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A peak flow meter (PFM) is a device used to measure how well your child's asthma is under control. The device measures air flowing out of the lungs, called peak expiratory flow rate (PEFR), as a child with asthma forcefully blows into the device. A peak flow meter, when used properly, can reveal narrowing of the airways well in advance of an asthma attack. Used mainly by children with moderate to severe and persistent asthma, peak flow meters can help determine:
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- when to seek emergency medical care.
- the effectiveness of your child's asthma management and treatment plan.
- when to stop or add medication, as directed by your child's physician.
- what triggers the asthma attack (such as exercise-induced asthma).
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The PFM removes a lot of guesswork out of managing your child's asthma. It can provide you, your child's physician, or even the school teachers with information about how open the airways are in your child's lungs.
The PFM can detect small changes in the large airways before your child starts to wheeze. Using a PFM every day will let you know when your child's peak flows are starting to drop. This allows you to make early changes in your child's medication or routine to help prevent your child's asthma symptoms from getting worse. The PFM can also identify the value at which you will need to call your child's physician or go to the emergency room.
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- Use the PFM once daily and whenever your child is experiencing early warning signs. Always use the PFM before taking reliever medication.
- Hold the PFM by the handle.
- Before each use, make sure the pointer is reset to zero.
- Have your child stand up straight. Remove chewing gum or any food from your child's mouth.
- Have your child take a deep breath and put the mouthpiece in his/her mouth. Seal his/her lips and teeth tightly around the mouthpiece.
- Let your child blow out as hard and as fast as he/she can. Remember a "fast blast" is better than a "slow blow."
- Note the number where the pointer has stopped on the scale.
- Reset the pointer to zero.
- Repeat this routine three times. You will know your child has done the technique correctly when the numbers from all three tries are close together.
- Record the highest of the three readings on a graph or in a notebook. Do not average these numbers together. This is called your "peak flow."
- Use the peak flow meter once a day. Measure peak flows about the same time each day. A good time might be when your child first wakes up or at bedtime.
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Peak flow zones are based on the traffic light concept: red means danger, yellow means caution, and green means safe. These zones are different for each person. Your child's physician will help determine your child's peak flow zones. Please use the Peak Flow Record below. The three peak flow zones include:
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Green Zone: 80% to 100% Peak flow number is higher than _________ L/min. This means that your child's asthma is under good control.
Green means go. Follow these steps:
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- Give your child medicines as usual.
- Continue doing activities as usual.
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Yellow Zone: 60% to 80% Peak flow number is between _______L/min. and _______L/min.
Yellow means caution. Follow these steps:
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- Begin rescue medicine (albuterol, also known as Proventil? or Ventolin?) _______times a day
- Give your child preventive medicines as usual.
- Check and record your child's peak flow 20 minutes after taking his or her rescue medicine.
- Call your child's doctor or nurse if peak flow does not go back up to the green zone, or to see if you need to change your child's medicine.
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You may want to increase the amount of liquids that your child drinks, give your child extra rest, or have him or her wear a scarf over his or her mouth when it is cold outside. Use your child's peak flow meter more often to see how your child is doing. Red Zone: Under 60% Peak flow number is below ________L/min.
Red means stop. Follow these steps:
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- Use albuterol by nebulizer or inhaler.
- Call your child's doctor or nurse.
- If you cannot reach the doctor, go directly to the hospital emergency room.
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The goal of the peak flow zones is to help recognize when the asthma may start to become uncontrolled.
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Each child's peak flow zones are based on his/her personal best peak flow number. To establish your child's personal best peak flow, have your child take his/her peak flow measurement each day at the same time for two to three weeks, when the asthma is under control.
After recording your child's peak flow measurements for two to three weeks consistently, your child's physician may also measure the optimum lung function with a spirometer (a device that can check lung function by measuring both the amount of air expelled and how quickly the air was expelled). The spirometer measurement may then be compared with the peak flow meter record to help set up an asthma management and treatment plan.
Your child's personal best peak flow measurement may change over time. Consult your child's physician as to when to check for a new personal best peak flow measurement.
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Peak flow meters should be used regularly to check how well the asthma is being controlled. In addition, the peak flow meter may be a valuable tool during an asthma attack, because it can help determine how well the short-term, quick-relief asthma medication is working. The National Heart, Lung, and Blood Institute (NHLBI) recommends measuring lung function during the following times:
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- every morning, before taking asthma medications
- during asthma symptoms or an asthma attack
- after taking medication for an asthma attack
- other times as recommended by your child's physician
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The peak flow meter is a tool to help collect information. The key to successful asthma management is communicating this information (the peak flow meter recordings, the severity of your child's symptoms, and the effectiveness of your child's medications) to your child's physician.
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Consult your child's physician about obtaining a peak flow meter and for step-by-step instructions on how to use the device.
If you are using more than one peak flow meter, be sure they are the same brand.
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An oximeter is a small machine that measures oxygen saturation (the amount of oxygen) in your child's blood.
To get this measurement, a small sensor (similar to an adhesive bandage) is taped onto your child's finger or toe. When the oximeter is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
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A spirometer is a device used by your child's physician that assesses lung function. Spirometry, the evaluation of lung function with a spirometer, is one of the simplest, most common pulmonary function tests and may be necessary for any of the following reasons:
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- to determine how well the lungs receive, hold, and utilize air
- to monitor a lung disease
- to monitor the effectiveness of treatment
- to determine the severity of a lung disease
- to determine whether the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow)
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After taking a deep breath, your child forcefully breathes out into the spirometer as completely and forcefully as possible. The spirometer measures both the amount of air expelled and how quickly the air was expelled from the lungs. The measurements are recorded by the spirometer.
The normal, healthy values measured by the spirometer for the amount of air exhaled vary from child to child. Your results are compared to the average expected in someone of the same age, height, sex, and race, according to the National Heart, Lung, and Blood Institute (NHLBI). However, if the values fall below 85 percent of the average, it may indicate a lung disease or other airflow obstruction. If a child has abnormal spirometer measurements, he/she may be referred for other lung tests to establish a diagnosis.
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Asthma: Peak Flow Meters / Oximeters / Spirometers
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