Child Asthma Action Plan

Green · Yellow · Red Zone Guide for Parents, Caregivers & School Nurses. Based on GINA and IAP guidelines.

📋 How to use: Review the zones below to determine your child's current status.
⚠️ For clinical decision support only. Always apply professional judgment.

🟢 GREEN ZONE — Doing Well

Signs: No cough, wheeze, or shortness of breath. Child can play, run, sleep normally.

✅ Action:
• Continue daily controller medication as prescribed (e.g., inhaled corticosteroid).
• Avoid known triggers (dust, smoke, pets, cold air).
• Review with doctor at next scheduled appointment.

🟡 YELLOW ZONE — Caution

Signs: Coughing, mild wheeze, chest tightness. Waking at night with breathing difficulty. Using reliever more than twice this week.

⚠️ Action:
• Give Salbutamol inhaler (Ventolin): 2–4 puffs via spacer every 4 hours as needed.
• If response is good, continue every 4 hours for 24–48 hours.
• Continue controller medication.
• Call your doctor if symptoms are not improving within 24 hours.
• If a second set of puffs is needed within 3–4 hours, call doctor immediately.

🔴 RED ZONE — Emergency

Signs: Severe breathing difficulty, cannot speak in full sentences. Lips or fingernails turning bluish/grey. Reliever inhaler not providing relief.

🚨 Immediate Action:
• Give reliever inhaler (salbutamol) 6–10 puffs via spacer immediately.
• Call 112 or go to the nearest Emergency Department immediately.
• Do NOT leave the child alone. Keep the child sitting upright.
• Repeat 6–10 puffs every 20 minutes while waiting for help.
• Take the written action plan and medication list to hospital.

📋 Quick Symptom Check — Which Zone is Your Child In?

🟡 Coughing, mild wheeze, or chest tightness → Yellow Zone
🟡 Waking at night with breathing difficulty → Yellow Zone
🟡 Using reliever inhaler more than twice this week → Yellow Zone
🔴 Severe breathing difficulty, cannot speak in full sentences → Red Zone — Emergency
🔴 Lips or fingernails turning bluish/grey → Red Zone — Emergency
🔴 Reliever inhaler not providing relief → Red Zone — Emergency

📋 Common Asthma Medications for Children

Medication	Type	When to Use	Typical Dose
Salbutamol (Ventolin)	Reliever / SABA	Yellow & Red Zone	2–4 puffs; 6–10 in severe attacks
Budesonide (Pulmicort)	Controller / ICS	Green Zone — daily	100–200 mcg/day
Fluticasone (Flixotide)	Controller / ICS	Green Zone — daily	50–100 mcg/day
Montelukast (Singulair)	Controller / LTRA	Add-on or allergy-triggered	4 mg (2–5y), 5 mg (6–14y) nightly

ICS = Inhaled Corticosteroid · SABA = Short-Acting Beta-2 Agonist · LTRA = Leukotriene Receptor Antagonist

Asthma is the most common chronic respiratory disease in children. Most children with well-controlled asthma can participate fully in sports and school activities.

📚 References: GINA Guidelines, IAP 2024 Guidelines. Always follow local protocols.