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ASSESSING ACCEPTABILITY:

The PneumoCheck will determine whether the maneuver just
performed should replace the maneuver that was previously stored
as BEST test. In making this determination, the PneumoCheck first
looks at the quality control messages for the new maneuver. A
“good” maneuver is one that has no identifiable faults, such as a
cough in the middle of the maneuver or a hesitating start (see p. 8).

SELECTING BEST TEST:

One Acceptable, One Not

If the new maneuver is acceptable and the previously stored BEST
maneuver was not, then the previously stored BEST maneuver is

discarded and the new maneuver is stored in its place.

Likewise, if the new maneuver is not acceptable while the previously

stored BEST maneuver was acceptable, then the previously stored

BEST maneuver is retained.

Both Acceptable, Both Unacceptable

If the stored BEST maneuver and the new maneuver are both

acceptable or both unacceptable, the PneumoCheck next deter-
mines which is BEST based on the following criteria:

Criterion For Best FVC Maneuver:

The larger sum of the FVC and FEVl

Criterion For Best MVV Maneuver:

The higher value as expressed in liters/minute.

DETERMINING REPEATABILITY:

In addition to selection of the best test, it is important to know that

the tests were reproducible, that is, to know that they matched. To
do this the currently stored best test is compared to the most recent
test and a message appears after the quality message.

15

Summary of Contents for PneumoCheck

Page 1: ...Fii Welch Allyn PneumoCheckTM and Printer Charger Operating Instructions...

Page 2: ...llyn PneumoCC Preliminary Operating Instructions The FVC Test Quick FVC Reference Chart Description Measurement Parameters Obtaining Good FVC Results Doing an FVC Maneuver Doing Multiple Tests on a Pa...

Page 3: ...btaining Good MVV Results 21 Doing an MVV Maneuver 21 Doing Multiple Tests on a Patient 22 Interpretation of Results 22 Parts of the PneumoCheck Printer Charger 23 Printer Charger Operating Instructio...

Page 4: ...lculating Predicted Values Manually 52 Reference Tables Knudson 19831 2 2 1 2 1 54 Knudson 1976 13 56 Morris Crapo et al 1981 14 4 57 European Community for Coal and Steel16 6 58 Coefficients for MVV...

Page 5: ...esults you should be familiar with the basic principles of spirometry A spirometer is a device that measures the amount of air that is breathed into or out of it To perform a spirometry test a patient...

Page 6: ......

Page 7: ...CHECK SPIROMETER 61000 PNEUMOTACH ASSEMBLY MOUTHPIECE LIQUID I CRYSTAL DISPLAY I BODY OF PNEUMOCHECK ON OFF SWITCH PNEUMOTACH ASSEMBLY L ORANGE SPEAKER FOR AUDITORY SIGNALS BODY OF PNEUMOCHECK CHARGIN...

Page 8: ...ill sound indicating the instrument s memory has been cleared 6 When SELECT is displayed select the type of test by repeatedly depressing the TEST button Press once and release to access FVC Press aga...

Page 9: ...ight Race Sex into Printer Charger I Instruct and Demonstrate Correct I Visually Check Screen of PneumoCheck I t Switch PneumoCheck ON wait for SELECT and press TEST DoFVC1 2 3 Place PneumoCheck into...

Page 10: ...rate during the first second of the FVC maneuver Other commonly used FVC parameters include FEVl FVC also called RATIO the ratio of the FEV1 to the FVC expressed as a percentage FEF25 75 Forced Expira...

Page 11: ...Restrictive disorders are those that cause the lung volume to be reduced such as congestive heart failure with pulmonary edema pneumonia pleural fibrosis pneumoconiosis and gross obesity In general i...

Page 12: ...l mouthpiece obstruction l quitting too soon 6 When the maneuver has been c message If a message appear maneuver see p 49 instruct tt problem and repeat the test Explain the test and what you expect D...

Page 13: ...ring the first second of the maneuver l mouthpiece obstruction by tongue lips or teeth l quitting too soon When the maneuver has been completed observe the quality message If a message appears indicat...

Page 14: ...MS Knudson 1983 Good FVC maneuver VS30P30 FVC X l r 2 l S E C 10 E 37 HEIGHT bbin B Z w F RCTURL NORM NORM RSN NORMS Knudson 1983 VS30P30 1 S l o w F V C s t a r t begin faster FVC Wl b a 6 89SEC I I...

Page 15: ...dson 1983 VS30P30 F V C i n t e r r u p t e d a v o i d c o u g h i n g FVC Xl 7 4 4 S E C COUGH 11 a 23 HEIGHT 72 1 n m z m rl ACTUAL NORM NORM RBN NORMS Crapo 198 1 VS30P30 Fugdon t e r m i n a t i...

Page 16: ...nhale deeply put the mouthpiece in his her mouth and exhale as completely and with as much force as possible After completely emptying the lungs the patient removes the instrument from the mouth The P...

Page 17: ...ation of the patient s effort The message for an acceptable effort is GOOD FVC For a complete list of the other quality control messages see p 49 Press and release the DATA button consecutively to see...

Page 18: ...se to access LAST FVC Press DATA button and release a third time to return to SELECT After accessing BEST or LAST memory wait three seconds for the quality control message Then push and release DATA t...

Page 19: ...d in its place Likewise if the new maneuver is not acceptable while the previously stored BEST maneuver was acceptable then the previously stored BEST maneuver is retained Both Acceptable Both Unaccep...

Page 20: ...ns on accessing BEST and LAST tests NOTE Turn the ON OFF switch to OFF and back to ON before beginning a test on a new patient so that the previous patient data memory is cleared 16 The PneumoCheck Pr...

Page 21: ...ed and the FVC is also below 80 of predicted the possibility of a superimposed Restriction in addition to the Obstruction exists If the FEVl FVC ratio is normal but the FVC is abnormal a re strictive...

Page 22: ...rmal some pulmonary specialists will examine the FEF 2575 MMEF If it is low the patient may have a slight obstruction There is some controversy regarding this variable and its clinical significance in...

Page 23: ...Yes FEV 1 above 60 __ Mifd of predicted Obstruction I No Yes FEV 1 above 40 of predicted Z on Severe Obstruction ti RESTRICTION FVC above 60 Yes of predicted Ztriction I No FVC above 50 Yes of predict...

Page 24: ...f employees exposed to cotton dust 4 Preoperative evaluation of overall breathing ability 5 Evaluation of dyspnea unexplained by the FVC maneuver MEASUREMENT PARAMETERS The parameters that are measure...

Page 25: ...ble conditions include l air leaking around the mouthpiece l mouthpiece obstruction by tongue lips or teeth l quitting too soon DOING AN MVV MANEUVER 1 Upon selection of MVV the PneumoCheck first meas...

Page 26: ...utton consecutively to see additional quality messages and MVV test parameters See pp 20 and 49 for more detail Press the TEST button to return to SELECT DOING MULTIPLE TESTS ON A PATIENT See page 14...

Page 27: ...PARTS OF THE PNEUMOCHECK PRINTER CHARGER 76100 OR 76105 PNEUMOCHECK STOP i DATA BUTTON INDICATOR GREEN PAPER SLOT 23...

Page 28: ...printed If individual prints of each test are desired e g for inhalation challenges evaluations for Social Security Disability etc l Print the very first maneuver l Turn the PneumoCheck OFF and then...

Page 29: ...ORT FORM ID LONG FORM NAME DATE ID AGE 36 HEIGHT 66in w Z B F Reason for test Cough Sputum Smoker Pack years ___________ Q u i t When Dyspnea When Chest Pain Heart Disease Wheeze Asthma CutlS Surgery...

Page 30: ...et in either inches or centimeters If the height entered is greater than 84 centimeters will be assumed Height should be measured accurately in stocking feet since it has the largest effect on predict...

Page 31: ...nsfer and the PneumoCheck Liquid Crystal Display will display SEND FVC and or SEND MVV or SEND CAL When data transfer is complete the green DATA indicator will stop flashing and a triple tone beep wil...

Page 32: ...ly until you release the FEED button For paper jams that do not involve paper wrapping around the pinch roller cut the paper from the roll and pull the paper out from the top of the printer Do not pul...

Page 33: ...h several inches of paper Replace the printer cover taking care to feed paper through opening NOTE This is thermally activated paper If paper is inserted backwards no printing will appear on paper STO...

Page 34: ...may need servicing l 3 FLASHES Data received from the PneumoCheck is invalid Press STOP and retransmit data by removing the Pneumo Check from the Printer Charger well temporarily If the error recurs...

Page 35: ...d so that the onset of a problem can be determined within one day eliminating needless reporting of false values for several weeks or months and also to help define day to day laboratory variability F...

Page 36: ...h through the PneumoCheck several times to equilibrate the temperature 4 Pull the syringe plunger back as far as it will go 5 Access the TEST MODE on your PneumoCheck fi Cc Cd H Turn vour PneumoCheck...

Page 37: ...display TEST MODE To review the result press the DATA button Results between 2 91 liters and 3 09 liters indicate an accurate instrument 3 of 3 0 liters as specified by ATS 10 Print the TEST MODE FVC...

Page 38: ...Pull back the plunger of the syringe when a double beep occurs and the PULL BACK message appears The PneumoCheck will display the STEADY message then RETRIM for approximately 45 seconds while measuri...

Page 39: ...L If any of the calibration maneuvers were not within 0 5 of the dalculated average a triple beep will occur and the message RETRY CAL will be displayed and the existing calibration factor will not be...

Page 40: ...nge to PneurnoCheck and TEST MODE Doing a Recalibration Attach syringe to PneumoCheck Flush syringe through PneumoCheck several times Follow messages to PULL BACK and DO CAL twice more CF XXXX followe...

Page 41: ...the batteries have been recharged NOTE After LOW BATT appears printing of the most recent test in the PneumoCheck memory is still possible A fully drained battery may be fully recharged in about 15 h...

Page 42: ...he output cord of the transformer into the charging jack of the PneumoCheck SPECIAL NOTES 1 2 3 4 5 Slight heating of the PneumoCheck during charging is normal Batteries will not leak If left without...

Page 43: ...attery life always replace both batteries at the same time To replace 1 2 3 4 Turn the PneumoCheck OFF Using a coin loosen the two set screws on the bottom of the PneumoCheck these screws will loosen...

Page 44: ...neumotach assembly and tighten the two screws on the bottom until the pneumotach is securely in place 7 Recalibrate the PneumoCheck see p 34 ACAUTION REPLACE WITH WELCH ALLYN NO 72500 BATTERIES ONLY U...

Page 45: ...cleaned and sterilized prior to any maneuvers involving inhalation such as MVV Routine maintenance of the pneumotach assembly should include cleaning and sterilization after every 50 maneuvers The pn...

Page 46: ...Note that spare pneumotach assemblies are available see p 43 and can be used interchangeably THE PNEUMOCHECK SHOULD BE RECALIBRATED ANY TIME THE PNEUMOTACH HAS BEEN REMOVED REPLACED BODY OF PNEUMOCHE...

Page 47: ...Case Disposable Nose Clips 1OO Box 4 Boxes Case Hose for 3 0 Liter Syringe 3 0 Liter Calibration Syringe Only 3 0 Liter Calibration Syringe and Hose Two 3 6 V Rechargeable Batteries 7 2 V Replacement...

Page 48: ...or agent or service representative This warranty does not include breakage or failure due to tampering misuse neglect accidents modification or shipping This warranty is also void if the instrument is...

Page 49: ...to select a different test Shows the Calibration Factor after a successful calibration was completed This value is now the new calibration value replacing the old one that was previously stored in mem...

Page 50: ...of a key or a low battery NO DATA B The FVC or MVV maneuver did not start within 20 seconds after the beep NO DATA C The FVC terminated normally but on analysis no exhalation was found NO DATA D G Th...

Page 51: ...eak battery Return instrument to an acceptable operating temperature range 15 to 35 or 59 to 95 F and fully charge before proceeding NOTE Encountering either the TEMP LIM or TRIM LIM messages during n...

Page 52: ...was exhaled during the first second of the FVC maneuver The total amount of air in liters that was exhaled during the FVC maneuver The average flow in liters per second during the middle half of the...

Page 53: ...ent remove his or her dentures and or advise the patient to refrain from coughing Sometimes a glass of water will help Each of the three calibration maneuvers was within 0 5 of the average The existin...

Page 54: ...tion factor is not updated TOO SHORT During FVC the maneuver was less than 3 seconds long The patient should inhale more deeply and exhale longer During MVV The maneuver was less than 6 seconds long T...

Page 55: ...DICTEDS AVAILABLE ON YOUR PNEUMOCHECK While the ideal study does not exist many studies are available all of which have unique advantages and shortcomings Unfortunately universal agreement as to which...

Page 56: ...placed in the ABN column if the actual parameter falls below the lower limit of normal LLN Manual calculations can be made using the procedure and tables which follow All predicted values except as n...

Page 57: ...calculated using the entry from the LLNF column as follows Lower Limit of Normal Value x LLNF for LLNF 0 or Lower Limit of Normal Value LLNF for LLNF c 0 For example our 20 year old male would have a...

Page 58: ...9 6 1990 0 588 0 078 8 06 2 711 FVC 0 0298 FEVl 0 0292 RATIO 0 105 MMEF 0 0363 PEF 0 035 Male 40 84 yrs FVC 0 0298 FEVl 0 0292 RATIO 0 105 MMEF 0 0363 PEF 0 035 Female 6 10 yrs 0 0844 8 7818 0 811 0 0...

Page 59: ...0 0169 FEV1 0 0190 RATIO 0 1896 MMEF 0 0309 PEF 0 025 Female 70 87 yrs FVC 0 0296 FEVl 0 0397 RATIO 0 1896 MMEF 0 0615 PEF 0 025 0 0444 3 1947 0 769 0 0332 1 8210 0 703 0 1852 121 6777 0 859 0 0300 0...

Page 60: ...0 887 0 087 103 64 11 02 0 045 1 864 1 901 0 094 5 993 3 408 FVC 0 092 FEVl 0 085 RATIO 0 109 MMEF 0 121 PEF 0 157 Female 20 78 yrs 0 033 3 469 0 820 0 027 2 703 0 692 0 111 107 38 12 57 0 025 1 893...

Page 61: ...33 1 666 Female 17 84 yrs FVC 0 0216 0 0491 3 590 0 676 FEVl 0 0255 0 0342 1 578 0 561 RATIO 0 252 0 2020 126 58 9 060 MMEF 0 0460 0 0154 2 683 1 363 NOTE Peak flow values PEF are always calculated us...

Page 62: ...E Per Quanjer 1983 male and female values are extrapo lated to age 87 by the printer and values provided for subjects aged 18 24 are the same as those provided for a 25 year old subject For subjects 6...

Page 63: ...ply to both the spirometer and the printer charger PNEUMOCHECK Power Consumption Charging Rate Low Battery Threshold Flow Resolution Flow Capacity Volume Resolution Volume Capacity Flow Sampling Rate...

Page 64: ...0 mm with core 15 to 35o C 59 to 95o F 20 to 40 C 4 to 104 F 0 14 I s 0 8 liters 0 7 s Knudson 1983 Knudson 1976 Morris Crapo et al European Community for Coal and Steel Short Form Long Form Flow Volu...

Page 65: ...for a full explanation of this method Back Extrapolated Volume The amount of air exhaled by a subject before the time zero which is determined by the method of back extrapolation In practice a large...

Page 66: ...It usually is from the best maneuver but may not be from the same maneuver as the best FVC The ratio of FEVl to FVC expressed as a percentage Forced Vital Capacity expressed in liters The amount of ai...

Page 67: ...d imitate the rapid breathing of strenuous exercise Peak Expiratory Flow Rate in liters per second It is the highest instantaneous flow during an FVC maneuver It is an index of patient effort See FEVl...

Page 68: ...of cardiovascular disease The Framingham Study Am Heart J 105 31 l 31 5 1983 Sparrow D Weiss ST Vokonas PS et al Forced vital capacity and the risk of hypertension Am J Epidem 127 734 741 1988 Gass G...

Page 69: ...1981 Lindall A Medina A Grismer JT A Re Evaluation of Normal Pulmonary Function Measurements in the Adult Female Am Rev Respir Dis 95 1061 l 064 1967 Quanjer PH Standardized lung function testing Rep...

Page 70: ...This manual applies to PneumoCheck software version 3 2 through 3 4 l Printer Charger software version 3 2 66...

Page 71: ...ii c Welch Allyn Welch Allyn Inc State Street Road P O Box 220 Skaneateles Fails NY 13153 0220 315 6854560 Part No 610140 3...

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