Picflowmetry  is a method of determining the peak expiratory flow rate. It is used to study lung function, to determine the obstruction of the bronchial tree.

The use of picflowmetry:

  • Assessment of bronchial obstruction severity and severity of bronchial asthma, COPD.
  • Objective monitoring of bronchial obstruction in outpatient conditions: observation of fluctuations in the degree of bronchial obstruction during the day, assessment of the effectiveness of therapy at home, monitoring of lung function during work and at the workplace; identification of some factors that provoke bronchospasm.
  • Determination of the degree of reversibility of bronchial obstruction.
  • Differential diagnosis of bronchial asthma and other chronic lung diseases.
  • Screening of patients with bronchial obstruction.
 

The equipment needed to perform this skill: 

  • pycfloumeter
  • chart
  • cotton balls 
  • antiseptic
  • Disinfection MI container
  • laptop  
  • virtual simulator “Picflowmetry”
  • diary

Description of the clinical situation (variant): 

You are a general practitioner. A patient has come to see you with a diagnosis of bronchial asthma, mild intermittent asthma. Due to deterioration of the patient's condition, picofluorometric monitoring is prescribed three times a day. Instruct the patient in the use of the picofluorometer. Conduct the study and interpret the results. 

The order in which the skill is performed:

Preparatory stage:

  • introduce yourself
  • Identify the patient by asking him/her to give his/her last name, first name, middle name, date of birth
  • take a history
  • Explain the purpose and progress of the procedure
  • obtain verbal informed consent
  • assess the patient's condition 

Patient position: standing. 

Main Stage: 

  • Perform hygienic hand sanitization
  • Pick up the device
  • Explain to the patient how to hold the picflowmeter so as not to interfere with the movement of the result pointer
  • Ensure that the pointer is at the beginning of the scale
  • Treat the mouthpiece of the picflowmeter with an antiseptic balloon
  • Dispose of the balloon in an appropriate container
  • Ask the patient to take a deep breath
  • Take the mouthpiece into the mouth.
  • Place lips firmly around the mouthpiece
  • Do not block the opening of the mouthpiece with the tongue and exhale with the greatest force and speed.
  • Record the result
  • Return the pointer to its original position
  • Ask the patient to repeat the procedure twice more
  • Record the best result according to gender, age, height (table data)
  • Interpret the result 

Note:

  • result >90% of normal - normal; 80-89% of normal - mild course; 50-79% of normal - moderate decrease, patient requires intensification of therapy; <50% of normal - sharp decrease;
  • Daily variability of peak expiratory flow rate (PEF) - not more than 20%

Final Step: 

  • Teach the patient to keep a diary
  • Teach the patient how to interpret the results correctly

 

Last modified: Monday, 30 September 2024, 3:00 PM