Peak Flow Procedure
Best Practice Respiratory Distress
In an acute situation where the patient is experiencing respiratory distress it may be appropriate to only take one reading. If the patient is unable to perform a peak flow this should be recorded.
Principle Rationale
The highest forced expiration should be recorded on the peak flow chart.
To keep a record of the patients progress
The procedure should be recorded at least twice daily morning and evening. Frequency of recordings will be increased depending on the severity of patients condition and medical staff instructions. It may be requested before and after nebulisers or inhalers.
To obtain a comparison of variation of airway function and any response to therapies.
Reversability Testing
Peak flows are often performed to test the effectiveness of medications.
A peak flow recording is taken prior to administering the medication and recorded on the peak flow chart with a large dot. The post medication peak flows should be recorded using an X. If both recordings are the same it should be recorded with a cross over the top of the large dot.
Note that an anticholinergic e.g.; "Ipratropium bromide (Atrovent) has a maximum effect 30-60 mins after its use" (British National Formulary 2001) so its effects should be assessed after 30 minutes. Administration of Salbutamol or Terbutaline, if used singly, can be assessed after 15mins. However, if used together, assessment should take place after 30 minutes.