Peak expiratory flow rate (PEFR) measures maximum airflow during forceful exhalation. PEFR indicates large airway flow, influenced by lung recoil and patient strength.
Maximal airflow during expiration may reflect effort rather than airway obstruction if values are low.
Measuring PEFR with a portable device is popular for monitoring airway obstruction in asthma and other pulmonary conditions.
Forced expiratory volume in 1 second reflects airway obstruction more accurately than peak expiratory flow rate.
PEFR monitoring is accurate for patients over 5 years, usually using a portable flow gauge or via a transducer during spirometry.
PEFR measurement is frequently used at home for both short- and long-term asthma monitoring benefits.
Proper PEFR measurement offers objective data for patients and clinicians to make therapeutic decisions.
Indications
Monitoring Asthma
Monitoring effects of ozone
Monitoring of COPD
Occupational and Environmental Health Monitoring
Assessment of Response to Bronchodilators
Feedback on predicted PEFR may enhance respiratory awareness and medication adherence in urban minorities.
Contraindications
Hemoptysis of Unknown Origin
Recent Pneumothorax
Recent Thoracic, Abdominal, or Eye Surgery
Unstable Cardiovascular Condition
Severe Obstructive Airway Disease
Recent Stroke or Neuromuscular Disorders
Acute Infectious Conditions
Outcomes
It conflicts data exists on PEFR monitoring’s asthma efficacy.
PEFR monitoring linked to comprehensive programs enhances benefits with symptom diaries and education.
PEFR monitoring equals symptom-based asthma action plans.
Symptom-based monitoring may lead patients to misuse medication unintentionally.
PEFR monitoring compliance is low due to record-keeping difficulties.
PEFR measurement is less useful for young children and elderly, but beneficial for poor and minority group children.
Equipment required
Peak Flow Meter
Mouthpiece
Cleaning Supplies
Patient Preparation:
A full stomach may affect effort while waiting for 1 to 2 hours after eating is ideal. Withhold short-acting bronchodilators 4–6 hours for assessment.
Choose calibrated peak flow meter for patient’s age and condition.
Before each use, ensure the indicator is at the starting position i.e, at zero.
Informed Consent:
Explain the procedure’s risks and potential complications clearly to the patient.
Patient Positioning:
PEFR is measured conventionally while standing or seated upright. PFM mouthpiece is inserted and sealed with lips in patient’s mouth.
The tongue should not be placed in the front opening of the meter.
Figure. Peak expiratory flow rate measurement
Technique
Step 1: Deep Inhalation:
Inform the patient to take a deep breath in to fill the lungs completely.
Step 2: Mouthpiece Placement:
Place the mouthpiece between the lips that ensure a tight seal without biting. Patients should not block the meter opening with the tongue.
Step 3: Forceful Exhalation:
Guide the patient to blow out as hard and as fast as possible in one quick blast.
Step 4: Recording the Reading:
Note the number where the indicator stops. Then repeat this rest in three attempts.
Allow a short rest with 30 seconds to 1 minute between attempts.
Perform three consecutive blows and record the highest value.
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Home » Procedure » Peak Expiratory Flow Rate Measurement
Peak Expiratory Flow Rate Measurement
Updated :
May 6, 2025
Peak expiratory flow rate (PEFR) measures maximum airflow during forceful exhalation. PEFR indicates large airway flow, influenced by lung recoil and patient strength.
Maximal airflow during expiration may reflect effort rather than airway obstruction if values are low.
Measuring PEFR with a portable device is popular for monitoring airway obstruction in asthma and other pulmonary conditions.
Forced expiratory volume in 1 second reflects airway obstruction more accurately than peak expiratory flow rate.
PEFR monitoring is accurate for patients over 5 years, usually using a portable flow gauge or via a transducer during spirometry.
PEFR measurement is frequently used at home for both short- and long-term asthma monitoring benefits.
Proper PEFR measurement offers objective data for patients and clinicians to make therapeutic decisions.
Monitoring Asthma
Monitoring effects of ozone
Monitoring of COPD
Occupational and Environmental Health Monitoring
Assessment of Response to Bronchodilators
Feedback on predicted PEFR may enhance respiratory awareness and medication adherence in urban minorities.
Hemoptysis of Unknown Origin
Recent Pneumothorax
Recent Thoracic, Abdominal, or Eye Surgery
Unstable Cardiovascular Condition
Severe Obstructive Airway Disease
Recent Stroke or Neuromuscular Disorders
Acute Infectious Conditions
It conflicts data exists on PEFR monitoring’s asthma efficacy.
PEFR monitoring linked to comprehensive programs enhances benefits with symptom diaries and education.
PEFR monitoring equals symptom-based asthma action plans.
Symptom-based monitoring may lead patients to misuse medication unintentionally.
PEFR monitoring compliance is low due to record-keeping difficulties.
PEFR measurement is less useful for young children and elderly, but beneficial for poor and minority group children.
Peak Flow Meter
Mouthpiece
Cleaning Supplies
Patient Preparation:
A full stomach may affect effort while waiting for 1 to 2 hours after eating is ideal. Withhold short-acting bronchodilators 4–6 hours for assessment.
Choose calibrated peak flow meter for patient’s age and condition.
Before each use, ensure the indicator is at the starting position i.e, at zero.
Informed Consent:
Explain the procedure’s risks and potential complications clearly to the patient.
Patient Positioning:
PEFR is measured conventionally while standing or seated upright. PFM mouthpiece is inserted and sealed with lips in patient’s mouth.
The tongue should not be placed in the front opening of the meter.
Figure. Peak expiratory flow rate measurement
Step 1: Deep Inhalation:
Inform the patient to take a deep breath in to fill the lungs completely.
Step 2: Mouthpiece Placement:
Place the mouthpiece between the lips that ensure a tight seal without biting. Patients should not block the meter opening with the tongue.
Step 3: Forceful Exhalation:
Guide the patient to blow out as hard and as fast as possible in one quick blast.
Step 4: Recording the Reading:
Note the number where the indicator stops. Then repeat this rest in three attempts.
Allow a short rest with 30 seconds to 1 minute between attempts.
Perform three consecutive blows and record the highest value.
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