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Make peak flow a habit

Asthma - make peak flow a habit; Reactive airway disease - peak flow; Bronchial asthma - peak flow

Checking your peak flow is one of the best ways to monitor your asthma and to keep it from getting worse.

Asthma attacks do not usually come on without warning. Most times, they build slowly. Checking your peak flow can tell you if an attack is coming, sometimes before you have any symptoms.

What is Peak Flow?

Peak flow (Liters per second) can tell you how well you blow air out of your lungs. If your airways are narrowed and blocked due to asthma, your peak flow values drop.

You can check your peak flow at home with a small, plastic meter. Some meters have tabs on the side that you can adjust to match your action plan zones (green, yellow, red). If your meter does not have these, you can mark them with colored tape or a marker.

Write Down Your Peak Flow Numbers

Write down your peak flow scores (numbers) on a chart or diary. Many brands of peak flow meters come with charts. Make a copy of your chart to bring with you when you see your health care provider.

Next to your peak flow number also write:

  • Date and time of your measurement and any signs or symptoms you felt.
  • Steps you took if you had symptoms or your peak flow dropped.
  • Changes in your asthma medicines.
  • Any asthma triggers you were exposed to.

Use Your Peak Flow Meter Every Day

Once you know your personal best, take your peak flow:

  • Every morning when you wake up, before you take medicine. Make this part of your daily morning routine.
  • When you have asthma symptoms or an attack.
  • Again after you take medicine for the attack. This can tell you how bad your asthma attack is and if your medicine is working.
  • Any other time your provider tells you to.

Check to see which zone your peak flow number is in. Do what your provider told you to do when you are in that zone. This information should be in your action plan.

Do your peak flow 3 times and record the best value every time you check it.

If you use more than one peak flow meter (such as one at home and another one at school or work), be sure that all of them are the same brand.

Open References

References

Boulet LP, Godbout K. Diagnosis of asthma in adults. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 51.

Chassay CM. Pulmonary function testing. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 81.

Mcdowell KM, Mokhallati N. Wheezing in older children: asthma. In: Bush A, Deterding R, Li AM, et al, eds. Kendig' and Wilmott’s Disorders of the Respiratory Tract in Children. 10th ed. Philadelphia, PA: Elsevier; 2024:chap 36.

Miller A, Nagler J. Devices for assessing oxygenation and ventilation. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 2.

National Heart, Lung and Blood Institute website. Asthma Management Guidelines: Focused Updates 2020. www.nhlbi.nih.gov/health-topics/asthma-management-guidelines-2020-updates. Updated February 4, 2021. Accessed February 9, 2024.

National Heart, Lung and Blood Institute website. How to use a metered-dose inhaler fact sheet. www.nhlbi.nih.gov/resources/how-use-metered-dose-inhaler-fact-sheet. Updated October 2021. Accessed February 9, 2024.

Vishwanathan RK, Busse WW. Management of asthma in adolescents and adults. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 52.

  • How to use a peak flow meter

    How to use a peak flow meter

    Animation

    •  

    How to use a peak flow meter - Animation

    You may have heard of a peak flow meter if you have asthma and wonder is it really worth it. How do you use it? What good is it really? Well it turns out that it's often hard to tell how strong your breathing is at any given moment. There are so many other things going on in your life - if you're tired, if you're feeling happy, if you're feeling down. And you may think you know how tight your airways are, but often people don't. I'm Dr. Alan Greene and I want to explain to you how powerful it can be to have real numbers telling you how well you're breathing. If you've got accurate numbers and you keep them day after day, you can use that to adjust your medicines. That means you can use the lowest amount of medicine possible to feel the best possible. So here's how they work. Usually there's a mouthpiece. You just screw into one end so you can keep it clean. And there's a little gauge here that reads the numbers and you move it all the way down to 0. Then just seal your mouth around the mouthpiece and blow hard, as hard as you can once. (Blow sound) Made it almost to the end. Scored pretty well. Then what you do is write down that number. Pull it back to the beginning and do it a total of 3 times. Whatever the highest number is, that's how well you're breathing right now. Then you can compare it that your asthma action plan. That number will either fall in the green zone, or the yellow zone, or the red zone. And it will help you know exactly what to do to best control your asthma with the minimal amount of medications. Really, really worth it.

  • How to use a peak flow meter

    Animation

    •  

    How to use a peak flow meter - Animation

    You may have heard of a peak flow meter if you have asthma and wonder is it really worth it. How do you use it? What good is it really? Well it turns out that it's often hard to tell how strong your breathing is at any given moment. There are so many other things going on in your life - if you're tired, if you're feeling happy, if you're feeling down. And you may think you know how tight your airways are, but often people don't. I'm Dr. Alan Greene and I want to explain to you how powerful it can be to have real numbers telling you how well you're breathing. If you've got accurate numbers and you keep them day after day, you can use that to adjust your medicines. That means you can use the lowest amount of medicine possible to feel the best possible. So here's how they work. Usually there's a mouthpiece. You just screw into one end so you can keep it clean. And there's a little gauge here that reads the numbers and you move it all the way down to 0. Then just seal your mouth around the mouthpiece and blow hard, as hard as you can once. (Blow sound) Made it almost to the end. Scored pretty well. Then what you do is write down that number. Pull it back to the beginning and do it a total of 3 times. Whatever the highest number is, that's how well you're breathing right now. Then you can compare it that your asthma action plan. That number will either fall in the green zone, or the yellow zone, or the red zone. And it will help you know exactly what to do to best control your asthma with the minimal amount of medications. Really, really worth it.

A Closer Look

 

Self Care

 
 

Review Date: 2/3/2024

Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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