ATS Pulmonary Function Laboratory Manual

chapter  3

7. Unusual or special procedures should be referred to the laboratory supervisor or medical director for clarifi- cation and scheduling.

Patient Demographics 1.

Medical history and medication information 1.1 A respiratory questionnaire may be given to the patient at the time of testing (example in Appendix 3.3), this may also include standardized questionnaires such as the COPD Assessment Test (CAT) or the Medical Research Council (MRC) breathlessness scale. 1.2 Medical history should include: past respiratory problems, occupation, and smoking habits. 1.3 Technologist comments of the patient’s condition at the time of testing might include comments about cough, dyspnea, wheeze, cyanosis, anxiety level, and cooperation during the testing session. 1.4 Record the diagnosis and/or reason the test is being performed. 1.5 Verify the absence of contraindications or when suboptimal conditions exist which may affect testing results (1). 1. Suboptimal conditions for a procedure should be reviewed with the ordering physician and/or medical director prior to test performance. 1.6 Record relevant medications and when last used. 1. Consideration of each medication and potential effects on test results must be reviewed both during the scheduling of the procedure and in the immediate pre-test period. 1.7 Record date of birth (preferred) or age (in years to nearest tenth [e.g., 8.3 years]) on day of test, gen- der, race, full name, and billing and medical record numbers. 2. Measuring height and weight 2.1 Measure height with the patient’s back against a wall in an upright position without shoes on the day of the test. The patient should be standing up straight and looking forward with their gaze roughly parallel to the ground. 1. A properly mounted stadiometer provides an accurate method for measuring height. A “physician’s” scale should not be used because it can lead to incorrect height measurements. 2. Record height in inches (in) to nearest ¼ inch or in centimeters (cm) to nearest 0.5 cm (4). 2.2 Accurately obtain and record weight in pounds (lb) to the nearest lb, or kilograms (kg) to the nearest half kg. 3. Estimating standing height for patients with spinal deformities or for those who cannot stand (1, 4). 3.1 Measurement of arm span closely equals standing height for individuals older than 16 years of age. 3.2 Have the patient stretch the arms in opposite directions and obtain the maximal distance between the tips of the middle fingers. Use the following corrections to obtain height: 1. Height for Caucasian men = arm span/1.03 2. Height for women = arm span/1.01 3. Height for African-American men = arm span/1.06 3.3 Pediatric height related to arm span 1. For boys <9 years the height exceeds arm span. 2. For girls <12 years the height exceeds arm span. 3. For boys age 9 to 16 and girls age 12 to 16, the ratio of arm span to height should be linearly interpolated between 1.0 and the appropriate values for adults. 4. Informed consent may be required for some specific tests based on institutional policy (8). 4.1 The informed consent should be written so the patient clearly understands the choices presented and the consequences of their consent.

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