ALERTDo not further stress patients who are severely short of breath or who are hemodynamically unstable by having them use a peak flowmeter. Do not attempt a peak expiratory flow measurement with patients who have had recent eye surgery after which straining is contraindicated. Show
Most children age 5 or olderundefined#ref3">3 are capable of using a peak flowmeter (Figure 1) as part of their asthma management plan. Use a low-range peak flowmeter for small children (typically 8 years old or younger) and use a standard-range peak flowmeter for older children, teenagers, and adults.2 Anticipate predicted values for peak expiratory flow rate (PEFR) (Table 1) to be approximately 10% lower for black and Hispanic patients than those shown in predicted peak flow tables.5 In children experiencing acute asthma exacerbations, PEFR correlates poorly with clinical appearance.1 OVERVIEWPeak expiratory flow measurement is also known as peak flow or PEFR. PEFR is the maximal flow rate that a person can achieve during a short maximal expiratory effort, following a full inspiration.3,4 Increased bronchospasm or narrowing of the airways results in a decreased speed of air flow. PEFR measurement is used to assess respiratory function in obstructive airway diseases (especially asthma) and to evaluate the patient’s response to bronchodilator therapy. Peak flow is the most commonly used objective value that can be assessed at the bedside or at home; a declining value indicates the patient’s condition is deteriorating or not responding to therapy. Three PEFR measurements are obtained and only the highest is recorded.3 Ideally, peak expiratory flow should be measured before and after nebulizer treatments. The practitioner decides which scale meter to use in measuring PEFR; most commonly used are the European Union (EU) scale meter and the Wright scale meter. In addition, electronic peak flowmeters are available and can automatically record and track PEFR. PATIENT AND FAMILY EDUCATION
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REFERENCES
ADDITIONAL READINGSGorelick, M.H. and others. (2004). Difficulty in obtaining peak expiratory flow measurements in children with acute asthma. Pediatric Emergency Care, 20(1), 22-26. doi:10.1097/01.pec.0000106239.72265.16 (classic reference)* U.S. National Library of Medicine, MedlinePlus. (2018). Peak flow meter use—series. Retrieved January 28, 2019, from http://www.nlm.nih.gov/medlineplus/ency/presentations/100202_1.htm *In these skills, a “classic” reference is a widely cited, standard work of established excellence that significantly affects current practice and may also represent the foundational research for practice. Elsevier Skills Levels of Evidence
How many readings should you take when you are measuring a patient's peak expiratory flow rate?The 3 readings should be close together. If not, adjust your technique. If you cough during a measurement, repeat the measurement. Record only the highest of the 3 readings on a graph or in a notebook.
How many readings should you take when you are measuring a patient's peak expiratory flow rate quizlet?How do you calculate the peak expiratory flow rate from the three readings? Use the highest reading as the peak expiratory flow rate.
How often should you measure peak flow?Measure your peak flow at least once a day, usually in the morning before you take your asthma medicines. You might have to check it more often if you are having more episodes than usual, or if your reading is below 80 percent of your personal best.
How do you calculate the peak expiratory flow rate from the three readings?How do you calculate the peak expiratory flow rate from the three readings? Add the readings and divide by 3.
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