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This document is a guide only and does not diminish the requirement to exercise clinical judgement and follow local policy. The publishers cannot accept
responsibility for the use of this information in clinical practice.
Note:
Values of FEV
1
and FVC are expressed as a percentage of the predicted normal for a person of the same sex, age and height.
1
Patient advice before the test
3
i
Avoid eating a full meal within two hours of the test
i
Avoid alcohol within four hours of the test
i
Avoid smoking within 24 hours of the test
i
Avoid exercise within 30 minutes of the test
i
Wear loose-fitting clothing.
Contraindications to spirometry
testing (always adapt to your place
of work and local policy)
3
i
Exacerbation in last 4–6 weeks
i
Haemoptysis
i
Pneumothorax
i
Unstable cardiovascular status
i
Thoracic, abdominal or cerebral aneurysms
i
Recent eye surgery
i
Nausea and vomiting
i
Recent thoracic/abdominal surgery
i
Pain.
How to perform spirometry?
Prepare the patient by fully explaining the test
1, 2
— allowing some practice attempts before
taking readings can help. No more than eight attempts (including practice ones) should be
taken at any one session.
4
Two sets of measurements will need to be undertaken — for both, the patient should be
seated and comfortable.
1, 2
i
Vital capacity —
this can be done first so that the patient becomes familiar with
the equipment:
O
Patient needs a nose clip or to hold their nose
O
Patient breathes in deeply and then exhales slowly and steadily until all the air is
blown out (encourage the patient to keep blowing)
O
Repeat test at least two more times and record values manually — the best two blows
should be within 100mls of each other.
4
i
Forced vital capacity —
the FEV
1
is taken from this test:
O
No nose clip is needed
O
Patient breathes in deeply and exhales hard and fast until all the air is blown out
O
Repeat test at least two times and record values manually — the best two blows
should be within 100mls of each other.
1. Global Initiative for Chronic Obstructive Lung Disease (2015)
Pocket guide to COPD diagnosis, management and prevention
.
Available online: http://bit.ly/1V9Xd3I
2. British Thoracic Society COPD Consortium (2005)
A practical guide to using spirometry in primary care
. BTS COPD
Consortium, London. Available online: http://bit.ly/1Ojvnxw
3. Loveridge C (2015)
J GPN
1(2):
28–33
4. Primary Care Commissioning (2013)
A guide to performing quality assured diagnostic
spirometry
. Available online: http://bit.ly/1Len4V5
Remember:
always interpret spirometry results alongside a patient’s full clinical history
3
!