Peak flow and inhaler technique Flashcards
How would you explain peak flow to a patient?
Brieflyexplainwhat the procedure will involve usingpatient-friendlylanguage:“Today we need to measure how well air flows in and out of your lungs, which is known aspeak 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.
What are the steps of peak flow measurement?
- Ensure the peak flow meter is set to zero.
- Position yourself sitting up straight or standing.
- Take the deepest breath you are capable of.
- 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.
- Exhale as forcefully as you are able to.
- Note the reading on the peak flow meter, which is measured in litres per minute.
- Repeat steps 1-6 twice more.
- The highest reading of the three attempts should be used as the final result.
What would you advise patients about the frequency of peak flow measurement?
Advisethe patient to takeregular peak flow readings, ideally each morning and night, recording them in apeak flow diary. Explain that these readings can then be reviewed to make informed decisions about theirasthmatreatment.
How would you generally tell a patient about an inhaler?
Provide ageneral overviewof the patient’sinhaler:
- You have been started on ….(name of inhaler)…for your asthma.”
- “This is what the inhaler looks like.”
- “This is the mouthpiece, this is the canister containing the medication and this is the dose counter.”
What are the different types of inhalers?
- Reliever(e.g. salbutamol inhaler)
- Preventer (e.g. beclomethasone inhaler)
- SMART (Single Maintenance and Reliever Therapy) regime
How would you explain a reliever to a patient?
“(Name of inhaler) is a reliever. This is useful to help relieve sudden asthma attacks. It works by relaxing the airways so that you can breathe more easily. You shouldn’t need this more than three times a week if your asthma is well controlled. Ask your GP for a review if you are using this more frequently. I would like you to inhale (x puff(s)) when you feel short of breath.”
How would you explain a preventer to a patient?
“(Name of inhaler) is a preventer – it helps to reduce the swelling in the airways and stops them from tightening up. You use this inhaler to reduce the risk of having asthma attacks. I would like you to inhale …(x puff(s))…(x time(s) a day)…everyday. It’s really important that you don’t miss doses, as regular use is key to keeping your asthma under control.”
“You should rinse your mouth after you use this inhaler as otherwise, you might develop a sore and inflamed mouth.”
How would you explain a SMART to a patient?
“Symbicort is used as both a preventer and a reliever. You need to use this regularly …(x puff(s))…twice a day to prevent symptoms and …(x puff(s))…each time you have an attack.”
“You should rinse your mouth after you use this inhaler as otherwise, you might develop a sore and inflamed mouth.”
How would you ask to check for a patient’s understanding?
“To make sure you’ve understood everything I’ve said could you tell me what type of inhaler you have and when it should be used? Don’t worry if you can’t remember everything right away, we can always go back over the important information.”
What should you do before using the inhaler?
Device test
If the inhaler hasn’t been used for5 days or more, the patient should be advised totest the device before using it:
1.Remove the cap and shake the inhaler well.
2.Point the mouthpiece away from you and press the canister to release a puff into the air.
Dose counter
Some inhalers have adose counterwhich shows thenumber of remaining dosesleft in the inhaler. Advise the patient tocheck the inhaler is not emptyand toseek a replacementwhilst they still have several doses left.
Expiry date
Theexpiry date shows when the medication within the inhaler will expire andno longer be effective. The expiry date is typically located on themetal canister of the inhaler. Advise the patient toseek a replacementin advance of their inhaler expiring and to avoid using it after the expiry date.
How would you use a spacer?
- Prepare the inhaler as previously explained.
- Attach the inhaler mouthpiece to the spacer device.
- Breathe out gently and slowly away from the spacer until your lungs feel empty.
- Place your lips around the spacer mouthpiece to create an effective seal.
- Release one dose of the inhaler into the spacer device.
- Breathe deeply, both in and out, through the spacer mouthpiece several times.
- Administer a second dose if required.
How often should you clean a spacer?
Once per month with detergent, leave to air dry
Replace every year
What are the main side effects of salbutamol?
salbutamol can cause tachycardia and tremor, particularly at higher doses.
What are the main side effects of steroids?
steroid inhalers can cause candidiasis, particularly if the patient doesn’t wash their mouth out effectively after each use.
How would you close a inhaler use consultation?
Check if the patient has anyquestions regardinginhaler technique.
Advisethe patient to use their inhalersas directed.
Explainthe potentialside effectsthey may experience when using their inhalers
Advise that if the patient has anasthma attackthatdoes not respondto their salbutamol inhalerafter10 puffs(with 30 seconds between each puff) they shouldcall 999 for urgent medical assessment.
Provide aninformation leafletfor the relevant inhaler device.
Arrange afollow-upappointment tore-assessthe patient’s inhaler technique.
Thank the patientfor their time.
Dispose of PPEappropriately andwash your hands
