Peak expiratory flow rate (PEFR) measurement often appears in OSCEs and requires you to both explain and demonstrate the skill. This step-by-step guide explains how to perform PEFR measurement in an OSCE setting with an included video demonstration.
Introduce yourself to the patient including your name and role.
Confirm the patient’s name and date of birth.
Briefly explain what the procedure will involve using patient-friendlylanguage: “Today we need to measure how well air flows in and out of your lungs, which is known as peak flow rate. To do this, we use a peak flow meter, which is this device here. By measuring peak flow we can check how well your asthma is controlled.”
Gain consent to proceed with PEFR measurement.
Position the patient so that they are sitting comfortably.
Ask the patient if they have any pain or shortnessofbreath before performing PEFR measurement.
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Ensure you clearly explain and demonstrate each of the following steps to the patient:
1. Ensure the peak flow meter is set to zero.
2. Position yourself sitting up straight or standing.
3. Take the deepest breath you are capable of.
4. Hold the peak flow meter parallel to the floor and position your mouth around the mouthpiece of the peak flow meter, creating a tight seal with your lips.
5. Exhale as forcefully as you are able to.
6. Note the reading on the peak flow meter, which is measured in litres per minute.
7. Repeat steps 1-6 twice more.
8. The highest reading of the three attempts should be used as the final result.
After you have explained and demonstrated PEFR measurement, observe the patient carrying out the procedure and providefeedback to allow them to refine their technique.
Insert peak flow mouthpiece
Explain the correct technique for measuring PEFR
Set the PEFR meter dial to zero
Demonstrate the PEFR measurement technique
Attach a new peak flow mouthpiece
Observe the patient's technique
Record the peak flow meter reading and ask the patient to repeat the process twice more
To complete the procedure…
Check if the patient has any questions regarding PEFRmeasurement.
Advise the patient to take regular peak flow readings, ideally each morning and night, recording them in a peak flow diary. Explain that these readings can then be reviewed to make informed decisions about their asthmatreatment.