Spirometry

SPIROMETRY TEST

Indication 

i.       i. Direct the presence or absence of lung disease.

·         History of pulmonary symptoms                                                             

Ø  Duspnea, wheezing.

Ø  Cough Phlegm production.

Ø  Chest pain, orthopnea.

·         Abnormal laboratory findings

Ø  Chest X ray study.

Ø  Blood gases.

·        Physical indicator

Ø  Decreased breath sounds.

Ø  Chest wall abnormalities.

Ø   

ii.      Quantify the extent of known disease on lung function.

·         Pulmonary disease

Ø  COPD

Ø  Cystic fibrosis.

·         Neuromuscular disease

Ø  G B Syndrome.

  III.            Measures effects of occupational or environmental exposure.

Ø  Smoking

Ø  Working in dusty environments.

  IV.            Determine the beneficial or negative effect.

Ø  Bronchodilators or steroids.

Ø  Pulmonary rehabilitation

     V.            Assess risk for surgical procedure.

Ø  Lung resection like Lobectomy.

Ø  Thoracic surgery like Stenotomy.

  VI.            To evaluate disability or impairment. 

Ø  Social security or other compensation.

Ø  Legal or insurance evaluation.

Procedure

The water sealed spirometers at the bedside may be limited to the size and weight of the device, problems may be leaks in tubing and bell, inadequate water level in device and improper position on bell before start of test. In spirometer a graphic tracing called spirogram In this patient should be positioned in an upright sitting pasture and nose clip should be used.

The patient should normally breath into the spirometer through tight fitting mouth piece until normal rhythm is established.  

1         Explain the reason for the test and the test procedure.

2         Loosen the tight clothing.

3         Subjected may be seated or standing.

4         The mouth piece should be positioned so that the chin is slightly elevated and the neck is extended.

5         Apply nose clip.

6         Instruct the subject to take maximal breath in from a normal breathing pattern put the mouthpiece and blow.

7         The operator should ensure that the paper is moving in appropriate speed.

8          The performance of maneuver should be evaluated and instruction should be given if necessary.

9         Ideally 3 reproducible acceptable tracing should be obtained.

And look for

A] Loss of air before the mouthpiece is properly in place.

B] Leaking around the mouthpiece during test.

C] Coughing through out the procedure.

D] Inability to sustain expiration for 5 seconds.

E] Less then the maximal effort both in inspiration and expiration.