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New York City Department of Health
Community Asthma Program

Name

 Date
Primary Care Provider

 Medical Record #

Phone Numbers
Clinic: Day || Night/Weekend
Taxi or Friend
Pharmacy


The colors of a traffic light will help you use your asthma medicines.

Green means Go Zone!
Use preventive medicine.

Yellow means Caution Zone!
Add quick-relief medicine.

Red means Stop Zone!
Get help from a doctor.

Personal Best Peak Flow.

GO
ACTION: Use these daily preventive anti-inflammatory medicines:

You have all of these:
  • Breathing is   good
  • No cough or   wheeze
  • Sleep through   the night
  • Can work and   play
    • Peak Flow from
    __________

     to
    __________
    Medicine
    How Much
    How Often









    CAUTION
    ACTION: Continue with your medicine, as above, and ADD:

    You have any of these:
  • First signs of a   cold
  • Exposure to   known trigger
  • Cough
  • Mild wheeze
  • Tight chest
  • Coughing at   night
    • Peak Flow from
    __________

     to
    __________
    Medicine
    How Much
    How Often









    DANGER
    ACTION: Take these medicines until you talk to your doctor

    Get help from a doctor now! Do not be afraid of causing a fuss.
    Your doctor will want to see you right away. It's important!
    Your asthma is getting worse fast:
  • Medicine is not   helping
  • Breathing is hard   and fast
  • Nose opens wide
  • Ribs show
  • Can't talk well
    • Peak Flow
     below

     __________
    Medicine
    How Much
    How Often









    If you cannot contact your doctor, go directly to the emergency room.
    Do NOT wait. Call an ambulance (911) if necessary.

    Make an appointment with your primary care provider within two days of an ER visit or hospitalization.

    Additional information: Directions to the Provider can be found here.
    Adapted from the NHLBI.

    The Asthma Action Line telephone number is 1-877-ASTHMA-0 or 1-877-278-4620.

    April 1999