Controlling Asthma

Some of the medications use to treat asthma are delivered to the lungs via a metered-dose inhaler — a small pressurized container that releases a specific amount of medication through the mouth to the lungs. In order to be effective, the aerosolized particles released by the inhaler need to travel throughout the lungs. Incorrect usage of an inhaler (e.g. to puff and then inhale) causes suboptimal treatment in which most of the particles just stay in the mouth. Using a spacer device with an inhaler and following the method below can help to ensure maximum effectiveness of the medication.

First, exhale completely. Then as you count from one to four over 4-5 seconds, do the following:

1. On "1", start inhaling

2. On the count of "2", squeeze the inhaler once, continue inhaling

3. On "3" continue inhaling

4. On "4", finishing inhaling and hold breath for 2-3 seconds.

If you have been prescribed more than one puff, you may repeat the steps after a few normal breaths.

Using a Peak Flow Meter

A peak flow meter is a simple, portable and inexpensive device which measures air flow into the lungs, or peak expiratory flow rate (PEFR). If used appropriately, a peak flow meter can be a valuable tool to:

Identify allergens
Determine the severity of asthma
Check the response to treatment during an acute asthma episode
Monitor progress in treatment of chronic asthma and provide objective information for any possible adjustments in therapy
Detect an often unrecognized worsening in lung function and thereby avoid a possible serious flare up in asthma with early intervention
Diagnose exercise-induced asthma.

Proper training is necessary for home peak flow monitoring, It is essential to learn from a skilled professional how to properly use the peak flow meter and what to do if the peak flow readings fall. According to the Statement on Technical Standards for Peak Flow Meters, the 10 steps toward an acceptable peak expiratory flow reading include:

Nose clips are unnecessary
Make sure the device reads zero or is at base level
Stand up (unless disabled, in which case the position should be the same for all maneuvers)
Take in a deep breath as far as possible
Place the meter in your mouth and close your lips around the mouthpiece
Blow out as hard and as fast as possible (one to two seconds)
Do not cough or let the tongue block the mouthpiece
Write down the value obtained
Repeat the process two additional times
10. Record the highest of the three numbers obtained and record in your diary

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