Spirometrics Spiro Flow User manual

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Spiro Flow™
Spirometrics®
Spirometrics Medical Equipment Co.
22 Shaker Rd. P.O. Box 680 Gray, ME 04039
[phone] Fax: [phone]
www.spirometrics.com
INSTRUCTION MANUAL
Peak Flo w Meter
Children’s

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Introduction
You are using the Children’s Spiro Flow™manufactured by
Spirometrics. This monitor meets all the technical standards
established by the National Asthma Education and Prevention
Program and other international standards.
Your Children’s Spiro Flow™was designed for use by patients
having a peak flow below 370 liters per minute. If your peak
flow is above 370 liters per minute, you should use the adult
(standard) version of theSpiro Flow™.
The 1997 National Heart Lung and Blood Institute in the
National Asthma Education and Prevention Program
recommended that individuals age five and older with
moderate or severe asthma monitor peak flow. Peak flow
may NOT be used to completely evaluate lung function.
The Spiro Flow™measures peak expiratory flow (PEF), which is
a valuable indicator of lung function and changes in your
asthma. A peak flow meter may be used to check your asthma
like a blood pressure cuff is used to check high blood pressure.
In order to help your physician provide the most appropriate
treatment, proper use of theSpiro Flow™is essential.
Note: A physician should be involved in the initiation of home
peak flow monitoring. Persons with cardiovascular or respira-
tory diseases should not use theSpiroFlow™unless under the
care of a physician.
Copyright © 2003 by Spirometrics Medical Equipment Company.
All rights reserved.

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What does peak flow measure?
Your peak flow is the flow that you can achieve when blowing
out as fast as possible after breathing in as much air as possible.
Your best peak flow or Best Effort is unique to you and will be
determined with the assistance of your doctor or respiratory
therapist.
Why should I use a Peak Flow Meter?
Asthma may cause the airways to narrow and limit how well you
can get the air out of the lungs. Your peak flow may help to
make you aware of these changes before you feel poorly. It is
important to monitor your symptoms and changes in peak flow.
Monitoring changes in your lung function will help you know
when your asthma is changing. Many times medications can be
taken before symptoms worsen. It may also help you avoid a
serious asthma episode.
Your doctor can further explain the importance of measuring
your peak flow. Knowledge of your normal or near normal peak
flow, or at least being able to achieve your best possible result as
a response to therapy, can give you security in the knowledge
that you are as good as you can be.
How does monitoring peak flow improve my
asthma care?
Monitoring peak flow helps your physician and other health care
providers evaluate how well your asthma is being controlled.
Always take the peak flow meter and daily recorder chart to
doctor appointments.
If you need to go to an emergency room or urgent care, always
take your peak flow meter and daily recorder chart. It provides
valuable information when treating asthma symptoms or acute
episodes.

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How to setup the Spiro Flow™
Note: Your asthma educator or physician may be able to assist you.
(Your Best Effort and Zone settings may differ from this example.)
•Once you have obtained your Best Effort reading from your
physician, determine your “Zone” indicator settings according
to the following:
Red Zone - 50% of Best Effort and below. Example:
For a Best Effort of 300, set your Red Zone indicator to 150 = 300 x 50%.
Green Zone - 80% of Best Effort and above. Example:
For a Best Effort of 300, set your Green Zone indicator to 240 = 300 x
80%.
Yellow Zone - 50% to 80% of Best Effort or between your Green Zone
indicator and your Red Zone indicator.
•Use a pen or similar item to move the Zone indicators to the
positions determined above.
•Your Spiro Flow™is now ready for use!

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•Setup your peak flow chart by recording your Name, Date and
Zone indicator settings as shown below:
•Perform your tests as prescribed and record the test results in
your chart. Record the date, hour, and if you took medication
along with the reading.
Fill in the box above the line of your reading.

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How to use the Spiro Flow™
Step One:
Your mouth must be empty. For best results, you should stand.
If you are unable to stand, sit-up straight.

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Step Two:
Move the Peak
Indicator to start
position where
shown.
Step Three:
Hold the Spiro Flow™in your
hand with your thumb and
forefinger on the grips and the
mouthpiece facing toward you.
Younger children may opt to
hold the device with both
thumbs underneath and fingers
on the grips as shown. Avoid
blocking the vent holes as
much as possible and do
not allow fingers to
interfere with the
red Peak Indicator.

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Step Four:
Take as deep a
breath as possible
filling your lungs
completely with air.
Step Five:
Place your mouth on the
mouthpiece, past your teeth
and form a tight seal with your
lips. Place your tongue below
the mouthpiece. Make sure your
tongue is not blocking the opening
at any time.

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Step Six:
Blow out as HARD and FAST as you can. This will cause the
indicator to move and indicate your peak flow. Do not spit or
cough into the device. If this occurs, repeat the test from Step
Two.
Step Seven:
Do not reset peak indicator. Repeat Steps Four through Six two
more times for a total of three maneuvers. The indicator will
automatically point to the best of the three efforts.

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What is my Best Effort peak flow?
Your physician, asthma coordinator/counselor, nurse or respira-
tory therapist should establish threshold or target values includ-
ing your Best Effort peak flow. Once the targets are determined,
your physician will use the information to write an asthma
management plan based on your needs.
What should I do when my peak flow changes?
It is important to develop an asthma management plan in
partnership with your physician. Your physician’s advice should
be followed to make changes in your asthma care based on the
peak flow results and symptoms.
Step Eight:
Once you have completed three maneuvers, record your best
effort on your “Daily Recorder Chart” provided with your
Spiro Flow™. The line or arrow in the middle of the Peak
Indicator points to your result.

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Caring for your Spiro Flow™
Always take your peak flow meter with you when scheduled for
breathing tests. The National Asthma Education and Prevention
Program guidelines recommend comparing peak flow and
spirometry at least once each year.
The Spiro Flow™is for single patient use, therefore it is not
necessary to clean it after each use. Once a week should be
sufficient.
The Spiro Flow™is dishwasher safe. Make sure it is placed in
the silverware basket. Take care to not allow any items to go
inside the unit and turn off drying heat if possible.
You may also wash the Spiro Flow™in warm soapy water. Rinse
well, shake out any excess water and let it dry before next use.
The Spiro Flow™was designed to last at least one year. Examine
your Spiro Flow™occasionally to make sure it is operating
properly.
Ensure that there is no food or other debris in the unit after
cleaning and before each use.
If you have cleaned your Spiro Flow™as described above and
still obtain unusual readings or suspect that yourSpiro Flow™
may not be working properly check the following:
The red peak indicator should not be loose or move when
the Spiro Flow™is tilted from side to side without
shaking.
The red peak indicator should move freely when pushed
with your finger or some other soft object.
If either condition above is not met, or you still suspect malfunc-
tion, please refer to our warranty policy later in this manual.

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CHILDREN & ADOLESCENTS - NHANES III*
PEAK EXPIRATORY FLOW RATE [liters/minute]
CAUCASIAN MALES CAUCASIAN FEMALES
Height [inches (cm)] Height [inches (cm)]
50
(127)
55
(140)
60
(152)
65
(165)
70
(178)
75
(191)
45
(114)
50
(127)
55
(140)
60
(152)
65
(165)
70
(178)
Age
8 197 248 303 364 429 499 155 190 227 269 314 363
10 210 261 317 377 442 512 192 226 264 305 350 399
12 230 281 337 397 462 532 220 254 292 334 397 427
AFRICAN-AMERICAN MALES AFRICAN-AMERICAN FEMALES
Height [inches (cm)] Height [inches (cm)]
50
(127)
55
(140)
60
(152)
65
(165)
70
(178)
75
(191)
45
(114)
50
(127)
55
(140)
60
(152)
65
(165)
70
(178)
Age
8 184 239 300 366 438 514 159 195 235 279 327 379
10 190 245 306 372 443 520 179 215 255 299 347 398
12 204 260 320 386 458 535 198 235 275 319 366 418
MEXICAN-AMERICAN MALES MEXICAN-AMERICAN FEMALES
Height [inches (cm)] Height [inches (cm)]
50
(127)
55
(140)
60
(152)
65
(165)
70
(178)
75
(191)
45
(114)
50
(127)
55
(140)
60
(152)
65
(165)
70
(178)
Age
8 197 258 326 399 478 563 156 197 242 291 345 403
10 205 266 334 407 486 571 185 225 271 320 374 432
12 220 281 348 422 501 585 207 248 293 342 396 454
Normal Predicted Average Peak Expiratory Flow
This page and the next contain tables of average peak flows
based on tests of large numbers of people. The peak flow for an
individual can vary widely. Individuals at altitudes above sea
level should be aware that peak flow readings may be lower than
those provided in the tables. Please apply the appropriate
altitude correction factor shown later in this manual.

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CHILDREN 3 TO 6 YEARS
ZAPLETAL††
HEIGHT PEAK EXPIRATORY
FLOW RATE
[liters/minute]
[inches] [cm]
35 89 93
36 91 99
37 94 105
38 97 112
39 99 119
40 102 125
41 104 133
42 106 140
43 109 147
44 112 155
45 114 163
46 117 171
47 119 180
48 122 189
49 125 197
50 127 206
51 130 216
CHILDREN & ADOLESCENTS - POLGAR †
PEAK EXPIRATORY FLOW RATE
[liters/minute]
HEIGHT
MALE FEMALE
MALES &
FEMALES
COMBINED
[inches] [cm]
43 109 143 153 147
44 112 157 166 160
45 114 171 178 174
46 117 185 190 187
47 119 199 202 200
48 122 214 215 214
49 125 228 227 227
50 127 242 239 240
51 130 256 252 254
52 132 270 264 267
53 135 285 276 280
54 137 299 289 294
55 140 313 301 307
56 142 327 313 320
57 145 341 326 333
58 147 356 338 347
59 150 370 350 360
60 152 384 363 373
61 155 398 375 387
62 158 412 387 400
63 160 427 400 413
64 163 441 412 427
65 165 455 424 440
66 168 469 437 453
67 170 483 449 467
*Hankinson J, Odencrantz J, Fedan K: Spirometrics Reference Values from a Sample of the General U.S.
Population (NHANES III). Am J Respir Crit Care Med 1999;159:179-187.
†Polgar G, Promhadt V: Pulmonary function testing in children: Techniques and standards. Philadelphia,
W.B. Saunders Company, 1971.
††Zapletal A, Chalupova´ J: Forced Expiratory Parameters in Healthy Preschool Children (3 - 6 Years of
Age). Pediatric Pulmonology 2003; 35:200-207.

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Temperature and Altitude Effects
Your Spiro Flow™was designed for use within the temperature
range indicated on the next page under “Performance Specifica-
tions”. Outside this temperature range your device may not be
accurate.
Your Spiro Flow™and all similar devices are also affected by
altitude. Your readings do not require correction when you use
your Spiro Flow™at sea level. Your readings will be lower when
you use your Spiro Flow™at higher altitudes and will require
correction. Follow the instructions below to correct for the
effects of altitude on your peak flow readings.
Altitude Correction
In the chart below find the row with the reading that is closest to
your peak flow and the column with the altitude that is closest to
your current altitude. Add the correction value located where
this row and this column meet to your measured peak flow to
obtain your true, altitude corrected, peak flow.
Record this value in your peak flow chart as appropriate.
ALTITUDE CORRECTION VALUES
PEAK FLOW
READING
[liters/min]
ALTITUDE [feet]
1000 2000 3000 4000 5000
100 235 7 8
150 3 5 8 10 13
200 3 7 10 13 17
250 4 8 13 17 21
300 5 10 15 20 25
350 6 12 18 23 29
400 7 13 20 27 33

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Warranty
The Spiro Flow™comes with a one-year replacement warranty.
If yo ur Spiro Flow™is not operating properly, contact Spiromet-
rics®and do not use the damaged meter.
Performance Specifications
This device meets the requirements of the following
standards:
Standardization of Spirometry, 1994 Update; American Thoracic
Society (ATS)
Statement on Technical Standards for Peak Flow Meters; January, 1991;
National Heart, Lung and Blood Institute
Respiratory Therapy Equipment - Peak Expiratory Flow Meters;
September, 1994; Australian/New Zealand Standard
Peak expiratory flow meters, BS EN 13826:2003, European Committee
for Standardization
Scale (Display): 50 to 370 liters / minute @ BTPS
Accuracy: ±7.5% or ±10 liters / minute
Repeatability: ±5% or ±10 liters / minute whichever is greater
Does not exceed 20 liters / minute
Flow Resistance: 6.7 cm of water @ 370 liters / minute
Environmental Conditions for Use:
10 to 50 °C and 0 to 100% Relative Humidity
Storage Requirements:
-40 to 70 °C and 0 to 75% Relative Humidity
Web Sites about Asthma
National Asthma Education and Prevention Program (NAEPP)
NHLBI Information Center
www.nhlbi.nih.gov/about/naepp
Allergy and Asthma Network - Mothers of Asthmatics, Inc.
www.aanma.org
Asthma and Schools
www.asthmaandschools.org
National Jewish Medical and Research Center
www.njc.org
American Association for Respiratory Care
www.aarc.org

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Manual Part Number: 20131
Rev. 02
REORDER INFORMATION
2450 Children’s Spiro Flow™Peak Flo w Meter
20058 Peak Flow Chart only
Spirometrics Medical Equipment Co.
22 Shaker Road, P.O. Box 680, Gray, ME 04039
Phone: [phone] Fax: [phone]
email: [email protected]
www.spirometrics.com