ATS Pulmonary Function Laboratory Manual

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

Procedure

Pre-Bronchodilator Administration 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 • Do not proceed. • Notify patient’s nurse or registration desk

The ID band is present but not attached to the patient

2. Check for a complete physician’s order. A laboratory-developed protocol that identifies indications for pre- and post-testing may be appropriate. 3. Prepare the bronchodilator administration equipment. 4. Explain the test to the patient. 5. Obtain physiologic data (e.g., pulse rate, blood pressure). This is optional.

Bronchodilator Administration

Step Action 1.

Explain and demonstrate the breathing technique to the patient. The demonstration will be dependent on the device being utilized. 2. Administer bronchodilator MDI

The technician should hold MDI 1 to 2 inches from the patient’s open mouth. If a valved holding chamber or spacer is used, it should be placed in the patient’s mouth (or as recommended by the manufacturer). Have patient exhale below functional residual capacity (FRC), but do not force them to exhale to residual volume (RV). Instruct patient to take a slow, deep breath. While the patient is inhaling from below FRC, activate the MDI; instruct the patient to continue inhaling until they are close to TLC. It is important that the inhalation be slow (i.e., a flow rate of approximately 0.5 L/s or less). Instruct the patient to hold the breath for 5 to 10 seconds, if possible, then exhale slowly (1). Wait approximately 30 seconds, then repeat steps 1 through 4 until the ordered or selected dosage has been delivered. SVN (continues on next page)

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