Recipient(s) will receive an email with a link to 'Office Spirometry' and will have access to the topic for 7 days.
Subject: Office Spirometry
(Optional message may have a maximum of 1000 characters.)
Forced vital capacity (FVC)
is the total amount of air that can be exhaled following a
maximal inspiration. The FVC is reported in liters.
Forced expired volume in 1
second (FEV 1.0) measures the expired volume during the first
second of an FVC maneuver. FEV 1.0 is reported in liters.
The ratio (FEV 1.0/FVC) is
the percentage of the FEV 1.0 compared to the FVC.
Peak expiratory flow (PEF)
is a measurement of how fast a patient can blow out during
expiration following a maximal inspiration. The PEF is reported
in liters per minute.
Handheld or desktop
Calibration syringe (3
Printer for hard copy of
Assess severity of
Determine existence of
lung disease with patients who smoke.
Diagnose and classify
Assess response to
Evaluate exposure to
inhaled toxins/irritants in the workplace.
Evaluate for disability
risk for pulmonary complications.
Moderate to severe
PITFALL: Spirometry should not be
performed if the patient has smoked within 4 hours. Smoking
can result in acute small airway constriction.
PITFALL: The accuracy of spirometry
depends upon the coaching and correct instructions provided
by the practitioner.
PITFALL: The procedure is repeated if the
patient performs any of the three maneuvers poorly, so that
three tracings with minimal variance in measurements are
obtained. Eight attempts is the limit for any given
Pearl: It is important that the
practitioner records the patient’s height, age,
gender, and race accurately. These factors affect lung
function and are used to determine the patient’s
predicted spirometry values. The spirometer’s
software programs will compare the predicted measurements to
the patient’s actual measured values. From this
comparison, a diagnosis can be made.
PITFALL: Even when patient’s
predicted spirometry values are computed, the normal range
of actual spirometer measurements for healthy individuals
can vary from 80 to 120%.
Pearl: The patient should have exhaled at
least 6 seconds, and longer if the volume-time graph
continues to ascend after 6 seconds.
pattern with airway obstruction
pattern with restrictive lung disease
Pearl: There is a good correlation between
PEF and FEV 1.0 in asthma, which allows the practitioner to
use PEFs to assess the patient with asthma. This correlation
decreases with patients with COPD. Airway collapsibility as
seen with COPD results in a varying relationship between PEF
and FEV 1.0. PEF testing in COPD can be misleading. In
addition, PEF does not detect small airway disease, which is
common in COPD.
pattern with mixed disease pattern
Small airway collapse
from dynamic airway compression during forced vital capacity can
occur in patients with COPD, asthma, emphysema, or chronic
bronchitis. This may result in wheezing noted on
occur if the patient is not instructed correctly.
results if the Pneumotach is used by multiple patients.
The patient may resume
regular activities immediately.
musculoskeletal pain is common, it should resolve with
The patient should follow
up with the referring provider.
RJ Brindley and
Associates, Inc., 337 Bluff RD, Carver, MN 55315-9511.
Phone:1-888-448-2834. Web site: http://www.PulmonaryFunction.com.
Mohawk Medical Mall.
Phone: 1-800-962-5660. Web site: http://www.mohawkmedicalmall.com.
Supply Inc., 902 JanMar Court, Clermont, FL 34715. Phone:
352-242-0110; fax 352-242-0973. Web site: http://www.medfirstonline.com.
Medical Solutions Inc.,
8633 Jefferson Highway, Osseo, MN 55369. Phone: 888-557-8020.
Web site: http://www.medicalsolutionsinc.com.