Spirometry testing

-patient demographics -brief clinical details -tests required -infection risk -signature of requesting physcian

-spirometer -calibration syringe -consumables (mouthpiece, bacterial and viral filter -nose clip -room thermometer

-pulse oximeter -disinfectant wipe -alcohol gel -tissues

-machine is working -consumables prepared -calibration checked -room temp recorded

-refrain from smoking for 24hrs -refrain from consuming alcohol for at least 4hrs before test -stop excersising at least 30mins before -do not eat a large meal in the 2hrs before -refrain from taking bronchodilators for the duration of their action

-introduction to patient -patient ID -contraindictions -patient history -influencing factors -height and weight

-may be absolute or relative -if contraindications are present, check with a senior member of staff before proceeding with the test -spirometry could cause harm or discomfort to the patient

-unstable cardiac status -haemoptysis of unknown origin -Infectious disease -pneumothorax -pulmonary emboli -recent thorax or abdomen surgery -thoracic,abdominal, cerberal aneurysms -eye surgery -acute disease process -extreme breathlessness

FEV1 but not FVC and using relaxed VC to calculate a FEV1/VC%

-check compliance with pre test instructions -drug history- inhaled medication -smoking history

1-which drugs -short or long acting? steroids? 2-what devices? -metered dose inhaler, dry powder device 3-what dose and frequency? -eg 2 puffs twice a day 4-when was it last taken? -record time before test

Yes- respiratory medicines -oral steroids -nebuliser/neubulising drugs -oxygen -otc medication

Number of cigarettes a day /20 x number of years smoked 1 pack year= 20 cigarrettes every day for 1 year

-heavy meal -alcohol -vigorous excersise -restricting clothing -false teeth -continence

minimum 3 attempts

1-explain 2-gain consent 3-enter patient details into spirometer 4-attach mouthpiece to spirometer 5-nose clips on patient 6-get patient to breath normally- stable baseline 7-then ask patient to breath in until absolute full 8-patient breathe out at a rate thats comfortable, until completly empty -remove mouthpiece -wait at least 30 seconds between each test -repeat until you obtain 3 acceptable and reproducible results

1-patient put mouthpiece into their mouth , tight seal with lips 2-patient breathe normally to obtain a stable baseline 3-patient breathe in until absolutely full 4-patient needs to blast out as hard and as fast as possible until completly empty 5-allow patient at least 30sec between tests -repeat until you achieve 3 acceptable and reproducible results

1-watch the patient closely 2-make sure they fully breathe in 3-make sure they put the mouthpiece in their mouth/tight seal 4-check no hesitation between inhaling and blasting out 5-ensure patient maintains good posture 6-watch the spirometer 7-enourage the patient 8-ensure plateau is achieved on spiromgram/FEV>15 seconds

1-rapid start to expiration 2-end of forced expiration 3-plateau achieved/ patient has exhaled for at least 6 seconds 4-patient has a FEV of >15 seconds 5-patient is unable to achieve a plateau

-three acceptable and reproducible results -no more than 100mls between each blow -Highests FEV1 and FVC from 3 efforts meeting repeatibility critera or within 5% of each other- whatevers smaller (below 1l) or higher (above 1l)

-smooth curve, upward and free or irreggularities -must reach a plateau -expiration must last at least 6 seconds

-almost vertical rise to PEF -sharp point at PEF -trace free of irregularities -trace merges with y axis

1-allow the patient to rest before leaving 2-inform patient of how they will be told about the results of the test 3-select the best 3 tests to be reported 4-note any influencing factors 5-write technical report 6-produce a report of test 7-dispose of consumables 8-clean equiptment 9-hand hygiene

pre test: 5min -record height and weight -ensure patient is comfortable -record medication record pulse oximetry test: 10min -set up equiptment -patient details -explain procedure -test report: 5min -technical report and clinical interpretation