Asthma Treatment Plan - The Pediatric Asthma Coalition of New ... 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by completing the top left section with the patient's name, parent/guardian's name and phone number, date of birth, emergency contact details, and the doctor's information.
  3. Next, collaborate with your healthcare provider to fill in the effective date and medication details for Healthy, Caution, and Emergency sections. Ensure they check the appropriate boxes for medications prescribed.
  4. Discuss and complete the patient's peak flow range and asthma triggers together. For minors, confirm their ability to self-administer inhaled medications and sign accordingly.
  5. After finalizing the form with your healthcare provider, make copies for school staff and caregivers while keeping a copy at home for easy access.

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The PACNJ Asthma Treatment Plan is designed to help everyone understand the steps necessary for the individual student to achieve the goal of controlled asthma.
Children aged 4-6 years should use a pMDI plus a valved holding chamber. Lastly, children older than 6 years can use either a pMDI, a DPI, or a breath-actuated pMDI. For all 3 groups, a nebulizer with a valved holding chamber (and mask in children younger than 4 y) is recommended as alternate therapy.
Avoiding the allergens that trigger your asthma can help control your symptoms and prevent flare-ups. Typical treatment includes inhaled corticosteroids. Your healthcare provider may also recommend adding biologic medicines or allergy shots, which can be specific to the allergen.
Asthma action plans include a list of the childs asthma medications taken, early warning signs for asthma symptoms, instructions on when to use the medicines and call your health care provider, and when to seek emergency care.
Tell the operator that someone is having an asthma emergency. Keep giving the person 4 separate puffs, taking 4 breaths for each puff, every 4 minutes until emergency assistance arrives.
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This plan has information about your childs allergy, what symptoms to watch for, and what to do in an emergency. It will also include important contact information. If your child does not have an Anaphylaxis Action Plan, ask their doctor for one. Give a copy to the school, their teachers, and other key staff.
An Asthma Action Plan is a written, individualized worksheet that shows you the steps to take to keep your asthma from getting worse. It also provides guidance on when to call your healthcare provider or when to go to the emergency room.
Most people with asthma should be able to: Sleep well almost every night. Go to school and work every day. Use a rescue medicine less than twice a week. Exercise and play sports. Decrease the number of E.R. visits and doctor visits.

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