Transcription of CNMC Asthma Action Plan UPO
{{id}} {{{paragraph}}}
Example: biology
CNMC Asthma Action Plan UPO
Asthma Action PlanName SchoolDOBH ealth Care ProviderProvider s PhoneParent/Responsible PersonParent s PhoneAdditional Emergency ContactContact PhoneAsthma Severity(see reverse side) Asthma Triggers Identified (Things that make your Asthma worse): Intermittent orPersistent: Mild Moderate SevereAsthma Control Well-controlled Needs better control Colds Smoke (tobacco, incense) Pollen Dust Animals_____ Strong odors Mold/moisture Pests (rodents, cockroaches) Stress/emotions Gastroesophageal reflux Exercise Season: Fall, Winter, Spring, Summer Other:_____ /___ /___Green Zone: Go! Take these CONTROL (PREVENTION) Medicines EVERY DayYou have ALLof these: Breathing is easy No cough or wheeze Can work and play Can sleep all night No control medicines required. Always rinse mouth after using your daily inhaled medicine. _____ , _____ puff(s) inhaler with spacer_____ times a dayInhaled corticosteroid or inhaled corticosteroid/long-acting agonist _____ , _____ nebulizer treatment(s)_____ times a dayInhaled corticosteroid _____ , take_____ by mouth once daily at bedtimeLeukotriene antagonistFor Asthma with exercise, ADD: _____ , _____ puff(s) inhaler with spacer 15 minutes before exerciseFast-acting inhaled agonistFor nasal/environmental allergy, ADD: _____Yellow Zone: Caution!
Asthma Action Plan Name School DOB Health Care Provider Provider’s Phone Parent/Responsible Person Parent’s Phone
Loading..
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document:
Related search queries
Safety/Emergency Action Plan Director On, Safety/Emergency Action Plan Director, Department Site Specific Procedure for the, Philadelphia Department, Department Site Specific Procedure for the Emergency Action Plan, Emergency Action Plan Template, Emergency, Department, Emergency Action, Plan, EMERGENCY ACTION PLAN Scope and Application, EMERGENCY ACTION PLAN, Scope and Application, Risks in the Emergency Department, Action