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Difficulty in obtaining peak expiratory flow measurements in children with acute asthma

Marc H Gorelick1, Molly W Stevens, Theresa Schultz

  • 1Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA. mgorelic@mail.mcw.edu

Pediatric Emergency Care
|January 13, 2004
PubMed

Insights

Peak expiratory flow rate (PEFR) measurements are challenging in children with acute asthma. Many children cannot adequately perform PEFR, limiting its use in emergency department evaluations.

Area of Science:

  • Pediatric Emergency Medicine
  • Respiratory Physiology
  • Asthma Management

Background:

  • Acute asthma exacerbations in children are common in emergency departments.
  • Peak expiratory flow rate (PEFR) is a key metric for assessing asthma severity.
  • Accurate PEFR measurement is crucial for guiding treatment decisions.

Purpose of the Study:

  • To assess the feasibility of obtaining reliable peak expiratory flow rate (PEFR) measurements in children aged 6 years and older presenting with acute asthma to an emergency department (ED).
  • To determine the frequency of adequate PEFR performance in this pediatric population.
  • To identify factors influencing the ability to perform PEFR.

Main Methods:

  • Prospective cohort study involving children aged 2-18 years treated for acute asthma in a pediatric ED over 12 months.
  • PEFR was to be measured before and after bronchodilator therapy in children aged 6 years and older.
  • Registered respiratory therapists assessed the adequacy of PEFR maneuvers.

Main Results:

  • Of 456 children enrolled (6-18 years), 64% had PEFR measured at least once; only 65% of those could perform it adequately.
  • Initially, 54% of children could perform PEFR; 72% of those unable to perform initially remained unable after treatment.
  • Children unable to perform PEFR were younger and more likely to be admitted to the hospital.

Conclusions:

  • Obtaining adequate PEFR measurements in children with acute asthma in the ED is difficult.
  • Reliance solely on PEFR for evaluating asthma severity in pediatric ED settings is not recommended.
  • Alternative or complementary methods may be needed for accurate assessment.
Abstract

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