ignore worsening symptoms. Always follow your Asthma Action Plan, use the 4x4x4 rule in emergencies, and call emergency services if severe symptoms don’t improve quickly. Keep your doctor involved in all follow-up care.

Tip: Keep your Asthma Action Plan in multiple places — on the fridge, in your bag, and saved on your phone — so it’s always accessible in emergencies.