Professional Documents
Culture Documents
● Vitalograph £6.65
PEAK FLOW
Causes of reduced peak flow
● Larynx
• tumour, oedema.
● Trachea
• tumour, goitre, strictures, relapsing polychondritis.
● Bronchi
• tumour, foreign body, asthma, COPD, bronchiectasis.
● Lung parenchyma
• tumour
● Chest wall
• ankylosing spondylitis, neuromuscular disease.
PEAK FLOW
‘Normal’
● Asthma
● ILD
● Mild COAD
● Asymptomatic smoker
PEAK FLOW
Pitfalls in measurement
● Poor effort
• confusion, weakness, lack of motivation, lack of co-ordination
emergency help
● Occupational testing
Bronchodilator reversibility
test
Patients Peak flow Predicted Peak flow
Post bronchodilator
Peak flow
6 minutes exercise
+5
+10
+20
Steroid trial
30 mg oral prednisolone daily
400
PEF l/min
300
200
100
1 7 14 21 28
Days
PEAK FLOW
● Cleaning
– Manufacturers instructions
● Wash in detergent
● Milton
● Dishwasher
● Glutaldehyde
● Calibration
● Very difficult to calibrate flow accurately
● Quality control
● Reference values for ‘normal’ staff