Current guidelines

Canllawiau presennol

Scan of lung

Peak Expiratory Flow Rate (PEFR) is an assessment tool to aid the diagnosis of asthma, which would be carried out in Primary Care. It is a useful tool for monitoring asthma control as per NICE guidance.

Current legislation, local and national guidance and protocols.

Recording PEFR daily will help to maintain good control; it can also decrease the risk of an attack. It is also an essential component for self-monitoring and part of the written asthma plan given to people with asthma.

www.asthma.org.uk

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Standard checks that should be undertaken on equipment

The meters should be EU compatible. Standard range meters are to be used in adults and low range meters in children.

A single use one-way disposable mouthpiece should be used and the meter should be washed in warm, soapy water. The meter should be dry before use.

National ‘age wise’ distribution of height and PEFR ranges

The result of the PEFR is influenced by height, age and sex. For example, a man and a woman of the same height and age would get different results. You could expect the male to have a higher reading than the female.

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Prior to performing the test, the individual should be assessed for any contraindications, such as being acutely unwell, an extremely abnormal respiratory rate, wheezing, acute shortness of breath or any recent surgery. It’s also important to identify any potential concerns the individual may have about the test.

Normal respiratory rate may be affected by anxiety, illness or infection.

Prior to taking a PEFR reading, the procedure should be explained to the individual/carer/guardian and verbal consent should be obtained.

To perform the test, the individual should ideally be standing, but if not possible, they should be sitting in their most upright position so that the result is as accurate as possible.

Then the following steps should be followed:

  1. The individual should be informed to exhale, completely emptying their lungs.
  2. The individual should then inhale deeply, filling their lungs with air.
  3. Insert the tube into the individual’s mouth, ensuring a tight seal.
  4. The individual should then exhale blowing as hard and fast as possible into the tube.

Constant monitoring of the individual should be performed throughout the test to ensure no ill effects such as coughing or light headedness.

Three readings should be taken for reliability. The best result of the three should be used and documented.

Dull asesu yw llif allanadlol (PEFR) i helpu i wneud diagnosis o asthma, a fyddai'n cael ei gynnal mewn Gofal Sylfaenol. Mae'n ddull defnyddiol o fonitro rheoli asthma yn unol â chanllawiau NICE.

Deddfwriaeth bresennol, canllawiau lleol a chenedlaethol a phrotocolau.

Bydd cofnodi llif allanadlol (PEFR) bob dydd yn helpu i gynnal rheolaeth dda; gall hefyd leihau'r risg o bwl. Mae hefyd yn gydran hanfodol ar gyfer hunanfonitro ac yn rhan o'r cynllun asthma ysgrifenedig sy'n cael ei roi i bobl ag asthma.

www.asthma.org.uk

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Archwiliadau safonol a ddylai ddigwydd gyda chyfarpar

Dylai'r mesuryddion fod yn gytûn â'r UE. Rhaid defnyddio mesuryddion ystod safonol mewn oedolion a mesuryddion ystod isel mewn plant.

Dylid defnyddio darn ceg unffordd tafladwy a dylid golchi'r mesurydd mewn dŵr cynnes sebonllyd. Dylai'r mesurydd fod yn sych cyn ei ddefnyddio.

Dosbarthiad 'oed briodol' cenedlaethol o daldra ac ystodau PEFR

Mae taldra, oedran a rhyw yn dylanwadu ar ganlyniad llif allanadlol (PEFR). Er enghraifft, byddai gwryw a menyw o'r un taldra ac oed yn derbyn canlyniadau gwahanol. Gallech chi ddisgwyl i'r gwryw gael darlleniad uwch na'r fenyw.

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Cyn gwneud y prawf, dylid asesu'r unigolyn ar gyfer unrhyw wrthrybuddion, fel bod yn ddifrifol wael, cyfradd resbiradol hynod annormal, gwichian wrth anadlu, diffyg anadl difrifol neu unrhyw lawfeddygaeth ddiweddar. Mae hefyd yn bwysig adnabod unrhyw bryderon posibl sydd gan yr unigolyn am y prawf.

Gall gorbryder, afiechyd neu haint effeithio ar y gyfradd resbiradol arferol.

Cyn cymryd darlleniad llif allanadlol (PEFR), dylid esbonio'r driniaeth i'r unigolyn/gofalwr/gwarcheidwad a dylid cael cydsyniad ar lafar.

Yn ddelfrydol i gynnal y prawf, dylai'r unigolyn fod yn sefyll, ond os nad yw'n bosibl, dylai fod yn eistedd mor syth ag y gallai fel bod y canlyniad mor gywir â phosibl.

Yna dylid dilyn y camau canlynol:

  1. Dylid gofyn i'r unigolyn anadlu allan, gan wagio ei ysgyfaint yn llwyr.
  2. Yna dylai'r unigolyn anadlu'n ddwfn, gan lenwi ei ysgyfaint ag aer.
  3. Rhowch y tiwb i mewn i geg yr unigolyn, gan sicrhau ei fod wedi'i selio'n dynn.
  4. Yna dylai'r unigolyn allanadlu mor galed a chyflym â phosibl i'r tiwb.

Dylid monitro'r unigolyn yn gyson drwy gydol y prawf er mwyn sicrhau nad oes unrhyw effeithiau gwael fel pesychu neu deimlo'n benysgafn.

Dylid cymryd tri darlleniad ar gyfer dibynadwyedd. Dylid defnyddio a dogfennu y canlyniad gorau o'r tri.