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Respiratory and Sleep Science > Spirometry testing > Flashcards

Spirometry testing Flashcards

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1
Q

What does a refferal form include?

A

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

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2
Q

What equiptment is needed for spirometry?

A

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

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3
Q

What other/ extra equiptment may we need for spirometry?

A

-pulse oximeter
-disinfectant wipe
-alcohol gel
-tissues

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4
Q

How do we prepare the equiptment for a spirometry test?

A

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

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5
Q

what are some patient instructions prior to the appointment?

A

-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

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6
Q

How do you prepare the patient for spirometry?

A

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

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7
Q

What are contraindications and why do we need to check them?

A

-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

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8
Q

What are some examples of contraindications?

A

-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

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9
Q

What could you test instead if the patient has an adverse reaction?

A

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

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10
Q

What should you check before the test- linked to the test?

A

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

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11
Q

What questions should we be asking in regards to inhaled medication?

A

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

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12
Q

Should we make a note of other medications the patient is using?

A

Yes- respiratory medicines

-oral steroids
-nebuliser/neubulising drugs
-oxygen
-otc medication

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13
Q

How do you calculate pack years?

A

Number of cigarettes a day /20 x number of years smoked

1 pack year= 20 cigarrettes every day for 1 year

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14
Q

what are some influencing factors of spirometry?

A

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

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15
Q

How long do we test Relaxed vital capacity and forced vital capacity form?

A

minimum 3 attempts

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16
Q

How do we perform relaxed vital capacity?

A

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

17
Q

How do we perform FEV1 and FVC?

A

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

18
Q

What should we be doing during the test?

A

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

19
Q

How to check the results are within manoeuvre criteria?

A

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

20
Q

What is the critera for repeatibility?

A

-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)

21
Q

Describe what the volume time spirogram curve looks like

A

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

22
Q

Descirbe what a flow volume spirogram curve looks like

A

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

23
Q

What should you do once the test is complete?

A

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

24
Q

Describe the time for testing steps

A

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

25
Q

what are some considerations of spirometry for children?

A

-increased elastic recoil of the lungs in children so FVC results reached early expiration

-FEV1 is an insensitive measure in children

-ensure plateau is achieved

-back extrapolation and repeatability critera same as adults

-do not exclude data if only one acceptable test is recorded

26
Q

What tests are better for children?

A

-peak flow is easier
-measure FEV1 , FVC and RVC from spirometry
-FEF 25-75% has a smaller coefficent of variation than in adults-can be used be a useful monitor of REF
-children under 5 are unlikely to be able to perform an accurate or repeatable spirometry

27
Q

Describe a paediatric test environment

A

-child friendly area
-tv
-toys and books
-child sized furniture
-child safety

Respiratory and Sleep Science (20 decks)

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