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Warnings
Note: Please read all the information in this manual before using the Vitalograph Peak
Flow Meter
• The Vitalograph Peak Flow Meter is recommended for single patient use.
• The Vitalograph Peak Flow Meter should be used under the supervision of a licensed
healthcare professional.
• Note: Patients symptoms take precedence over Peak Flow Meter readings.
• If the Vitalograph PFM is used for longer than its specified life, the accuracy of the
device may deteriorate.
What is a peak flow meter?
A peak flow meter is a device intended to measure how well your asthma is under control.
The device measures air flowing out of the lungs as you blow into the device as fast as
hard as possible. A peak flow meter can reveal narrowing of the airways well in advance of
an asthma attack. Used mainly by persons with moderate to severe and persistent asthma,
peak flow meters can help determine:
• when to seek emergency medical care.
• the effectiveness of a person’s asthma management and treatment plan.
• when to stop or add medication, as directed by your physician.
• what triggers the asthma attack (such as exercise-induced asthma).
With asthma, sometimes you may feel your breathing is fine, but when you measure it with
a peak flow meter, your lung function may be decreased. A peak flow meter can help you
determine airway changes and better manage your asthma.
Asthma Care in Partnership with your Physician
Your doctor will take the time to educate you in Self-Management of your asthma. This
will start upon diagnosis and continue with all members of the healthcare team. Your
Action Plan will be tailored to your needs, but will include: basic facts about asthma; roles
of medication; skills required for your inhaler, spacer and Peak Flow Meter, environmental
control measures; when and how to take rescue actions.
You and Your Asthma
Most people with asthma need to monitor their asthma at least twice a day and to have a
plan of action to keep it under control. This leaflet provides detailed information on your
Peak Flow Meter and how the Self-Management Action Plan works.
Q. What is Peak Flow?
A. Peak Flow is a measurement of how fast you can blow air out of your lungs. Your peak
flow score will be higher when you are well, and lower when your airways get narrower.
Peak flow scores are therefore a useful guide to the openness of your airways at any given
moment and hence, the severity of your asthma. You should measure peak flow as soon as
you wake up and in the evening before taking your bronchodilator, or as directed by your
Doctor.
Although how you feel and what you can do is important, peak flow scores show
accurately how your breathing is changing. Modern asthma medicines aim to give you the
best possible peak flow score, keeping you in the green zone. It is also important to aim for
stable peak flow, i.e. little difference between morning and evening scores and from day to
day.
Q. Why do I need to measure my peak flow?
A. Many people over the ages of five will benefit from monitoring their asthma with a
Peak Flow Meter, indicating when and how much to use their reliever medication. It will
also help your doctor because peak flow scores make it easier to see how well your asthma
is controlled and when treatment needs changing.
Q. How do I get an Action Plan?
A. Only your doctor can determine the best Action Plan for you. This is likely to be
preceded by an initial assessment followed by a diagnostic phase. During the diagnostic
phase you will need to record your peak flow scores . Your Action Plan is then assessed
against your peak flow scores over several days. Your treatment and/or Action Plan may
be changed following the diagnostic phase. This procedure may be repeated until your
optimum Action Plan is proven.
Q. What is my Normal Value?
A. Your ‘Normal Value’ is the best Peak Flow value that you can achieve. This is your
‘100%’ or ‘reference’ value. Population normative standards are not clinically useful in
ongoing serial monitoring of your asthma.
Your Action Plan
Self-Management including peak flow monitoring will significantly improve the outcome
of your asthma. Your doctor will decide on your Action Plan, which depends on your
individual condition and circumstances. Only your doctor or specialist nurse should
complete your Action Plan label (where provided).
Your measured best Peak flow is: ___________________ L/min BTPS
Your Best means the highest Peak flow when you are feeling well.
Updating Your Action Plan
You should visit your doctor at least twice a year to assess any changes in your condition
and change your plan if required. If you find yourself in the yellow zone most of the time,
inform your doctor immediately.
Understanding your Action Plan
Your current Action Plan is written down and on a label (if provided) which is attached to
the back of your Peak Flow Meter. Your doctor or specialist nurse may also mark your
‘zones’ on the scale side of your peak flow meter. If so, use these ‘colour bands’ instead of
the scale reading in your day to day management.
Above the green boundary, your asthma is well controlled. Your doctor writes in a plan,
such as: ‘2 puffs preventer inhaler morning and evening’. The Peak Flow value in the box
between green and yellow zones is typically 80% of your best.
Yellow means additional treatment such as: ‘2 puffs reliever every half hour’.
Between yellow and red, this box will show your warning threshold value PEF (Peak
Expiratory Flow) which is typically 60% of your best. Red means medical alert, e.g. ‘take
half steroid tablet’ or simply ‘contact doctor’.
How to use your Peak Flow Meter
1. Stand Up (unless your physician advises otherwise).
2. Slide the point down to the bottom of the scale at the end where you blow in.
3. Lightly hold the meter on its edge in front of you, (as shown in figure 2) with the scale
away from your hand. Breathe in as deeply as possible. Holding your breath, place the
mouthpiece well into your mouth, bite the mouthpiece lightly, and seal your lips firmly
around it.
4. Do not bend your neck down.
5. Blow out as HARD and as FAST as you can for a second or more. Be careful not to
block the mouthpiece with your tongue or teeth. A ‘spitting’ action will give falsely high
readings.
The subject may experience side effects such as dizziness or fatigue, during the test
procedure. If this occurs, stop the manoeuvre.
6. Your peak flow is shown on the scale against the pointer. Note where it is (colour band)
and slide the pointer back to the bottom of the scale.
7. Do this three times using the highest as your guide for your Action.
8. During a diagnostic phase you must record your highest peak flow reading or colour
every morning and evening on a chart for your doctor. If you are not in the green zone most
of the time your management plan must be reviewed.
Making sense of your Peak Flow Score
If you often fall below your usual peak flow, it may be a sign that your asthma is getting
worse. Similarly, bigger differences between morning and evening scores may mean your
asthma is worsening, especially if you also start waking at night with a cough or wheezing.
Your own Asthma Action Plan.
Affix your ‘Action Plan’ label (where provided) onto the reverse of your Peak Flow Meter.
Following the Action Plan enables you to adjust your treatment according to your peak
flow scores. If you act quickly, you can usually prevent severe asthma attacks occurring.
Your peak flow scores will fall within one of the Self-Management colour zones. Follow
the Action Plan instructions, which apply to that colour zone.
Important Note: Only your doctor or specialist nurse should complete or change your
Action Plan, so it is important to take your meter with you whenever you visit the doctor. If
you are starting a new Action Plan your doctor will need to see your diagnostic phase
record as well. Your Peak Flow Meter may have coloured tabs on the scale label to simplify
matching your peak flow score with the relevant colour zone of your Action Plan. DO NOT
CHANGE THE POSITION OF THE COLOURED MARKERS YOURSELF. If this
should occur inadvertently, contact your doctor or specialist nurse for advice. You may
cover the sliders with invisible tape to prevent them from being moved accidentally, but do
not block the orifice where the pointer slides.
Before performing a test session, ensure the coloured tabs are in their correct position by
checking them against the numeric values on your ‘Action Plan’ label.
The Diagnostic Phase
When your doctor first diagnoses your condition and as your disease improves or worsens,
recording your peak flow scores two or more times a day is required for a week or longer.
This is to ensure that the treatment you are following is adequately keeping your peak flow
score in the green zone. If the diagnostic phase proves unsatisfactory, your doctor will change
your treatment and start a new diagnostic phase. After satisfactory scores and an Action Plan
are established you will probably no longer be asked to record your peak flow scores, but
simply to follow your Action Plan.
Care and Cleaning of your asmaPLAN Peak Flow Meter
Your Peak Flow Meter should continue to give reliable measurements for up to three years,
after which time you should ask your doctor for a new unit. Avoid crushing the unit and keep
it clean and dust free. If you suspect the unit is damaged or is measuring incorrectly, contact
your doctor immediately.
The outer surfaces should be thoroughly cleaned every week, more often if necessary.
We recommend the use of an ordinary alcohol wipe (IPA 70-90%), paying special attention to
the mouthpiece area.
NEVER ATTEMPT TO DISMANTLE THE UNIT. THIS CAN CAUSE FAULTY
PEAK EXPIRATORY FLOW SCORES.
In Clinic:
When used for multiple subjects always use a disposable SafeTway® mouthpiece.
The Peak flow meter should be externally disinfected using an IPA wipe (70%) between each
patient, and should be disposed of after 30 patients or 2 weeks, whichever is the earlier.
Caution: Federal Law (USA) restricts this device to sale by, or on the order of, a physician.
Technical Specifications
Material: Recyclable ABS plastic.
Accuracy: ± 10 L/min or ± 10% of the reading
Repeatability: ± 5 L/min or ± 5% of the reading
Altitude effects on the Peak Flow Meter (and on the expired air): Lowers readings by approx.
5% per 1000m, (decreased air density increases PEF by approx 5% per 1000m)
Highest resistance to flow: 0.00384 kPa/L/min @ 720 L/min
Measurement Range: 50-800 L/min BTPS
Storage Conditions: Temperature: 10-35°C; Relative Humidity: 30%-75%
Peak Flow Meter performance standards: BS EN ISO 23747:2007; ATS/ERS; AS/NZS4237;
NHLBI
Frequency response: Profile A/B difference less than 15 L/min/15 % (Annex B, EN ISO
13826:2003)
Warranty
Your Peak Flow Meter is guaranteed for one year. Replace if it is faulty, otherwise replace the
unit every three years.
Vitalograph is a registered trademarks of Vitalograph Ltd.
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