Contraindications - LF Testing Flashcards
What is a contraindication?
Suggest or indicate A particular technique/drug that should not be used in the case in question.
Absolute VS Relative Contraindications?
Absolute - cause injury, trauma or death
Relative - require the requesting physician or scientists to judge when it is appropriate or safe to perform the test
4 key factors to look out for when completing Respiratory tests?
1) Maximal pressures generated in the thorax (impact on thoracic/abdominal organs/tissues)
2) Large swings in blood pressures causing stress on body tissues
3) Expansion of chest wall/lungs
4) Active communicable diseases (TB/HepB/HIV)
Spirometry Contraindications?
1) Haemoptysis of unknown cause - forced manoeuvre may aggravate underlying cause
2) Pneumothorax
3) Unstable cardiovascular status - forced manoeuvre may worsen angina or cause BP change
4) Pulmonary Embolism (PE) or recent MI
5) Thoracic, abdominal or cerebral aneurysms - danger of rupture due to increased thoracic pressure
6) Acute illness or symptoms (nausea)
7) Recent thoracic, abdominal or eye surgery
8) Infection
What is an Aneurysm?
- Bulge in a blood vessel (artery)
- Weakened/damage in blood vessels
- Develop anywhere BUT common in abdominal or thoracic aorta/ cerebral (brain)
- As it gets bigger increases risk of rupture
- haemorrhage
- sudden death
What is Pneumothorax?
- Abnormal collection of air in the pleural space
- Compresses the lung, causing collapse or partial collapse of the lung
- Causes, include:
- trauma / underlying lung disease (COPD)
- patients on mechanical ventilation
- no obvious cause
–> Symptoms inc chest pain and breathlessness
Risk Matrix?
The risk of any test must be outweighed by the benefit gained.
Precautions for LF tests?
- Discussion with clinician/senior staff
- Test appropriate?
- Limited no. of test manoeuvres
- Performed in ‘Safe” setting
- Alternative test?
Sleep Studies/Overnight Oximetry
- -> Patients at risk from strangulation from wires/leads on monitoring devices - risk assessment
- -> Children at particular risk
- -> prisons suicide risk from tubing
CPAP treatment
Prescribed by those with appropriate training/understanding of complications/contraindications:
- Epistaxis = nose bleed
- Recurrent/Untreated Pneumothorax = collapsed lungs
- Bullous lung disease = COPD/hyper-inflated lungs
- Recent ENT surgery/ear infections/severe sinusitis
- Laryngeal Trauma
- Lacerations/facial burns (mask)
- Central Sleep Apnoea
- Raised intracranial pressure
Alternative Tests?
- Spirometry … Relaxed VC
- Respiratory Muscle Pressures …Oscillometry (Breathe normally)
- FET … Field Exercise Tests
- Blood Gases … Pulse Oximetry/Transcutaneous monitoring
Infection control?
- Requirement for urgent PFT testing in TB is rare
- Immunocompromised patients usually tested first
- MRSA
- Common Cold v Chest Infection
- Bacterial and Viral filters
- Hand washing/ good lab procedures
- Up to date vaccinations
