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OBTAINING GOOD MVV RESULTS

MVV results are also extremely effort-dependent.

Obtaining a Good MVV Result:

1. Explain the test and what you expect.

2. Demonstrate how to put the disposable mouthpiece in the mouth

(teeth on the outside, forming a good seal with the lips).

3. Demonstrate how a maneuver is done by breathing in and out

quickly and deeply for a few seconds.

4. Coach your patient throughout the test.

5. Learn to recognize most poor maneuvers by observing the

patient:

An acceptable maneuver requires:

at least six seconds of test time

a rapid pace

Unacceptable conditions include:

air leaking around the mouthpiece

mouthpiece obstruction by tongue, lips, or teeth

quitting too soon

DOING AN MVV MANEUVER

1. Upon selection of MVV the PneumoCheck first measures zero

airflow through the pneumotach to assure maximum accuracy.

During this time (no more than seven seconds) the word

STEADY is displayed and it is important to hold the Pneumo-
Check still so that an accurate reference can be made. If the
PneumoCheck is moved during this time, the STEADY message

will remain until the PneumoCheck is held quite still for at least
three seconds, or until an UNSTEADY message appears.

Should an UNSTEADY message appear, depress the TEST
button to start MVV again.

2. The PneumoCheck then displays the message DO MVV 1,

and beeps.

21

Содержание PneumoCheck

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 6: ......

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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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