W5 Respiratory Diagnostics Flashcards
What are the diagnostic tests for asthma? (6)
FeNO
Obstructive spirometry
Bronchodilator reversibility test
BDR test
Peak flow variability
Direct bronchial challenge test with histamine or methacholine
Diagnostic summary
(for info)
What is right breathe?
for info
Videos on inhaler technique
- Inhalers
- Spacers
- Pathways (guidelines)
What is a BAI?
What are some examples of them?
Breath-actuated metered dose inhaler
Easi-breathe, Autohaler, K-haler
What are some general tips for inhalers?
- Turbuhalers, Respimat and pMDI devices should be primed before they are used for the first time.
- For inhalers with a dose counter, it is important to check there are sufficient doses remaining in the inhaler before each use.
- For the Respimat inhaler, ensure the cartridge has been loaded into the device before using the inhaler for the first time.
- All pMDIs should be shaken before each dose. Do not shake dry powder inhalers (DPIs).
- For all types of inhalers, it is important to keep the chin tilted up so the medicine reaches the lungs effectively.
- After use, wipe down the mouthpiece of the inhaler with a dry cloth.
- For inhalers containing corticosteroids, it is important to rinse the mouth out with water after using the inhaler to remove any residual medicine. This will reduce the likelihood of voice changes and oral thrush
pMDI inhaler technique:
Breathe in gently, or dose will all hit back of throat as when sprayed, it comes out with force
1, Remove inhaler cap
2. Hold inhaler upright and shake well
3. Breathe out gently away from the inhaler
4. Put mouthpiece between teeth without biting and close lips to form a good seal
5. Breathe in slowly through the mouth and, at the same time, press down firmly on canister
6. Keep breathing in slowly and deeply and hold breath for 5 seconds or as long as comfortable
7. While holding breath, remove inhaler from mouth
8. Breathe out gently, away from the inhaler
9. If an extra dose is needed, repeat steps 2 to 8
10. Replace cap
pMDI & spacer
- Prepare the spacer*
- Remove inhaler cap
- Hold inhaler upright and shake well before inserting into spacer
- Put mouthpiece between teeth without biting and close lips to form a good seal
- Breathe out gently, into the spacer
- Hold spacer level and press down firmly on inhaler canister once
- Single breath: Breathe in slowly and deeply and hold breath for around 5 seconds or as long as comfortable. Take spacer out of mouth while holding breath
OR
Tidal breath:** Breathe in and out normally for 3 or 4 breaths before removing spacer from the mouth - Breathe out gently
- Remove inhaler from spacer
- Ifanextradoseisneeded,repeat steps3to9
- Replace cap on inhale
Accuhaler
- Open cover using thumb grip
- Hold horizontally, load dose by
sliding lever until it clicks - Breathe out gently, away from the inhaler
- Place mouthpiece in mouth and close lips to form a good seal, keep inhaler horizontal
- Breathe in steadily and deeply
- Hold breath for about 5 seconds
or as long as comfortable - While holding breath, remove inhaler from mouth
- Breathe out gently, away from the inhaler
- If an extra dose is needed repeat steps2to8
- Closecovertoclickshut
Autohaler
- Remove cap
- Hold inhaler upright and shake
well - Push lever up
- Breathe out gently, away from the inhaler
- Put mouthpiece between teeth without biting and close lips to form good seal
- Breathe in slowly and deeply. Keep breathing in after hearing click
- Hold breath for about 5 seconds or as long as comfortable
- While holding breath, remove inhaler from mouth
- Breathe out gently, away from the inhaler
- Pushleverdown
- If an extra dose is needed,
repeat steps 2 to 10 - Replacecap
Breezhaler
- Remove cap
- Flip the mouthpiece to open
- Remove the capsule from blister and place in chamber
- Close the mouthpiece until it clicks
- Press side buttons in ONCE and
release (do not shake) - Breathe out gently, away from inhaler
- Put mouthpiece between teeth without biting and close lips to form good seal
- Breathe in quickly and steadily, so capsule vibrates
- Hold breath for about 5 seconds, or as long as comfortable
- While holding breath,remove inhaler from mouth
- Breathe out gently, away from inhaler
- Openmouthpieceandremove capsule
- If more than one dose is needed. repeat steps 3 to 12
- Close mouthpiece and cap
Ellipta
- Slide the cover down until you hear a click (do not shake)
- Breathe out gently, away from the inhaler
- Place mouthpiece in mouth and close lips to form a good seal. Do not cover air vent
- Breathe in steadily and deeply
- Hold breath for 5 seconds
or as long as comfortable - While holding breath, remove inhaler from mouth
- Breathe out gently, away from the inhaler
- Slide the cover upwards as far as it will go, to cover the mouthpiece
Genuair
. Remove cap by squeezing arrows and pulling
2. Hold inhaler so large coloured button is facing straight up
3. Without tilting inhaler, press and release the button
4. Check control window has changed to green
5. Breathe out gently, away from inhaler
6. Place mouthpiece in mouth and close lips to form a good seal. Keep inhaler horizontal
7. Breathe in strongly and deeply. Keep breathing in after click is heard
8. Hold breath for about 5 seconds or as long as comfortable
9. While holding breath, remove inhaler from mouth.
10. Breathe out gently, away from inhaler.
11. Check control window has changed to red.
12. Replace cap
Handihaler
- Open cap
- Flip open mouthpiece
- Remove capsule from blister and place in chamber
- Close mouthpiece until it clicks 5. Press green piercing button in
once and release (do not shake) - Breathe out gently, away from inhaler
- Place mouthpiece between teeth without biting and close lips to form a good seal
- Breathe in slowly and deeply, so capsule vibrates
- Keep breathing in as long as comfortable
- While holding breath, remove inhaler from mouth
- Breathe out gently, away from inhaler
- Repeat steps 7 to 11 to take the full dose
- Open mouthpiece and remove capsule
- Close mouthpiece and cap
Respimat
- Hold inhaler upright with the cap closed
- Turn base in direction of arrows until it clicks (half a turn)
- Open the cap until it snaps fully open
- Breathe out gently, away from inhaler
- Place mouthpiece in mouth and close lips to form a good seal. Do not cover air vents
- Breathe in slowly and deeply through mouth and, at the same time, press down on the dose button
- Keep breathing in slowly and deeply
- Hold breath for 5 seconds or as long as comfortable
- While holding breath, remove inhaler from mouth
- Breathe out gently, away from inhaler
- Click cap shut
- Repeat from step 1 to get the full dose (as two inhalations is the usual dose for medicines used with Respimat)
prime before using for first time
