Asthma Helpline Case Study December 2011
My name Louise and I am in my late thirties. My GP says I might have asthma or COPD. He has arranged spirometry testing for me in the local hospital. I am nervous and wondering how do I prepare for this and what exactly does it involve?
Asthma Nurse's Advice
Asthma is a condition that affects the airways-the small tubes that carry air in and out of the lungs. With asthma, the airways become over-sensitive and react to things that would normally not cause a problem, such as cold air or dust. Muscles around the wall of the airway tighten up, making it narrow and difficult for the air to flow in and out. As opposed to
COPD (chronic Obstructive Airways disease) which is a chronic slowly progressive disorder with narrowing of the airways. Asthma and COPD often produce similar symptoms of cough breathlessness and wheeze but are different conditions and respond differently to various medications. These two conditions can often overlap and co exist together in the same individual hence accurate diagnosis is essential for correct management. Asthma is characterized by more intermittent behaviour than COPD. When Asthma is well controlled symptoms are minimal or even absent. COPD on the other hand, is a condition which leads to chronic symptoms of breathlessness and cough.
Spirometry (meaning the measuring of breath) is a simple breathing test that gives measurements of lung function which may include a reversibility test that measures lung function before and after a dose of reliever medication to see if it has improved your lung function. This can be helpful with asthma diagnosis. Spirometry is a sensitive way of assessing airflow obstruction in COPD. Peak flow meters are a more useful tool for monitoring asthma but are of little value in COPD diagnosis, as the readings may lead to an underestimation of the extent of airway narrowing.
Spirometry assesses lung function by measuring the volume of air the patient is able to expel from the lungs after a maximal inspiration. It is a reliable method of differentiating between COPD and Asthma. Spirometry can also be used to determine the severity of COPD.
The test should take about 15 minutes to perform and a few minutes longer if ‘reversibility’( explained above) is to be performed.
A Respiratory Scientist, Doctor or nurse proficient in the procedure may perform the test.
A medical history will be obtained from you prior to procedure
They will ensure that you are sitting comfortably and begin by explaining the purpose of the test. The Health Care Professional HCP may demonstrate the correct technique themselves before inviting you to use the spirometry for the first time.
A record will be made of your sex, age and height, origin ie; Caucasian or asian. . This is needed so that your readings can be compared with predicted values for your age height and sex.
It will be noted if you suffering from an exacerbation or have recently taken an inhaler.
It is usually advised not to take inhalers if possible before the test. The hospital may have a factsheet with specific information and instructions for you to read prior to procedure.
Format /Instructions
You will be asked to breathe in as deeply as possible. Then put the mouthpiece into your mouth, grip gently with your teeth and seal your lips around the mouthpiece. Sometimes you may be required to wear a nose clip to ensure all the air comes out through your nose and not through your mouth.
You will then blow out as hard and as fast as you can, until there is nothing left to expel. The HCP will encourage you to keep blowing. This manoeuvre may take up to 15 seconds. This procedure will be repeated at least 2 more times. It is desired to have 3 readings of which 2 are within 5% of each other which indicates that the test was performed correctly.
The results of the test can then be sent to your GP who can discuss the results with you.
To speak to an Asthma Nurse on any asthma related query, call the Asthma Helpline in confidence on 1850 44 54 64 from 10am to 1pm, Monday to Friday.
