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Peak Flow Meter Use in a 5 year-old

post #1 of 11
Thread Starter 
Has anyone used a peak flow meter in a 5 year-old? My daughter recently switched from a nebulizer to an inhaler with a spacer and is doing fantastic with it. The ped. and I both think she'd be able to use a peak flow meter but I wanted to get some BTDT experience.
post #2 of 11
We tried with my 9 year old when he was about 6 and he just didn't get it -- I think. The reason I say I think is that we got the same exact reading every single time. You know how they say take 3 measurements and use the best -- they'd be identical every time, and then the next day would be the same, and if he was in the middle of an attack -- still the same. The readings were also all alarmingly low, in the "red zone", so it was scary until I decided it wasn't working.

So, either we had a broken meter or he didn't do it right. I thought it was weird that he couldn't do that but had not problem with PFTs in the clinic.

Having said that they cost like $20 -- so why not get one and try it? My son's asthma is very chronic, and he has no sudden flares, so I didn't feel it was an important tool for us anyway, but if your DC's profile is different then it's probably worth really working at learning how to use it.
post #3 of 11
I was using a spacer when I was five or six but couldn't use a peak flow correctly until I was older, maybe 10. There are ways to "cheat" and make the number higher (like making a "tuh" motion with your mouth instead of "huh" when breathing out- and it's not necessarily audible), and it can also be hard to coordinate breathing (I usually get one reading out of three that is off because I breathed out too slow), for those two reasons I think it would be very hard for a five year old to use.

I would suggest getting one for her and introducing the concept though, but I wouldn't really expect her to be getting accurate readings (as in, if she is suppose to have a PF of 200 and only scores 25 I wouldn't rush her to the ER unless she was in distress).. I have a small collection of them- I would suggest a big clear one for a child (like this http://z.about.com/d/pediatrics/1/0/...flow_meter.jpg), it seems easiest for a child because you can see the line go up . That way it can be a game- how high can you get the line. After she can use it consistently and accurately I prefer these http://graphics8.nytimes.com/images/...adam/19367.jpg because they are more portable and come with "cool" cases (I have both the child version for when I'm really sick and the adult version for when I'm doing better, both are nice).

Have you ever tried using one? My 44 year old mother can't use one correctly . It takes practice. It can also be very hard to use when I'm sicker or have a cough. It does help with telling what medicine works best though, on advair I am around 590, on just pulmicort or flovent I'm around 500.
post #4 of 11
Thread Starter 
Thanks for your input - since it is reasonable, I ordered one for us to practice with. She's really good with the deep breaths part of the office exam and can inhale and hold it for lung x-rays so hopefully with a little practice, we'll get her using the peak flow meter properly.

We're wanting to use it to help determine if her current medication setup is optimal. She coughs after exercise/activity but otherwise sounds OK so the doc wants to get an idea of what her flows are like after exercise to see if she needs a medication change or if perhaps something else is triggering the cough.
post #5 of 11
I have a peak flow meter and was charting my son when he was 6. The readings were always low and I gave up on it. I may try again and see , but we had trouble using it.
post #6 of 11
Thread Starter 
Village Mama - is yours for pediatric and adult use?
post #7 of 11
Ours is specifically for pediatric use. He doesn't seem to have the power to get it to work properly. He is on the autistic spectrum though, and although I don't think that it is affecting the way he uses it, maybe it is making things a little trickier in the execution... I am not sure.( how could I tell, right?)
post #8 of 11
Thread Starter 
My daughter is also on the spectrum. She is a sensory seeker and mouths everything so I know we'll be ablento get it in her mouth at least. Coordinating the rest may prove troublesome though. Thanks again for all your input. The meter should arrive sometime this week.
post #9 of 11
Thread Starter 
Well we got it this evening right after she started complaining that her chest hurt when breathing. She was able to do a 110 (the first was 80 then two 110s in a row); according to the chart that came with it, 147 is 'normal' for her height so she probably wasn't too far off. We're going to test it again after her breathing treatment.
post #10 of 11
We got one for ds right before his 5th birthday. It had a pediatric calibration and a mouthpiece that made it more naturally-sized for kid mouths.

We used to talk about taking a deep breath to blow air into the sails of a ship to run away from pirates or something like that. We made it a game, but gave ds a visualization.

What really took a week or so for him to get was the hard & fast blow.

On an asthma board I used to frequent, there would be conversations about how a peak flow meter only measures large airways. So, depending on how asthma is affecting your child's pulmonary system, a peak flow meter may or may not help as much. If the most constriction/inflammation is in smaller, lower airways, I think the PFM doesn't help as much.

If you've had PFTs done through the computer at your dr's office, you should be able to ask whether your child's larger or smaller airways are more problematic... PFMs are good if you're trying to get daily measurings of the larger airways.

sorry for novel, don't feel like paying atteniton to editing.
post #11 of 11
Thread Starter 
Thanks for the novel - it was good. My doughter hasn't had one done via a computer - I'll have to ask the ped for it. My daughter still appears to be in the yellow zone on a regular basis and so we're hoping to get a measure of her flows to determine if she really is in the yellow zone or might just appear to have these extra symptoms.
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