My Asthma Wallet Card

Full text

Originally published by the National Heart, Lung, and Blood Institute (NIH Publication No. 07-5245). U.S. government work, public domain. Reproduced as archived reference, not current guidance.

My Peak Flow

My best peak flow

Green Zone (80–100 percent of best peak flow)

Yellow Zone (50–79 percent of best peak flow)

Red Zone (Less than 50 percent of best peak flow)

Talk to Your Doctor About:

Wallet Card

n Your asthma treatment goals and My Asthma

how to achieve them n Your medications—what they are for, how much to take, and when and how to take them n How to use your inhaler and a peak flow meter, if you have one n Your asthma triggers and how to avoid them n Warning signs of an asthma attack and what you should do if your symptoms get worse

Ask for a written asthma action plan for responding to worsening symptoms— Carry This Card To Help and make sure you understand it. Control Your Asthma www.nhlbi.nih.gov

NIH Publication No. 07-5245 January 2007

My Asthma Action Plan My Medicines

Long-Term Control Medicines

Name Dose When To Take

Doctor’s Name

Address

Telephone Number

Quick-Relief Medicines

Name Dose When To Take Emergency Contact Name Short-acting beta2-agonist:

Hospital/Emergency Department Number

Warning Signs of an Asthma Attack

Check below any things that you know may warn you of an attack coming on:

n awakening at night n difficulty breathing n wheezing n coughing, especially at night n chest tightness n feeling very tired n itchy or sore throat n itchy nose n itchy, watery or glassy eyes n need more beta2-agonist than usual n other