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Respiratory Measurement and Treatment
Gail M. Maier, Ph.D., R.N.Associate Director, ED&RThe Ohio State University Wexner Medical Center
Peak Flow and MDI
Objectives
Peak Flow Meters
A peak flow meter is a portable, hand held device which measures the maximum expiratory flow rate.
Readings can be obtained by health care staff and the patient
Readings can help the provider recognize early changes of worsening pulmonary function
Bronchoconstriction
Constriction of the air passages is a common occurrence in patients with asthma
Reduced peak flow readings correlate with severity of bronchoconstriction
Decreased expiratory flow rate can be recognized before demonstrable symptoms occur
Green Zone
Peak flow reading is 80-100% of the
patient’s normal peak
flow readings.
Considered “under control”
Regular maintenance
level of medications is
continued
Yellow Zone
The measured peak flow rate is 50-80% of the patient’s normal
peak flow measurement.
This indicates the beginning of narrowing
of the air passages.
The patient should use their “rescue inhaler”
or take a nebulizer treatment
Red Zone
The measured peak flow rate is less than 50%
This indicates severe bronchoconstriction and
symptoms will be observed, i.e. wheezing and shortness
of breath
Rescue inhaler needs to be taken immediately and the
physician notified
A hospital visit may be required
Inhalers for Respiratory Medication
Two types of inhalers• Metered dose inhaler
(MDI)• Dry powder inhaler
(DPI)
Using a MDI
An MDI can be used with or without a
spacer
A spacer makes it easier for some
to use the MDI
Watch the video demonstration of the MDI at the end of this program.
Review the attachment for the correct procedure
Using a Dry Powder Inhaler
Delivers medication to the lungs in the form of a dry powder
May require a procedure to prepare a measured dose of powder to be
ready for the patient to take
Medication is commonly held either in a capsule for manual loading or a
proprietary form from inside the inhaler
Using a DPI
Remove the cap or cover
Load a dose of medication• May have an
opening that you push medication into
• May have a lever that is pushed or twisted until it clicks
DPI procedure continued
Turn your head to the side
and breathe out as much as possible
Lungs should be as clear as possible so all
medication can be inhaled
DPI procedure continued
Close your lips around the DPI
firmly so that no
medication is able
to escape
Continue breathing in until
your lungs are
completely full.
Hold your
breath for at least 10
seconds
Slowly
breathe out
DPI procedure continued
If more than one dose is required, wait one full minute
before taking the second dose.
Place cover on the DPI. Avoid getting moisture or dirt into the
inhaler as it may clog the opening and reduce the amount
of medication that is being delivered.
Peak Flow Video
1:46 minutes
MDI Video
2:44 minutes
In summary
Proper use of inhalers, either the MDI or the DPI, is important for health care staff and patients to understand and to practice as it will increase the likelihood that the prescribed amount of medication is being delivered to the patient.
Please watch the following videos on the proper technique of obtaining peak flow meter readings and the use of an MDI and DPI type of inhaler.
Thank you for completing this module
If you have any questions, please contact me.
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