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I'm attaching a checklist and action plan that's on my website, as well as the sample emergency information card that I have customized and carry in my wallet. The information is from a fake patient with the form that can be used to complete (or modified as appropriate) so that you can make it fit YOU.
I keep my medical information form on my computer and try to remember to update it every time I have any changes in medications or provider, or at least annually.
Having the medication list kept up to date as well as the providers and contact info is very handy. I can just hand it to the providers when I check in for my appointments and they can ask about or note any changes. It's a lot easier having all the information in ONE place. I make two copies of my current information on cardstock and trim to fit --one in my wallet and the other in my medication bag. I put packaging tape over it, to make it more durable and water resistant.
On the right hand side of the COPD Action Plan, I'd write all my maintenance medications down--the strength and how often I take them for the green zone. For the yellow zone, I'd confer with my physician about what s/he wants me to do when I feel specific worsening of symptoms and write them out. For me, that may include getting a sputum sample to the lab and also starting a specified antibiotic. For the red zone, we will also specify what steps need to be taken (so far, I've never reached the red zone and hope to remain out of it).
Download the SAMPLE Emergency Information 2017 June document
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It is not our intention to serve as a substitute for medical advice and any content posted should not be used for medical advice, diagnosis or treatment. While we encourage individuals to share their personal experiences with COPD, please consult a physician before making changes to your own COPD management plan.