Peak Flow Meter Instructions Fact Sheet Page 3
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3Patient Name: _________
Patient ID:_________
Evaluator Initials:_________
Date: ___/___/___
PEAK FLOW METER TECHNIQUE CHECKLIST
Trained assessor to read to participant: Please show me exactly how you use your peak flow meter at home.
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1. Before each use, make sure the indicator is at the
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bottom of the scale.
2. Grip the peak flow meter in your hand.
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3. Standing or sitting in an upright position, take in a deep
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breath.
4. Place the mouthpiece into mouth and form a tight seal
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with your lips.
5. Exhale as quickly as possible until your lungs are
completely empty. The indicator will move and show the
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measurement on the scale.
6. Repeat steps 3 to 5, two additional times in order to get
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your best result.
7. Record the highest value on your flow sheet and follow
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your asthma action plan.
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Participant's Score:
___/7
___/7
___/7
___/7
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Score the participant's performance by assigning 1 point to each correct step and adding across
the 7 steps. If score is less than 7, demonstrate to the participant appropriate technique and
repeat assessment.
Comments:______________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
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