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Chapter 2: Astra 300 Functional Operation
The Spirometry Source
2.4
PERFORMING SPIROMETRY
Before testing patients, it is important to keep in mind that
spirometry is an effort-dependent test requiring the complete
cooperation of the patient. In order to achieve this, you as
the coach play a critical role.
Be sure the patient is comfortable. Make note as to
whether the patient is seated or standing, because
subsequent testing of that patient should be performed from
that same position. If the patient is standing, have a chair
behind him in the event that he becomes lightheaded after
the blow. It is generally a good idea to have the elderly
seated for spirometry testing. If the patient is wearing a
shirt or blouse with a tight-fitting collar, have him unbutton
the top button and if wearing a tie, it should be loosened. If
wearing dentures that are loose, it may be necessary to
have the patient remove them.
Explain clearly and in simple terms that they will be
performing a “breathing evaluation”. Try to avoid the word
“test” since this has connotations of passing or failing and
may make the patients apprehensive. Point out that they will
be taking a slow maximal inhalation followed by a maximal
exhalation, but that the exhalation will be “blasting out” the
breath as fast as they can and as hard as they can. Key
them that you will be coaching them to continue to blow out
for a minimum of six seconds. Assure them that it is quite
normal to blow out for that period of time. The American
Thoracic Society in their 1994 Standardization of Spirometry
Update highly recommends that a six second blow be the
goal for all spirometry testing.
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To ensure that the patients take an adequate deep
breath, it is valuable to emulate exactly what you expect. A
good way to do this is through one of the filters. Prior to
your demonstrating the maneuver, tell your patient to be
especially aware of the latter portion of the blow when you
are “squeezing out” the last bit of air. If the patient has a
visual cue as to what a “big deep breath” is and can actually