Respiratory: Measuring peak expiratory flow rate (for nursing assistant training)

Peak expiratory flow rate, or PEFR for short, is the fastest and the hardest someone can exhale after a full inspiration.

This can be used to measure the client’s ability to push air out of their lungs and, thus, measure the amount of obstruction in the airways of clients with certain respiratory conditions, like asthma.

This is essential to determine how open their lungs are, if their treatment is working properly, and if they need a dose adjustment or even a new medication.

Measurement of PEFR is performed with a special portable handheld device called a peak flow meter.

This is made up of a mouthpiece attached to a numbered scale with a small arrow that moves as the client blows air out, indicating the speed of airflow measured in liters per minute.

Now, before you start assisting a client with measuring PEFR, here are some general considerations.

Clients that are experiencing pain, motor function impairments, and people with dementia or other cognitive impairments might be unable to measure PEFR independently. Those who can, should perform PEFR measurements at home or in a healthcare facility.

Measurements are done regularly at certain times, such as first thing in the morning and last thing at night, before or after using asthma medications, or when experiencing symptoms of an asthma exacerbation, like shortness of breath, cough, or wheezing.

When assisting a client with their PEFR test, first make sure the client is standing erect if they’re able.

The arrow should be set on the zero mark and a clean, disposable mouthpiece should be attached to the device.

Instruct the client to inhale through the mouth by taking a deep breath and placing their lips tightly around the mouthpiece, keeping their tongue away from the opening.

Then, the client should exhale as fast and forcibly as possible. This process should be repeated twice more.

Each time, make sure their head remains in the same position and that arrow is reset to zero. Dispose of the mouthpiece and practice hand hygiene before and after the procedure.