ATS Pulmonary Function Laboratory Manual

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

Procedure

Pre-Test Preparation

Step Action 1. Check patient identification. Ask the patient to state or spell his/her first and last names, and date of birth. Verify the spelling and date of birth against ID band, and/or requisition. IF THEN Patient unable to provide information • Get information from family member or caregiver, if present. • Notify person in charge, if a family member or caregiver is not present to provide the information The identifiers do not match • Contact registration • Resolve discrepancies before proceeding The ID band is present but not attached to the patient • Do not proceed. • Notify patient’s nurse or registration desk 2. Check for a complete physician’s order. 3. Collect and record demographic information. 4. Explain and discuss the test procedure, and what will be required of the patient, including performing acceptable and repeatable spirometry, type of inhalation flow required for the inhaler, and demonstrations as required. 5. Patient should be seated for the test. If the patient needs to use the toilet, they should do so before starting the test. Enter patient demographic information into spirometer, as applicable. 6. Pre-challenge spirometry: Have patient perform spirometry according to ATS/ERS guidelines (8). Check for any contraindications (e.g., patient’s FEV 1 should be ≥ 70% of predicted, and patient should be able to perform acceptable-quality spirometry).

Test Procedure for Mannitol Challenge Test (7)

Step Action 1.

Determine Baseline FEV 1 1.1. Remove the 0 mg mannitol capsule from foil, twist open the inhaler, place capsule inside inhaler, and close inhaler, 1.2. Pierce the capsule only once by fully depressing both piercing buttons on the sides of the inhaler simultaneously. 1.3. Instruct the patient to attach nose clip. Have patient hold inhaler and tilt inhaler at a 45 degree angle (mouthpiece down), exhale away from inhaler, seal lips tightly around inhaler mouthpiece and to take a controlled and deep inhalation. During a successful inhalation, a rattling sound should be heard as the capsule spins within the inhaler. (continues on next page)

144