department of athletics policies & procedures - UNC Wilmington ...

determine what PEFR value is normal for each individual.
To determine an individual patient's normal PEFR, they should measure their PEFR when
they have no asthma symptoms. Three PEFR measurements should be done with the
same peak flow meter two to four times daily for two to three weeks. For long term
management, most clinicians will recommend testing once per day, usually in the
morning.
The patient should note the highest PEFR measure achieved; this is the "personal best"
PEFR. This number is used to determine if future PEFR readings are normal or low, and
is also used to create a normal PEFR range (between 80 and 100 percent of the personal
best PEFR).
Readings below the normal range are a sign of airway narrowing in the lungs. A low
PEFR can occur before asthma symptoms such as wheezing or shortness of breath
develop.
A personal best PEFR value should be remeasured each year to account for growth (in
children) or changes in the disease (in both children and adults). In addition, home PEFR
measurements should be verified with readings taken with equipment in a healthcare
provider's office since this equipment is more sensitive.
The action plan — once the normal range can been established, the healthcare provider
will provide tailored guidelines (also called an action plan) to follow when the PEFR
begins to decrease.
Peak expiratory flow rates are divided into three zones, which are assigned colors similar
to those of a traffic light. These zones can be used to make decisions about the need for
treatment:
GREEN (80 to 100 percent of personal best) signals that the lungs are functioning
well. When readings are within this range and symptoms are not present, patients
should continue their regular medicines and activities.
YELLOW (50 to 80 percent of personal best) is a sign that the airways in the
lungs are somewhat narrowed, making it difficult to move air in and out. A shortterm
change or increase in medication is generally required. Patients should
change or increase their medication to reverse airway narrowing according to the
treatment recommendations previously discussed with their provider.
RED (below 50 percent of personal best) is a sign that the airways are
significantly narrowed and requires immediate treatment. The "rescue" inhaler
should be used according to the treatment recommendation previously discussed
with the provider. PEFR should be rechecked 10 to 15 minutes after the rescue
medication is used. If the PEFR improves, the patient should monitor their PEFR
throughout the day. The healthcare provider should be contacted after the patient
improves; daily medication may be changed or increased.
IMPORTANT TO NOTE:
It is the athlete’s responsibility to have their inhaler at all athletic activities.
210