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.

Gail.Maier@osumc.edu

Survey

We would appreciate your feedback on this module. Click on the button below to complete a brief survey. Your responses and comments will be shared with the module’s author, the LSI EdTech team, and LSI curriculum leaders. We will use your feedback to improve future versions of the module.

The survey is both optional and anonymous and should take less than 5 minutes to complete.

Survey