1. Peak expiratory flow (PEF) monitoring is more useful for established asthma patients than for initial diagnosis. 2. Asthma control is lost if PEF drops below 80% of personal best or predicted value, or if diurnal PEF variation is over 20% over one week. 3. PEF should be measured sitting or standing using the best of three blows from maximum inhalation with less than two seconds pause before blowing.

1. PEF is more useful in the monitoring of patients with established asthma, than in making the initial diagnosis3.
Asthma Control Lost: if PEF drops below 80% predicted or personal best 2,3,3.
Asthma Control Lost: if PEF diurnal variation is over 20 % over 1 week1
1. PEF measurement may be preformed sitting or standing3.
2. PEF measurement is preformed before the quick relief inhaler (FABD)
3. Further blows should be done if the largest 2 PEF are not within 40 l/min3.
4. PEF is the best of 3 forced expiratory blows from maximum inhalation and
with a maximum pause of 2 seconds before blowing3.
5. Record the morning best of 3 PEF measurements as am for each day.
6. Record the evening best of 3 PEF measurements as pm for each day.
Peak Expiratory Flow Facts and Figures.
7. Diurnal variation of PEF1: Measure am & pm PEF for 2 weeks.
Diurnal variation = (highest – lowest)/highest X 100.
Age (years)Adapted by Clement Clark for use with EN 1386/EU scale peak flow meter
From Numm AJ Gregg I, Br Med J 1989:298;1068-70. (see reference 3)
FPAGC
1. Lougheed MD et al; Canadian Thoracic Society 2012; Can Respir J Vol 19 No 2 March/April 2012 . 2. GINA Update 2011. http://www.ginasthma.org/uploads/users/files/GINA_Pocket_April20.pdf.
3. British Guideline on the Management of Asthma: A national clinical guideline; Revised January 2012;. 4. Guidelines for the Diagnosis and Management of Asthma; NIH Publication Number 08-5846. Oct 2007
Authored / Adapted by Dr. A. Ciavarella MD and Dr. A. Kaplan MD | Asthma Action Plan™ is a trademark of the Family Physician Airways Group of Canada
The Asthma Action Plan™ is designed to be used only as a guide for educational purposes and does not replace physician’s advice.

2. Date
Asthma Action Plan™ : Self Assessment Monitor [SAM]
PEFbest/date =
PEFpredicted =
FPAGC
10
20
30
40
50
60
70
80
90
3 00
10
20
30
40
50
60
70
80
90
4 00
10
20
30
40
50
60
70
80
90
5 00
10
20
30
40
50
60
70
80
90
2 00
6 00
Peak Expiratory Flow:
l/ min
10
20
30
40
50
60
70
80
90
1 00
1. PEF measurement may be preformed sitting or standing3.
2. PEF measurement is preformed before the quick relief inhaler (FABD)
3. Further blows should be done if the largest 2 PEF are not within 40 l/min3.
4. PEF is the best of 3 forced expiratory blows from maximum inhalation and
with a maximum pause of 2 seconds before blowing3.
5. Record the morning best of 3 PEF measurements as am for each day.
6. Record the evening best of 3 PEF measurements as pm for each day.
Peak Expiratory Flow Facts and Figures.
7. Diurnal variation of PEF1: Measure am & pm PEF for 2 weeks.
Diurnal variation = (highest – lowest)/highest X 100
Authored / Adapted by Dr. A. Ciavarella MD and Dr. A. Kaplan MD | Asthma Action Plan™ is a trademark of the Family Physician Airways Group of Canada
The Asthma Action Plan™ is designed to be used only as a guide for educational purposes and does not replace physician’s advice.
1. Lougheed MD et al; Canadian Thoracic Society 2012; Can Respir J Vol 19 No 2 March/April 2012 . 2. GINA Update 2011. http://www.ginasthma.org/uploads/users/files/GINA_Pocket_April20.pdf.
3. British Guideline on the Management of Asthma: A national clinical guideline; Revised January 2012;. 4. Guidelines for the Diagnosis and Management of Asthma; NIH Publication Number 08-5846. Oct 2007
Page __

3. 1. Lougheed MD et al; Canadian Thoracic Society 2012; Can Respir J Vol 19 No 2 March/April 2012
2. GINA Update 2011. http://www.ginasthma.org/uploads/users/files/GINA_Pocket_April20.pdf.
3. British Guideline on the Management of Asthma: A national clinical guideline; Revised January 2012;
Scottish Intercollegiate Guideline Network (SIGN). www.brit-thoracic.org.uk .
4. Guidelines for the Diagnosis and Management of Asthma; NIH Publication Number 08-5846. Oct 2007
References:
Asthma Guideline References: 1.Canadian Thoracic Society 2012 Guideline update; 2. GINA 2011; 3. SIGN 2012; 4. NAEPP – NIH 2007
Authored / Adapted by Dr. A. Ciavarella MD and Dr. A. Kaplan MD | Asthma Action Plan™ is a trademark of the Family Physician Airways Group of Canada
The Asthma Action Plan™ is designed to be used only as a guide for educational purposes and does not replace physician’s advice.
4. Peek Expiratory Flow
Predicted Values and Charting
FPAGC 2014