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Peak Expiratory
Flow Rate
(PEFR)
PEFR ! What is it ?
Maximum expiratory flow rate during a forced expiration.
PEFR are different for everyone. They are based on age, sex and height.
In other words, a peak flow meter measures how fast air can be expelled
from the lungs.
The peak expiratory flow (PEF), also called peak expiratory flow rate
(PEFR) is a person’s maximum speed of expiration, as measured with a
peak flow meter, a small, hand held device used to monitor a person’s
ability to breathe out air.
Peak Flow Meter
A portable device that can help measure air flow in and out of the lungs.
Can be a good indicator of air flow in and out of the lungs in those over
age 5.
Peak Flow Meters
1. Brand:
Mini-Wright peak flow meters (EN 13826)
2. Scale
Wright/ATS/EU
3. Range
Low Range Small Child
Standard Range Older Child, Teen, Adult.
Mechanical Peak Flow Meter
Electronic Peak Flow Meter
The Original Wright Peak Flow Meter - Standard and
Diagnosis:
- Asthma
1. ⇧>=20% in PEFR following administration of a bronchodilators.
2. Diurnal variation >=20%.
- Document the work-relatedness of asthma.
Indication
Epidemiological Investigation
- You will see a drop in peak flow readings even before the symptoms of
asthma (like coughing or wheezing) get worse.
- Decreases in peak flow may indicate that you need to increase your
medication.
- The peak flow value can give the physician a better idea of how the
patient are responding to treatment at home.
Indication
- It is difficult to say exactly what a person's best peak flow should be.
For example you can expect:
Normal Values:
Peak flow measurements are most useful when a person compares his or
her “personal best”.
MALE
Age
Peak Expiratory Flow Rate (PEFR)
The average range for an adult for peak flow lie between
PFR 450 (EU) and PFR 600 (EU).
Because the peak flow depends on age, gender, race and height, the
measured result is compared to that predicted for a person’s age, gender
and height, using special charts and the measurement is compared with
what would be expected.
No cough.
This flow rate serves as a benchmark in your daily self management plan.
To determine your personal best, typically, you’ll take readings twice a day
for two weeks when you’re not having symptoms.
Determining your personal best
The highest consistent reading during the trial period is “personal best”
peak flow rate.
To take a peak flow reading: Put the marker to zero, take a deep breath, seal
your lips around the mouthpiece, then blow as hard and as fast as you can
into the device, note the reading.
Repeat three times. The ‘best of the three’ is the reading to record on the chart.
When recording a peak flow result, the three readings should be within 20
liters per minute of each other; if not the peak flow rate recording should be
repeated up to five times.
Peak Expiratory Flow Rate (PEFR)
Highest at night.
Effort Dependent.
Peak Expiratory Flow Rate (PEFR)
To find your personal best peak flow number, take peak flow readings:
1. Twice a day for two to three weeks when asthma is in good control.
2. At the same time in the morning and in the early evening.
3. You should always use the same peak flow meter and disregard any
readings that are very different from the rest.
Your personal best PEF is important because it is the number to which all of
your other peak flow reading will be compared.
Your asthma action plan, developed along with your asthma doctor, is
based on this number.
Once you have determined your personal best PEF, work with your asthma
Care provider to determine at what point you should relieve an asthma
attack or seek emergency medical attention. These are called your asthma
peak flow zones.
You should be relatively symptom free and can maintain your current
medical regimen.
If you are on chronic medications and peak flow is constantly in the green
zone with minimal variation, your physician my consider gradually
decreasing your daily medication.
Yellow Zone
Even then, the more severe forms of the disorder may take many weeks of
treatment before reversibility becomes apparent.
Monitoring of Asthma Treatment
PEF measurements are ideally compared to the patient’s own previous best
measurements using his or her peak flow meter.
Peak flow monitoring should not be used as a substitute or stand alone tool
for monitoring asthma severity.
Because PEFR is dependent on the level of client effort and because it may
be more sensitive to large airway than small airway narrowing, its
usefulness may be limited in some populations, e.g. young children or
individuals who are not highly motivated to give their best effort. Always
do a ‘best of three’ readings.
- Within 1 to 2 minutes.
- Inexpensive (meter costs less than Php 1000).
- Simple, useful for frequent follow up use.
Disadvantages
Submitted By:
Harbir Singh (Kento Hirabayashi)
Joana Mae Garcia
Regine Dumlao
CJ Cariaga