Bedside Spirometry
Bedside spirometry measures forced vital capacity (FVC) and forced expiratory volume (FEV), allowing calculation of other pulmonary function indices, such as timed forced expiratory flow rate. Depending on the type of spirometer used, bedside spirometry can also allow direct measurement of vital capacity and tidal volume.
Bedside spirometry aids in diagnosing obstructive or restrictive pulmonary dysfunction, evaluating its severity, and determining the patient’s response to therapy. It’s also useful for evaluating preoperative anesthesia risk. Because the required breathing patterns can aggravate conditions such as bronchospasm, use of the bedside spirometer requires a review of the patient’s history and close observation during testing.
Equipment
Spirometer ▪ disposable mouthpiece ▪ breathing tube, if required ▪ spirographic chart and recording pen, if required ▪ gloves ▪ Optional: vital capacity predicted-values table, noseclips, bacteria filter if required by your facility’s infection control policy.
Preparation of Equipment
Review the manufacturer’s instructions for assembly and use of the spirometer. If necessary, firmly insert the breathing tube to ensure a tight connection. If the tube comes preconnected, check the seals for tightness and the tubing for leaks. Check the operation of the recording mechanism, and insert a chart and pen, if necessary. Insert the disposable mouthpiece and make sure it’s tightly sealed. Make sure that the unit has been calibrated according to the manufacturer’s guidelines.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Explain the procedure to the patient. Emphasize that his cooperation is essential to ensure accurate results.
Instruct the patient to remove or loosen bras, belts, and other constricting clothing to prevent alteration of test results from restricted thoracic expansion and abdominal mobility.
Instruct the patient to void to prevent abdominal discomfort.
Obtain the patient’s weight and height without shoes. These measurements are needed to calculate predicted lung volumes.
If the patient wears dentures that fit well, leave them in place to promote a tight seal around the mouthpiece. However, if the dentures fit poorly, have the patient remove them to prevent incomplete closure of his mouth around the mouthpiece, which could allow air to leak around the mouthpiece.
Plug in the spirometer, and set the baseline time.
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