Spirometry

Question 1

Contraindications for spirometry

Answer 1

Chest infection in last 6 weeks
Thoracic, abdo or ophthalmic surgery in last 3 months
Risk of stroke or AAA

Question 2

Problem with the ESC score in spirometry

Answer 2

Only for patients aged 25-70

Question 3

Prep for spirometry

Answer 3

Calibrate machine with room air
Get patient to sit in armchair with feet flat on floor
Put nose clip on patient

Question 4

How many breaths in spirometry

Answer 4

Maximum of 5 relaxed vital capacity first

Followed by maximum of 5 forced vital capacity (at least 6 seconds)

Question 5

How to test reversibility

Answer 5

Give salbutamol nebuliser with spacer and repeat spirometry in 12 minutes

Question 6

Examples of unacceptable spiro loops

Answer 6

Slow start I.e delay before using the mouthpiece
Not full inspiration
Glottal stop
Submaximal effort - rounded peak on flow vs volume curve

Question 7

How to do peak flow

Answer 7

Patient standing up
Use best result of 3 every morning and evening for 2 weeks to assess diurnal variation
If asthma confirmed continue to self monitor everyday