Asthma Action Plan (Nursing)

00:00 So every patient needs an asthma action plan. Now, whenever I teach this concept in nursing school, I always ask who has asthma in the class. If the students feel comfortable sharing and then I'll say "How many of you have an asthma action plan?" So when I ask how many people have asthma, lots of hands go up. When I asked how many people have an asthma action plan, lots of hands go down with really confused looks. See that's inexcusable in this day and age.

00:29 Everyone who has asthma should have a clearly defined asthma action plan. Need to talk to your healthcare provider. They're not open to that? You need another healthcare provider.

00:40 Because this is the standard and what should be done. Every patient needs to know which medications to take and when. They need a list of their possible asthma triggers that are known. We may discover others, but then we need to have a written list of what their triggers are so they're very aware of that and we've defined it. We need them to recognize what the early symptoms are of a flare-up and what to do when the early symptoms occur. So they don't just try to power through it. When they see the early symptoms, boom, that's when we intervene. We want the patient and the family members to have a plan for an acute asthma attack. That means if you're likely to have an asthma attack or even if you think you're not going to, you need to have your rescue inhaler with you. When I work with teenagers, I don't know how many times I'd been on a trip with a teenager and they didn't have their inhaler with them. Don't be that kid because it's really really scary. Lastly, we need them to understand very clearly when this cannot be handled with the medications you have on hand, you need to go to the hospital for emergency care. See, an asthma attack can become life threatening. So that's why you need all those things. Know which medications to take and when, know your triggers, recognize that we have early early symptoms of an oncoming asthma attack you intervene, you have a plan for knowing what to do including always having your rescue inhalers with you and when you need to go to the hospital. That's what an asthma action plan involves.

02:15 So the patient and the healthcare team collaborate and know what the triggers are then they create an asthma action plan. They develop it because they want to, first of all, minimize exposure to your triggers. If you know that pet dander is a problem and maybe specifically cats are problem for you, not a good idea for you to go and adopt 4 new kitties. Right? And if you're going to someone else's house, you need to medicate up before you go if they have your trigger. Now we want to reduce the severity and how often an asthma attack happens and what to do in response to that asthma attack. Every asthma action plan is different. Why? Because each asthma action plan should be individualized. So my action plan should look different than your action plan or Bob's action plan or Sue's action plan. They should be different. Now sometimes we kind of color code them. They're red, yellow, green.

03:11 Green means "Sweet, I'm at my baseline, I just take my regular regular meds." Yellow says "Uh oh by the PEFR, what my normal baseline is, now it's getting a little less. Right? I'm having a harder time expiratory flow rate. I'm having a harder time with that, it's a lower number." So the healthcare provider has already told me when your peak expiratory flow rate falls within this range, it's a little bit lower than your normal baseline which would be the green value, then what the issue is I want you to change your medications in this way. I want you to take more of this, more of that and here is specifically how much more I want you to take.

03:50 Now the red zone is trouble. Kind of think of it like you're on your way to the hospital, to the emergency room, this is what we want you to do. So that's why a peak expiratory flow rate monitor will really help you get a very pacific like a spa-cific, one is a better way to say it.

04:10 A clear, concise objective clinical measurement of how much trouble or respiratory distress you're heading into. So the patient and the healthcare team they do it together. They know the asthma triggers, they make this plan so the patient knows what to do based on their PEFR number, they know what medications they should adjust and then remember each plan is different because it's individualized to each patient.