Performing Spirometry in General Practice
Professor John Wilson and Mr Bruce Thompson from The
Alfred Hospital present the role of spirometry in the general
practice setting for the diagnosis and management of asthma.
The Role of Spirometry
Video Clip One (3 mins 32 secs)
-
A practical example of the technique for performing spirometry
on a patient in the surgery.
- Introducing and explaining the test procedure to the
patient.
- Coaching the patient through the test.
- Obtaining the best possible patient effort.
Discussion and Interpretation of Spirometry
Video Clip Two (3 mins and 42 secs)
- Advice to the patient about medication prior to coming
for the test.
- What the patient can expect during the test.
- When spirometry should not be attempted.
- How to optimise results.
- What the results show about asthma.
Spirometry - an objective measurement
The preferred objective measurement for the diagnosis,
management and monitoring of asthma is spirometry.
Two important measurements that are made are:
| Vital Capacity (VC) |
The maximum volume of air that can
be exhaled or inspired during either a forced (FVC)
or a slow (VC) manoeuvre. |
| Forced Expired Volume in one
second
(FEV1) |
The volume expired in the first
second of maximal expiration after a maximal
inspiration and is a useful measure of how quickly
full lungs can be emptied. |
The consistency and reproducibility of the FEV1,
as well as the additional information provided by the spirometer, are among the
reasons why spirometry is preferred over peak expiratory flow rate (PEFR) in
general practice.
The additional information is
- FEV1
- FVC,
- the calculated ratio of FEV1/FVC,
and
- the record of the flow/volume loop.
|
With practice, the GP can deduce a great deal of information
about the state of the lungs from the shape of the flow/volume
loop.
|
