Author: Marson Francesca

RESPIRATORY ACTION PLAN Take this action plan with you when you visit a doctor or nurse

Name:

My respiratory condition is:

WHEN I FEEL WELL

My symptoms are under control

Breathlessness at rest

1 2 3 4 5 6 7 8 9 10

None Mild Moderate Severe

I cough up sputum daily:

Yes

No

Amount of sputum cleared daily e.g. 1 teaspoon

Colour of sputum

White

Grey

Pale yellow

Light green

Dark green

Oxygen saturation %

on air

on oxygen

l/min

Swelling present

None

Feet

Ankles

Leg

Usual level of activity

Usual medication

Usual:

Chest clearance

Breathing control

Exercise

WHEN I FEEL WORSE

My symptoms are starting to change

I have increased

Breathlessness

Cough/wheeze

Sputum

Discoloured sputum

WHAT TO DO:

I’m more breathless

Increase reliever to

puffs, up to

times a day

My breathlessness has not improved within 24 hours: start a course of steroids

My sputum has changed colour for 24 hours or more: start a course of antibiotics

Chest clearance: increase frequency of usual chest clearance

My rescue medication is:

Antibiotics

Steroids

WHEN I FEEL VERY ILL

My symptoms are much worse

My symptoms are getting much worse even though I have followed the actions in the ‘When I Feel Worse’ section
WHAT TO DO: Speak to my GP or dial 111 if: I have increased or new swelling of my feet, ankles or legs and/or a fever
Dial 999 for an ambulance if: I am extremely short of breath, unable to complete a sentence, feel confused, drowsy or have unexpected, persistent or new chest pain

Use this colour chart to guide whether you need antibiotics for an infective exacerbation

Antibiotics not likely

Antibiotics not likely

Antibiotics may be taken

Antibiotics likely

Antibiotics likely