KURSUS

PENGENDALIAN
ASTHMA
5/10/06
KPL MAHMOODIAH
PEAK FLOW METER
Penggunaan dan
penilaian
WHAT IS PEAK FLOW
METER?
 A simple, portable, inexpensive
device that you blow into

 It measures the fastest rate of

air (airflow) that you can blow
out of the lungs or peak
expiratory flow rate (PEFR).

 It records air flow in litres/min

WHAT IS PEAK FLOW
METER?
 A peak flow for asthma is
like a thermometer for
fever, BP set for HPT

 A tool that helps you

monitor what’s going on
inside your body.

 A peak flow meter can

help to determine airway
changes & better
management of asthma.
PEFR IN DIAGNOSIS OF
ASTHMA
 PEF increases > 15% 15-20min after
inhalation of a rapid-acting B2-agonist.

 PEF varies >20% from morning

measurement upon arising to
measurement 12hrs later in pts who are
taking a bronchodilator( > 10% in pts who
are not taking a bronchodilator).

 PEF decreases more than 15% after 6 min

of sustained running or exercise.
PEAK FLOW RATE – valuable
tool in asthma management
 Determine the severity of asthma
 Response to treatment during an acute
asthma episode
 Monitor progress in treatment of chronic
asthma & provide objective information for
any possible adjustments in therapy
 Detect worsening in lung function &
thereby avoid a possible serious flare-up
in asthma with early intervention
When should a PEAK FLOW
METER be used?
 Peak flow meters should be used regularly to
check how well the asthma is being controlled.

 The National Heart, Lung, and Blood Institute

(NHLBI) recommends measuring lung function
during the following times:
 every morning, before taking asthma medications
 during asthma symptoms or an asthma attack
 after taking medication for an asthma attack
 other times recommended by your physician
 HOW TO USE A PEAK FLOW
METER
 Make sure the device reads zero or is
at base level
 Stand up (unless you have a physical
disability),hold the PFM without
restricting movement of the marker.
 Take as deep of breath as possible
 Place the meter in your mouth & seal
your lips around the mouthpiece.
 Breathe out as hard and as fast as
possible
HOW TO USE A PEAK FLOW
METER
 Do not cough, spit or let your
tongue block the mouthpiece
 Write down the value obtained
 Return the marker to zero.
 Repeat the process two additional
times, and record the highest of
the three numbers in your chart.
 Record PEFR before & after using
inhalers
PEAK FLOW CHART
 Keep a chart of peak flow reading with each
day recorded in.

PEAK FLOW VARIABILITY

PEAK FLOW VARIABILITY
 Important measure of asthma control
 Without asthma or well-controlled asthma,
PEFR vary less 15%.
 PEFR is useful in monitoring the severity of
asthma at night.
 A decrease of 15% or greater from the
previous night’s measurement may
indicate nocturnal asthma
PEAK FLOW CHART
American Lung Association
WHAT IS NORMAL PEAK
FLOW READING?
 Normal PEFR reading
vary.
 Depending on age,
height & gender
 Normally, in healthy
people, peak flow
readings vary slightly
from time to time.
 The reading is often
slightly higher in the
evening compared to
the morning.
PEAK FLOW READING &
HEIGHT & PEFR ZONING
PERSONAL BEST
READING
 a 25-year-old man, who is 6'1"
(185cm or 1.85m) tall, to have an
average peak flow of 635 litres per
minute.

 a 40-year-old woman, who is 5'2"

(157cm or 1.57m) tall, to have an
average peak flow of 465 litres per
minute.

 a child who is between 6 and 15

years of age and 4'7" (140cm or
1.40m) tall, to have an average
peak flow of 300 litres per minute.
“PERSONAL BEST
READING”
 The personal best peak flow is
the highest PEFR of a patient.
 Can be achieve over 2 – 3
week period when the asthma
is under good control.
 Personal best values will
change as children grow taller
& as disease status changes
 ‘periodically readjust’
DETERMINE PERSONAL
BEST
 Always use the same peak flow meter.
 Record peak flow reading twice a day for 2
weeks.
 The highest PEFR value is the ‘personal
best.
 Asthmatic patient should make every
effort to maintain values within 80% of
personal best value.
WHAT ARE PEAK FLOW
ZONES
 Peak flow zones are based on the
traffic light concept: red means
danger, yellow means caution, and
green means safe.
 The goal of the peak flow zones is to
help to recognize when the asthma
may start to become uncontrolled.
 The goal is to stay within the 80
percent value of the personal best
peak flow measurement.
PEAK FLOW ZONES
 Green: PEFR 80 – 100% of
personal best; asthma is under
control.
 Relatively symptom-free
 Patient can maintain current
asthma management.
 PEFR constantly in the green
zone with minimal variation –
consider gradually decreasing
daily medication
PEAK FLOW ZONES
 Yellow: PEFR 50 -79% of personal
best
 ‘Caution’ as asthma is getting
worse;
 A temporary increase in asthma
medication is indicated
 If on chronic medication,
maintenance therapy need to be
increased.
PEAK FLOW ZONES
 Red: PEFR below 50% of personal best
 ‘Danger’- medical alert,
 Asthma management program is failing to
control symptoms.
 Used inhaled bronchodilator.
 If PEFR reading do not return to yellow
zone, seek medical help immediately.
 Maintenance therapy need to be increased
TERIMA KASIH
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