Child & Clinic Info
Triggers
Record your child’s known asthma triggers.
Peak Flow
Zone from current value
—
Enter personal best + current to auto-calc.
Green: ≥ — (≥80% personal best)
Yellow: — to — (50–79%)
Red: < — (<50%)
Green Zone — Good
Asthma is under control.
- No coughing or wheezing, even while playing.
- Sleeps through the night.
- Breathing well.
- Peak flow is above — (≥80% of personal best).
Daily controller medicines
Before exercise (rescue)
Call your child’s health care provider if rescue medicine is needed more than 2–3 times per week.
Yellow Zone — Caution
Symptoms may be getting worse.
May include:
- Waking from sleep
- Coughing (night or early morning)
- Mild wheezing
- Chest tightness
- Peak flow — to — (50–79%).
Add to daily medicines
Call your child’s health care provider if:
Also call if rescue medicine is needed more than 2–3 times per week.
Red Zone — Warning
Needs medical help right away.
Your child may be in the red zone if:
- Breathing hard and fast
- Nose opens wide; ribs/neck muscles pull in
- Lips/fingers/toes look bluish
- Trouble speaking in full sentences
- Peak flow is less than — (<50%).
- Symptoms don’t improve within 15–20 minutes after rescue medicine (bronchodilator)
This is an emergency. Do not wait to see if symptoms go away. Get medical help right away (call 911 in the U.S.).
School Permission Slip
This document is not intended to replace advice given by your health care provider.