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An action plan provides simple instructions for routinely managing your asthma, plus advice on what to do if your asthma symptoms flare up.

The main aims of asthma treatment are to:

• keep symptoms under control
• prevent flare-ups or ‘attacks’
• keep lungs as healthy as possible
• stop asthma from interfering with school or work
• help you or your child enjoy a full and active life.

What is an asthma action plan?

An asthma action plan is created by you and your doctor to help manage your asthma. It includes information about what you must do to stay healthy, and what to do when your asthma is unstable and you need help.

There is no ‘standard’ asthma action plan, as everyone’s asthma is different. Your plan needs to be developed to deal with your own triggers, signs and symptoms, and medication. It might be based on symptoms, peak-flow readings or both. However, symptom-based plans are more common.

Action plans are available in many different formats, you can also upload it to the Asthma Buddy mobile website.

Download an asthma action plan template .

Contents of an asthma action plan

An asthma action plan includes:

• how to care for your day-to-day asthma (it lists your regular medications and how many times each day you should take them)
• key things that tell you when your asthma is getting worse or a flare-up is developing, and the steps you should take to manage it
• symptoms that are serious enough to need urgent medical help (with emergency information on what to do if you have an asthma flare-up).

Review your asthma action plan with your doctor every 6 months, or after a severe asthma flare-up.

Asthma action plans for children

If you are a parent or carer of a child with asthma, it is important to obtain a clear, written summary of how to manage your child’s asthma. This is called an asthma action plan and is an important tool for anyone caring for your child.

It provides up-to-date, detailed information (including your child’s emergency first aid plan) to help manage your child’s asthma. Give a copy of the plan to your child’s school, kindergarten, childcare centre and anyone else caring for your child.

When your child is old enough to understand, make sure that you explain asthma to them and encourage them to be aware of their symptoms and how to treat them.

Common asthma triggers

Asthma is a big health problem in Australia. More than 2 million people have asthma (about 1 in 9 adults and children). While the cause is not always known, allergy often plays a large part.

Asthma can be triggered by a variety of factors, including things in our everyday environment. Triggers can also vary from person to person.

Common asthma triggers include:

• viral infections – such as colds, flu and respiratory conditions
• cigarette smoke
• physical activity – having asthma should not stop you from playing sport or exercise, it is essential for our overall health and wellbeing. On advice from your doctor, symptoms can be managed with extra medication or warm-up exercises before you begin
• allergens – such as house-dust-mite droppings, pollens, mould and pets.
• food – some food and food preservatives, flavourings and colourings (in rare cases)
• irritants in the environment – dust, pollution, wood smoke and bushfire smoke
• weather – changes in air temperature or thunderstorms
• workplace – wood dust, chemicals or metal salts
• chemicals and strong smells – such as perfumes and household cleaners
• certain medications – including aspirin and some blood pressure medicines
• stress or high emotions (including laughter or crying).

Treatment for asthma

The two main types of asthma medication are relievers and preventers. Everyone who has asthma needs a reliever to use when they have asthma symptoms.

Some children and most adults with asthma also need to take preventer treatment. This helps to make the airways less sensitive to triggers and reduces the inflammation.

Reliever medication for asthma

Reliever medication is used for an asthma flare-up or emergency. It opens the airways quickly and is taken as needed for immediate relief from asthma symptoms.

Reliever medication is sometimes overused. Using too much, or too often, could lead to side effects, including tremors (shaking or trembling) and a rapid heart rate.

These side effects are not likely to cause harm. However, frequent use of reliever medication may be a sign that your asthma is not being well controlled.

If you need to use a reliever more than twice a week for asthma symptoms (apart from use before exercise), see your doctor to review your asthma and medication.

Preventer medication for asthma

Preventer medication makes the airways less sensitive and reduces inflammation and swelling. It needs to be taken as prescribed, over the long term, to be most effective in reducing the risk and severity of any flare-ups.

Most preventer medication for asthma is inhaled corticosteroid. Because the medication goes straight to your lungs where it is needed, the risk of side effects from taking inhaled steroids is very low.

Most adults with asthma can achieve good control of their asthma symptoms with a low dose of inhaled corticosteroid.

Preventer medication for children with asthma

Some children with asthma need to take a regular preventer. This can be an inhaled corticosteroid (like the adult medication).

There is also non-steroid medication available, including a tablet.

Talk to your doctor about the best type of medication for your child – this usually depends on the child’s symptoms and age, as well as how easy it will be to give properly.

Safety and extra preventer medication for asthma

People who use a regular preventer (such as an inhaled corticosteroid), but still get regular asthma symptoms, may need to step up their medication.

These stronger preventers are called ‘combination’ therapies because they include a second medicine and the inhaled corticosteroid. Asthma preventers should be prescribed at the lowest strength that works for you or your child. There is no extra benefit in taking medication that is stronger than you need.

Inhaler devices for asthma medication

Some people need extra help to take their asthma medication and make it work more effectively.

Work with your doctor to decide which device is best for you.

Inhalers are the most common devices for asthma medication. The 3 main types of inhaler devices are:

• Metered-dose inhaler (puffer) – an aerosol canister that produces a fine mist of medication. Always shake the canister before use. It is recommended to always use a spacer with your puffer.
• Breath-activated inhaler (autohaler) – a spring-loaded aerosol canister. The medication automatically mists out when you start to breathe in through the mouthpiece. These are good for children and for people who find it hard to coordinate a puffer.
• Dry-powder inhalers – contain medication as a dry powder, rather than liquid like aerosol inhalers. Deep breathing is required to release medication to the lungs. Young children and anyone who struggles with shortness of breath may find these difficult to use.

Watch National Asthma Council videos which show you how to use different types of inhalers, including this video on how to use a standard metered-dose inhaler.

Some other types of medication may be used for more severe asthma. Your doctor may prescribe these additional therapies or refer you to a respiratory specialist.

Spacers for asthma

A spacer is used to make it easier for people with asthma to inhale their medicine.

Using a spacer with an inhaler (puffer) lets more medication reach your lungs and reduces possible side effects from the medication.

A spacer is a special device that looks like a clear tube. It is attached to a metered-dose inhaler.

Fire one puff of the medicine into the spacer, breathe in slowly and deeply, then hold your breath for about 5 seconds or as long as comfortable.

Young children should breathe in and out normally for 4 breaths, before the next puff is fired into the spacer.

Nebulisers for asthma

Nebulisers were once commonly used for asthma. Research suggests a puffer with a spacer works just as well as a nebuliser – they are also easier and cheaper to use and reduce the risk of side effects.

If you still use a nebuliser for taking asthma medication – whether day-to-day or just when symptoms flare up – talk to your doctor about making the switch.

How to take asthma medication effectively

Taking medication regularly can be difficult. It can be easy to forget and many people dislike having to take medication, especially when they feel well and have no symptoms. But it is important to take your medication correctly and follow medical advice.

Tips to help you take asthma medication include:

• Ask your health professional for written instructions on the role of each medicine as part of your asthma action plan . Include details on how, when and how much to take, and what to do if symptoms get worse.
• Know the side effects of your medication so that you know what is and isn’t normal.
• Ask your doctor if your medication can be simplified. Such as using one device for all your medications.
• Ask for a device that you feel comfortable with. There are special aids for people who have trouble coordinating inhalers (puffers).
• Make sure you know how to use your devices correctly. Ask your doctor or health professional to check your technique.
• Create memory aids to remind yourself to take your asthma medication, such as before brushing your teeth in the morning and evening.

If you have any concerns, talk to your doctor, asthma educator or pharmacist.

Tips for parents and carers of children with asthma

All the above tips also apply to children, but useful tips to help your child manage their asthma include:

• Generally, your child can take their preventer medication before and after school.
• As your child gets older, involve them in decisions about their asthma medications and management.
• Linking asthma medication to your child’s own goals can help. For instance, a child who loves sports may take asthma medication more readily if they know it helps them participate.

Other medication and asthma triggers

Some medication for other health conditions can make asthma symptoms worse and trigger an asthma flare-up or attack.

It is very important that you inform your doctor and pharmacist that you have asthma when a new medicine is prescribed to you or when you are buying over-the-counter medication or complementary therapies.

If you feel a particular medicine is making your asthma worse, treat your symptoms and contact your doctor immediately.

Some medicines known to trigger asthma symptoms in some people include:

• aspirin – contained in some medication, such as pain relievers
• non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen (Nurofen) and naproxen (Naprogesic)
• beta-blocker tablets – often used to control high blood pressure
• beta-blocker eye drops – to treat the eye condition glaucoma
• ace inhibitors – often used to control high blood pressure.

Asthma first aid

An asthma flare-up (attack) can take anything from a few minutes to a few days to develop. It can be a very frightening experience. Anyone who is having an asthma attack needs immediate help.

The 4 steps of asthma first aid are:

1. Sit the person upright and give reassurance – do not leave them alone.
2. Without delay, give the person 4 separate puffs of their blue/grey reliever medication (such as Airomir, Asmol, Bricanyl or Ventolin). If using an inhaler (puffer) (like Ventolin or Asmol), this should be taken one puff at a time via a spacer. Ask the person to take 4 breaths from the spacer after each puff of medication.
3. Wait 4 minutes. If there is little or no improvement, repeat steps 2 and 3.
4. If there is still no improvement, call triple zero (000) for an ambulance immediately. Repeat steps 2 and 3 continuously while waiting for the ambulance to arrive.

Where to get help

• Asthma , 2020, Kids Health Information, Royal Children’s Hospital, Melbourne
• Asthma action plans , 2019, National Asthma Council Australia
• My asthma guide , 2021, National Asthma Council Australia
• Australian Asthma Handbook , The National Guidelines for Health Professionals 2020, National Asthma Council Australia

This page has been produced in consultation with and approved by:

This page has been produced in consultation with and approved by:

This page has been produced in consultation with and approved by:

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