1. Peak Flow Measurements in practice Lea Katajarinne RN, PHN, MA Nurse Administrator, Trainer Finnish Institute of Occupational Health Department of Research and Development in OHS e-mail:lea.katajarinne@ttl.fi

2. Guidance on peak flow measurements Personal guidance and motivation of the patient Guidance /control of the right blowing technique Guidance/control of the right intake of medicine Guidance on how to fill out the form, example row lkat /twin/17.9. 2003

3. Peak flow workplace follow-up An investigation without medication, when work-related asthma is suspected Bronchodilator if needed, same asthma medication every day (if on inhaled steroids) Measurements: every two hours during workdays and the same on days off first in the morning immediately at wake-up all the day every two hours at night if awake, other times if symptoms lkat/twin/17.9. 2003

4. How to blow PEF Ensure that the pointer is set at Zero Hold the Peak Flow Meter so that your fingers are clear of the scale and slot, do not obstruct the holes at the end of the meter Take a deep breath, place the Peak Flow Meter in the mouth and hold horizontally, closing the lips around the mouthpiece, then blow short as hard and as fast you can lkat/twin/17.9. 2003

5. How to blow PEF Note the scale indicated by the pointer Return the pointer to Zero(L/Min position) Repeat the procedure twice more to obtain three readings on the chart The differense between the two best results is not allowed to be more than 20 units Choose to stand or sit when you blow, but DO IT ALWAYS IN THE SAME POSITION lkat/twin/17.9. 2003

6. Recording PEF results Instruction to the worker lkat/twin/17.9. 2003 F= FREE W= WORK

7. 580 530 550 530 450 200 430 350 550 350 540 300 500 250 580 480 300 430 280 470 350 470 300 460 300 550 450 lkat/twin/17.9. 2003 Recording PEF results

8. lkat/twin./17.9. 2003