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Respiratory Health Spirometry Procedures Manual

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Respiratory Health Spirometry Procedures Manual Respiratory Health Spirometry Procedures Manual January 2011 TABLE OF CONTENTS Chapter Page 1 SPIROMETRY OVERVIEW .......................................................................... 1-1 1.1 Overview of the Spirometry Exam Component .................................. 1-1 1.2 The Bronchodilator Subcomponent .................................................... 1-2 1.3 Chronic Obstructive Pulmonary Disease ............................................ 1-3 1.4 Asthma ................................................................................................ 1-4 1.5 Basics of Respiration .......................................................................... 1-5 1.6 Spirometric Measurements ................................................................. 1-6 ACKNOWLEDGMENTS AND REFERENCES ............................................ 1-13 2 EQUIPMENT AND SUPPLIES ...................................................................... 2-1 2.1 List of Equipment and Supplies .......................................................... 2-1 2.2 Description of Equipment and Supplies ............................................. 2-2 2.2.1 Equipment ........................................................................... 2-2 2.2.2 Supplies ............................................................................... 2-3 2.3 Equipment Setup Procedures .............................................................. 2-4 2.3.1 Equipment ........................................................................... 2-4 2.3.2 Supplies ............................................................................... 2-6 2.4 Equipment Care and Maintenance ...................................................... 2-6 2.4.1 Spirometer ........................................................................... 2-6 2.4.2 Hoses ................................................................................... 2-7 2.5 Equipment Packup Procedures ........................................................... 2-7 2.5.1 Equipment ........................................................................... 2-8 2.5.2 Supplies ............................................................................... 2-8 3 EXAMINATION PROTOCOL ....................................................................... 3-1 3.1 Eligibility Criteria for Spirometry and Bronchodilator Components ........................................................................................ 3-1 3.2 Spirometry Safety Exclusion Questions ............................................. 3-1 3.3 Spirometry Examination Procedures .................................................. 3-6 3.3.1 Spirometry Testing Procedures ........................................... 3-7 iii TABLE OF CONTENTS (continued) Chapter Page 3.3.2 Instruction and Preparation ................................................. 3-8 3.3.3 Initiate Test.......................................................................... 3-10 3.3.4 End of Test .......................................................................... 3-16 3.3.5 Procedures for Repeat Spirometry Testing ......................... 3-18 3.4 Troubleshooting Spirometry Examinations ........................................ 3-20 3.4.1 Spirometer ........................................................................... 3-20 3.4.2 Weather Station ................................................................... 3-22 3.5 Report of Findings .............................................................................. 3-23 4 QUALITY CONTROL .................................................................................... 4-1 4.1 Equipment Cleaning and Calibration .................................................. 4-1 4.1.1 Quality Control Checks Screens ......................................... 4-1 4.1.2 Equipment Cleaning ............................................................ 4-5 4.1.3 Equipment Calibration ........................................................ 4-5 4.2 Equipment Maintenance ..................................................................... 4-8 4.3 Review of Results During the Exam ................................................... 4-8 4.4 Observation ......................................................................................... 4-9 4.5 Review of Exam Status ....................................................................... 4-9 4.6 Review of Results During Analysis .................................................... 4-9 4.7 NIOSH Quality Control Reports ......................................................... 4-10 4.7.1 Operator Reports ................................................................. 4-10 4.7.2 Statistics .............................................................................. 4-11 4.7.3 Grades ................................................................................. 4-11 4.7.4 Summary and Trend Analysis Reports................................ 4-11 5 SAFETY PROCEDURES ............................................................................... 5-1 5.1 Spirometry Safety Precautions ............................................................ 5-1 5.1.1 Safety Exclusion Screening ................................................. 5-1 5.1.2 Infection Control Measures ................................................. 5-1 5.1.3 Prevention of Electric Shock ............................................... 5-2 5.2 Standing vs. Sitting During Spirometric Testing ................................ 5-2 5.3 Comprehension or Language Difficulties ........................................... 5-3 5.4 Emergency Procedures ....................................................................... 5-3 iv TABLE OF CONTENTS (continued) List of Appendixes Appendix Page A NIOSH Spirometry System Design Criteria .................................................... A-1 B Screenshots for Spirometry Safety Exclusion Questions ................................. B-1 List of Tables Table 1-1 Lung diseases and spirometry results .............................................................. 1-12 3-1 Spirometry safety exclusion items by age ....................................................... 3-2 List of Figures Figure 1-1 The respiratory tract ......................................................................................... 1-5 1-2 Normal volume-time curve .............................................................................. 1-8 1-3 Normal flow-volume curve .............................................................................. 1-8 1-4 FVC and FEV1 on a normal volume-time curve ............................................. 1-9 1-5 FVC on normal flow-volume curve ................................................................. 1-9 1-6 Normal and restrictive patterns volume-time curves ....................................... 1-10 1-7 Flow-volume curves ........................................................................................ 1-10 1-8 Obstructive pattern shown on a volume-time curve ........................................ 1-11 1-9 Obstructive pattern shown on a flow-volume curve ........................................ 1-11 v TABLE OF CONTENTS (continued) List of Exhibits Exhibit Page 3-1 Aneurysm help screen ...................................................................................... 3-3 3-2 Spirometry exclusion ....................................................................................... 3-4 3-3 End of subsection screen .................................................................................. 3-4 3-4 End of exam screen .......................................................................................... 3-5 3-5 Begin spirometry test screen ............................................................................ 3-6 3-6 OMI/NIOSH main program screen .................................................................. 3-7 3-7 Temperature warning message ........................................................................ 3-7 3-8 Proceed with testing screen .............................................................................. 3-8 3-9 Curve display screen – pre-test ........................................................................ 3-10 3-10 Curve display screen ........................................................................................ 3-11 3-11 Test results screen ............................................................................................ 3-12 3-12 Results and quality code box ........................................................................... 3-13 3-13 Override acceptability code screen .................................................................. 3-15 3-14 Post-Test data screen ....................................................................................... 3-16 3-15 End of subsection – complete screen ............................................................... 3-17 3-16 End of exam screen .......................................................................................... 3-18 3-17 Technologist bronchodilator referral script screen .......................................... 3-19 3-18 End of exam – SP to bronchodilator screen ..................................................... 3-19 4-1 Quality Control Checks – Start of Stand QC ................................................... 4-2 4-2 Quality Control Checks – Daily QC ................................................................ 4-2 4-3 Quality Control Checks – Start of Session QC ...............................................
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