Spirometry

Question 1

What is important to remember when setting up/beginning spirometry ?

Answer 1

• Patients should have spirometry performed sitting down as forced exhalation may cause dizziness.
• Ensure adequate hand hygiene Introduce yourself and explain your role.
• Explain to the patient what you are proposing to do and why and what they will need to do in order to perform the test. Ask if they have any questions and obtain verbal consent.
• Record if they are on any medications and what they are. Record whether they smoke and how much.
• Ask if they have any difficulties with breathing.
• Enter their gender and height into the device ( this is to allow the device to predict the normal values for that patient)

Question 2

How should hygiene be maintained?

Answer 2

Each patient should have a separate disposable mouthpiece. If you are not performing a flow volume loop this should have a filter and valve, if you are performing a flow volume loop the mouthpiece should be open at both ends.

Question 3

How should spirometry be performed?

Answer 3

From the main menu on the spirometer select the type of spirometry required ( forced or relaxed)

Patient should sit upright with a straight back and feet flat on the floor

Patient should ideally have a nose peg placed on their nose to ensure that all air is exhaled/inhaled through the mouth.

Patient should inhale to full capacity prior to closing the lips tightly around the mouthpiece to form a good seal

Relaxed Spirometry;
- Patient should be instructed to exhale fully and normally ( as if sighing)

Forced Spirometry;
- Patient should be instructed to exhale maximally and fully, and encouraged to continue exhaling for at least 4 seconds ( “ Take a deep breath in, then blow it out as hard as you can and continue to breathe out for as long as you possibly can……..keep blowing, keep blowing, keep blowing”)

If the patient is required to create a flow volume loop they should inhale fully after exhalation with their lips still making a tight seal on the mouthpiece

As the patient to perform the maneuver until 3 maneuver’s have been recorded with FEV1 within 5% of best. Leave at least 30 seconds between each recording for the patient to recover.