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Predicted Peak Flow

Should nurses/docs etc. use predicted peak flow or your known best peak flow when working out the percentage of how good/bad your current peak flow is?

I'm pretty certain it should be based on known best, but I wanted to check before I write a stroppy letter (sorry - a polite letter of concern...) to my GP surgery.

I went to my surgery on Friday (they have a drop in service for emergencies) as peak flow had fallen to 70% of best and my respiratory nurse at the hospital had asked me to get reviewed by a GP.

I had to see the nurse first who decides if you're really unwell enough to see the GP, she said my peak flow was 90% because she was using predicted (my best is well above my predicted) and so tried to stop me seeing the GP. I had to argue my case which is not what I want to be doing when feeling unwell and eventually ended up in tears because I knew I should be seeing the GP, my plan said I should, my respiratory nurse said I should, but this practice nurse wouldn't let me.

Just wanted to check what was right before I write the letter...

10 Replies

Should be using your best ratty. Especially because you have been monitoring for a while. My PF is way above what I am predicted so if they go by the wrong one I would be stuffed.

Sounds like a bit of education needed at your practice....sorry you had a bad time....hugs. oh and make it a stroppy letter - darn sure I would!

Stay strong,



no, should always be on YOUR best peak flow not a generalised peak flow as someone elses best peak flow could be your worst or vice versa :S if you see what i mean

in an emergency i.e. in A+E if they cant understand or use your best peak flow to work out your perecenttage then they do use your predicted in that instance.

my predicted is 435, my best is 550, yet when i get 390, even then i feel awful tite - to them thats okay as its 90% of my predicted, but less than 70% best so clearly not that okay.....

you are right to right a letter

good luck and keep well xx


Thanks both, I thought it was on best, but wanted to be sure before writing the letter.

Snowy, my predicted and best are the same as yours - and I was at 390 on Friday when the nurse was saying you're 90%, you're fine, don't know why you're here...


It's meant to be your individual best. My predicted peak flow is less than 60% of my personal best. If they only treated me when my peak flow was dropping significantly below my predicted peak flow I'd be very poorly indeed.

EDIT: corrected a typo



i get that everytime with my practice nurse, even if i am symptomatic...

i dun always wheeze, nellie putting on weight is main symptom with endless coughing which of course doesnt always affect my PF..

so i say my best PF to gp or astrhma nurse is 550, then do 390 and they say oh well your pred is only 435 so your fine :S so frustrating!! my own GP that i reg see understands, but of course u cant guarantee u see him in emergnecy....

good luck in writing the letter, and i hope u get a great response :)

mich x x


This is dreadful!

I had no idea how lucky I was......my GP, nurse and hosp all ask my normal PF and go by that - never my predicted. It's not good that you folk ar4e having to struggle with this too.

Maybe have it written into your action plan and if poorly take it with you?



yea, as fee says get it written into your action plan.

i got mine written in mine. so if you say your PF is same as mine it be similar to me, ONLY confirm it with your asthma nurse/consultant. mine was last updated last sept, only now i am much worse and have now got new consultant + nurse and my nurse due to ring me tomorrow to go through my treatment and a new action plan and things:

PF personal BEST 550

PF 330 start pred

PF 280 go to A+E

but then my other asthmauk action plan was different, green, amber and red sections accroding to % below my best:

green = 75% 410 - 550

amber = 50 - 75% 220 - 410

red = below 50% < 220 or if more unwell, struggling etc...

i think thats right :S ......

anyways, like fee says, get your best pf written into your actionplan and go from there, but defo write your letter



Thanks all. I do have my levels written into my action plan from my consultant and I also have a very clear letter from my consultant for emergencies wherever I am (GP, Green men, A&E) detailing my levels. My threshold for help is really high - increasing Pred and getting help if I fall below 400 as I can be okay till then and then suddenly it all goes very very wrong.

My GP surgery have always been fine and they all know me, but this one nurse has always been a bit off with me so I've always just asked to see someone else - unfortunately she was the only one available on Friday.

My action plan and consultant letter are all in my medical notes, she just didn't follow them even when I pointed out the issue. I've written a letter to the practice manager asking that these be made prominent and important in my notes. Hopefully it will help.


My resp con goes on my personal best if it was soes in predicted best i would live in hossie as my pfs are consistenly very low eg this yr i havent been over 200! For me i know if mim under 150 post neb things arent good but often go on symptomsas well as pf.


my resp consultant + reg GP go on personal best, other GPs dont GRRR!



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