Using a peak flow meter to monitor your asthma

A peak flow meter is a device that measures how much air you can push out of your lungs with maximum effort. Using a peak flow meter can help you and us assess how open your airways are. That way, you'll be aware of times when your asthma may be worsening. The peak flow meter can be used generally down to the ages of five or six years. It can help determine if your child's airways are getting narrower; often times even before your child has any asthma symptoms. By taking asthma medicine early (before symptoms), you may be able to help prevent an asthma attack from occurring altogether.

For your children, a peak flow meter may help you:

• Decide if your child is starting to have an asthma attack.
• Learn what makes your child's asthma worse.
• Decide when to seek emergency care.
• Decide if your child's asthma attack has been brought under control.

Here are three examples of peak flow meters (PFM's). Our preference is for the Personal Best ® which is available as a Pediatric range (0-400 L/min) or Adult range (0-800 L/min) unit.

Instructions:
Your peak flow is a measure of how much air you can push out of your lungs with maximum effort. We will tell you when and how often to measure your peak flow. Below are simple instructions for using a peak flow meter. Be sure to write down your results. Take the results with you when you visit us. Regular monitoring tells you how well your treatment plan is working.

• Move the marker to 0 or to the lowest point/position on the scale. Stand. If you can't stand, be sure to sit up straight. Make sure you're in the same position each time you test.
• Take in as deep a breath as you can.
• Put the mouthpiece of the peak flow meter in your mouth between your teeth. Close your lips tightly around it. Be sure your tongue does not block the opening. Blow into the mouthpiece once, as hard and as fast as you can.
• Take the peak flow meter out of your mouth. Look at the marker. It will have moved along the numbered scale. Write this number down. Move the marker back to 0 or to the lowest point/position on the scale.
• Repeat the test two more times.

How your child should use a peak flow meter

• Move the marker to 0 or to the lowest point/position on the scale. Stand. If you can't stand, be sure to sit up straight. Make sure you're in the same position each time you test.
• Take in as deep a breath as you can.
• Put the mouthpiece of the peak flow meter in your mouth between you teeth. Close your lips tightly around it. Be sure your tongue does not block the opening. Blow into the mouthpiece once, as hard and as fast as you can.
• Take the peak flow meter out of your mouth. Look at the marker. It will have moved along the numbered scale. Write this number down. Move the marker back to 0 or to the lowest point/position on the scale.
• Repeat the test two more times.

Write the highest of the three numbers on your chart or in your diary. This is your peak flow meter number. When you are totally well, the highest reading you achieve will be your personal best.

What the results mean:
We can help and will help you create an Asthma Action Plan that tells you what to do if your asthma gets out of control. Action plans are often based on the asthma zone you're in at a given point in time. There are three zones currently used to help define the state of your asthma at any one time: the green (best), the yellow (intermediate), and red (worst). We will explain how your symptoms or peak flow numbers can help you know which asthma zone you are in. In general using the personal best peak flow reading as determined above, the following explanations apply:

Green zone: under control. The green zone is 80-100% of your personal best reading.

When you're in your green zone, you feel good. Your asthma doesn't get in the way of work, activities, or sleep. You're doing a good job helping to control your asthma.

Action: Keep following your daily treatment plan.

Yellow zone: caution. The yellow zone is 50-80% of your personal best. When you're in your yellow zone, your airways are becoming swollen, inflamed, and narrower. You may have warning signs such as coughing, wheezing, chest tightness, or shortness of breath. Your asthma may keep you from doing some normal activities. If you don't take action right away, you may move into the red zone and have an asthma attack.

Action: Take the medications suggested in your action plan. Get away from your triggers.

Red zone: medical alert. The red zone is 0-50% of your personal best. When you're in your red zone, you're having an asthma attack. You're most likely coughing, wheezing, and having a lot of trouble breathing. Stop and take action.

Action: Take your fast-acting inhaler and any other medications your action plan suggests. Then talk to your healthcare provider right away or go to the hospital. Call 9-1-1 (emergency) instead if you are struggling to breathe, can't walk or talk because of shortness of breath, or your lips or fingernails are turning blue.

Note: If you are not staying in your green zone, discuss your daily treatment plan with us at your earliest convenience.

November 2001