Explain that peak flow measurements may be used to guide medication doses on the practitioner’s recommendation 6 and that peak flow measurements may also be taken before and after exposure to potential triggers.Advise the patient that the practitioner may select a more reliable test, such as spirometry, to confirm or exclude airflow limitation. Instruct the patient that although the PEFR is useful for detecting changes in his or her asthma control, significant testing variability can occur. Recognizing this change allows early medical intervention and can prevent severe symptoms. Explain that in many cases the first sign of an “asthma attack” is a decrease in peak flow measurements, even in the absence of symptoms.Instruct the patient to initiate bronchodilator therapy and contact the practitioner immediately or call 911 for emergency medical assistance if the PEFR does not return to the yellow or green zones after bronchodilator therapy. 2 Warn the patient that this signals a medical alert, because airway narrowing and obstruction may be severe.
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