![]() ![]() If patients do not put in their best possible effort, the results may not give a true reflection of their current respiratory state. It depends significantly on the patient’s technique, cooperation and effort, so clear instructions, demonstration and encouragement are required.PEFR expressed as % of best or predicted valueĪlthough peak flow measurement is a simple, inexpensive and easily performed technique, there are several drawbacks to its use, which must be considered: The peak expiratory flow rate (PEFR), expressed as a percentage of the best or predicted value, is a useful tool in establishing the severity of an asthma attack. ‘Normal’ is considered to be a reading that is at least 80% of the predicted or best known value. The greatest reading is compared either with the patient’s own best known reading or with a standardised chart that predicts what it should be according to height and gender ( Figure 64.2). The best reading of three is taken so that the patient’s best effort is what is documented. If measurements are taken daily for monitoring purposes, they should be taken at the same time each day. Patients will often keep a peak flow diary, which can be used to demonstrate this. In addition, diurnal variation is often seen in asthma, with early morning dips in the peak flow values. Recording serial peak flow readings provides objective evidence of progress or response to treatment of the airway obstruction. The trend in peak flow rate is more important than the actual value. However, there are also patients with COPD or emphysema who demonstrate a degree of reversibility, so the differentiation in diagnosis between COPD or asthma is not always clear. If there is no convincing reversibility, the diagnosis is unlikely to be asthma but may well be chronic obstructive pulmonary disease (COPD). ![]() Following administration of a bronchodilator, for example via a salbutamol nebuliser or inhaler, an improvement of over 15% in peak flow rate indicates that the airway obstruction has a reversible component, in keeping with asthma. Peak flow can be used to diagnose asthma by demonstrating ‘reversibility’. Symptoms: Another way to monitor your asthma control is to track your symptoms.Peak flow measurement is useful in the diagnosis and monitoring of obstructive airway disease.Your healthcare provider will use your personal best peak flow rate to calculate the zones in your asthma action plan. Your personal best is the highest peak flow number you achieve in a two- to three-week period. To use your peak flow rate to determine the zones on your asthma action plan, you first need to spend some time determining your personal best. Your peak flow rate is measured with a peak flow meter. Your peak flow rate can show if your asthma is getting worse, even before you feel symptoms. Peak Flow Rate: Your healthcare provider may want you to use peak flow monitoring, especially if you have moderate to severe asthma.Your asthma action plan can be based on peak flow rate or asthma symptoms. You should work with your healthcare provider to determine your zones. ![]() Follow the steps in your asthma action plan and get immediate medical treatment if your symptoms do not improve. And, the red zone means you are experiencing severe asthma symptoms or an asthma flare-up. This is where you should slow down and follow the steps including the use of your quick-relief medicine to keep your asthma from getting worse. The yellow zone means that you are experiencing symptoms. Continue to take your long-term control medicine(s) even if you're feeling well. In this zone, you have no asthma symptoms and you feel good. The green zone is where you want to be on a daily basis. An asthma action plan is divided into three zones (green, yellow and red). ![]()
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