ATS Pulmonary Function Laboratory Manual

ATS Pulmonary Function Laboratory Management & Procedure Manual | 3rd Edition

Pre-Test Preparation

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Step Action 3.

Collect and record demographic information.

4. Explain and demonstrate test maneuver, including correct posture while in the sitting position. Advise the patient that the maximal expiratory maneuvers may make the ears “pop.” Instruct the patient to keep a tight lip seal and to give maximum effort. A tight-fitting nose clip should be properly in place.

Maximal Inspiratory Pressure

Step Action 1. Place a rubber-flanged mouthpiece, a circular non-flanged rubber mouthpiece or other rigidly constructed tube firmly onto the mouthpiece adapter. 2. Patients are normally seated and a nose clip is not required, but may be used. 3. Instruct the patient to exhale slowly and completely (to RV), seal his/her lips firmly around the mouthpiece, and then inhale with as much force as possible. 4. Strong encouragement is necessary, and the patient should be urged to “suck real hard” or “pull in hard” for at least 1.5 seconds (5). 5. Obtain at least three efforts with a maximum of eight efforts. 6. A goal for repeatability should be that the two highest values agree within 10%. If the final effort is the highest value, obtain an additional effort (6–8). 7. Allow the patient to rest for 30 to 60 seconds between efforts (3, 6, 8). Step Action 1. Place a rubber-flanged mouthpiece, a circular non-flanged rubber mouthpiece or other rigidly constructed tube firmly onto the mouthpiece adapter. 2. Patients are normally seated and a nose clip is not required, but may be used. Patients often need coaching to prevent air leaks around the mouthpiece and to support the cheeks during the expiratory efforts. One ap- proach is to have the patient pinch their lips around the mouthpiece (5). 3. Instruct the patient and demonstrate correct placement of the rubber mouthpiece or tube held firmly against pursed lips (not inside the mouth like other mouthpieces). If the patient can’t perform the test acceptably, switch to a different style of mouthpiece or interface. 4. Instruct and urge the patient to inhale completely (to TLC), press the mouthpiece firmly against his/her lips, and then to exhale with as much force as possible against the mouthpiece for at least 1.5 seconds (5). 5. Watch the patient closely to ensure there are no leaks. 6. Obtain at least three efforts with a maximum of eight efforts. (continues on next page) Maximal Expiratory Pressure

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