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Office Location
705 W. La Veta Ave.
Suite 101
Orange, CA 92868
(714) 639-7847


New Approaches to Treating Asthma: An Early Warning Device

A peak flow meter is a device that measures how well air moves out of your lungs. During an asthma episode the airways of the lungs begin to narrow slowly. The peak flow meter can be used to determine if your airways are narrowing — hours and even days — before you have any symptoms of asthma. By taking your medicine early, before symptoms develop, you may be able to stop the episode quickly and avoid a severe asthma attack. Peak flow meters are used to monitor asthma the way that blood pressure cuffs are used to monitor high blood pressure.

The peak flow meter also can be used to help you and your doctor:

  • Determine if your asthma management plan is working well.
  • Determine when to increase medication or stop taking a medication.
  • Determine when to seek emergency care.
  • Identify the triggers that cause your asthma symptoms to worsen.
  • Maintain better control over your asthma.
Who Should Have a Peak Flow Meter?

Generally, doctors recommend that everyone who has asthma have a peak flow meter and know how to use it. Most people with persistent asthma should use the peak flow meter daily to maintain better control over their asthma and to understand triggers that bring on symptoms. Ask your doctor to show you how to use a peak flow meter.

Peak flow meters are especially helpful for people aged 5 and older who have moderate or severe, persistent asthma. In some cases, children as young as age 3 can use a peak flow meter.

How to Use a Peak Flow Meter

  1. Place the indicator at the base of the numbered scale.
  2. Stand up.
  3. Take a deep breath.
  4. Place the meter in your mouth and close your lips around the mouthpiece. Do not put your tongue inside the hole.
  5. Blow out as hard and as fast as you can.
  6. Write down the number you see on the meter in your Weekly Asthma Symptoms and Peak Flow Diary.
  7. Repeat steps 1 through 6 two more times.
  8. Make a note of the highest of the three numbers you achieved.
Find Your Personal Best Peak Flow Number

Your personal best peak flow number is the highest peak flow number you can achieve over a two-week period when your asthma is under good control. Good control is when you feel good and do not have any asthma symptoms.

Each person's asthma is different and your best peak flow may be higher than the average number for someone of your height, weight and sex. That's why it is so important to find your own personal best peak flow number. Your asthma management plan must be based on your personal best peak flow number — not someone else's.

To find your personal best peak flow number, take peak flow readings and record them in your Weekly Asthma Symptoms and Peak Flow Diary:

  • Use the meter every day for two weeks, mornings and evenings (when you wake up and about 10 to 12 hours later).
  • If you take an inhaled beta agonist, use the meter before taking the medication and 15 minutes after taking it.
  • Follow your doctor's instructions for using the peak flow meter.
  • Your doctor may want to give you a short course of an oral corticosteroid medication to establish your personal best peak flow reading.
The Peak Flow Zone System

Once you know your personal best peak flow number, your doctor will give you the ranges of peak flow numbers that will help you monitor your asthma and help you know what actions to take when your peak flow number changes. The peak flow ranges are set up like traffic lights, providing green, yellow and red signals that tell you how to respond:

  • Green Zone — If your peak flow number is from 80 percent to 100 percent of your personal best number, it is in the Green Zone, which signals all clear. You don't have any asthma symptoms, and you can continue to take your medications as usual.
  • Yellow Zone — If your peak flow number is 60 percent to 80 percent of your personal best, it is in the Yellow Zone, which signals caution. You may be having an episode of asthma that requires an increase in your medications or your overall asthma may not be under control and the doctor may need to change your asthma management plan. Call your doctor the same day you find yourself in the Yellow Zone and carefully follow your doctor's instructions.
  • Red Zone — If your peak flow number is below 60 percent of your personal best number, it is in the Red Zone, which signals a medical alert. You must take an inhaled beta agonist immediately and, if your peak flow number does not return to the Yellow or Green Zone and stay there, call your doctor immediately.
Warning: If your peak flow number does not return to the Yellow or Green Zone within one hour after taking the inhaled beta agonist, or if your symptoms are getting worse, go immediately to the closest emergency room or call 911 or your local emergency number.

Do Not Hesitate: It is much better for you to be seen promptly by your doctor or emergency personnel than to put yourself in a dangerous situation. While the goal of good asthma management is to prevent attacks and keep you out of the Red Zone, your doctor wants and expects you to take these potentially lifesaving steps when
you are in the Red Zone.

  • Record your personal best peak flow number and peak flow zones in your Weekly Asthma Symptom and Peak Flow Diary.
  • Use the diary to keep track of your peak flow rate.
  • Write down your peak flow number in the diary every day, or as instructed by your physician.
  • Talk to your doctor about what to do when your peak flow numbers change.
Don't Forget: A decrease in peak flow of 20 percent to 30 percent of your
personal best may indicate the start of an asthma episode.

When this happens, follow your asthma action plan for treating an asthma episode.

The usefulness of your peak flow numbers is dependent on your efforts-if you don't consistently and accurately record your readings, they may not be reliable. This is especially important for children.

Make sure you show your doctor the peak flow numbers you have written down.
A daily log of peak flow numbers can help your doctor understand how your asthma has been affecting your life.

Excerpted from Understanding Asthma Health Management Bulletin: Information for asthma patients and their friends

Medical Writer: Claudia Morain, Davis, Calif.

a: Your Appointment With Your Doctor

Last Updated: February 2005 by Steven R. White, M.D., Associate Professor of Medicine, University of Chicago, Pulmonary and Critical Care Medicine
© Original Copyright 1997 American Medical Association. Updated February 2005.

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