The environment in which a spirometry session is administered is crucial regarding measurement accuracy. According to the Standardization of Spirometry 2019 Update (ATS 2019) by the American Thoracic Society and European Respiratory Society, there are some key points that need to be ensured.
Testing environment details
SpiroClinic Pro is a calibration-free device, meaning there is no need to calibrate it before use, but according to ATS 2019, calibration verifications should be done at least daily using a 3L syringe cycled at least three times to give a range of flows varying between 0.5 and 12 L/s.
Physical testing environment
The session should be administered in preferably a quiet and comfortable environment. It should happen in a separate room other than the waiting area for the subjects.
Drinking water should be available in the room for the subject being tested. Also, there should be tissues or paper towels provided for any secretions that may come up during the testing.
The subject's posture
The subject's seat should be one in which one can sit straight, with shoulders angled slightly back and chin slightly elevated. The chair should have arms to prevent falling if the subject were to sway sideways, should not be wheeled, and should have a height adjustment to ensure that the subject's feet are flat on the floor (a footstool should be provided to ensure this for children and smaller adults).
Recording the environmental details
Ambient temperature, barometric pressure, and time of the test should be recorded before starting. Temperature is especially important for most pulmonary function tests and sometimes is measured directly by the instrument just as it is the case with SpiroClinic Pro which takes these measurements by using its Smart Dock, but the operator also should confirm these measurements.
Starting the test
- The SpiroWay Pro should be inserted (with the handle forward) into the body of the SpiroClinic Pro.
- The bacterial viral filter should be inserted into the SpiroWay Pro.
- The subject should put on the nose clip correctly to ensure there is no air coming out of the nose.
- After the steps above are completed, the subject should be instructed to start the test.
- Once the test session is done, the BVF and the nose clip should be disposed of and the device and all the surfaces the subject contacted should be wiped with medical wipes in preparation for the next subject.
Hygiene & infection control
The bacterial viral filter should be changed for each subject and the device body should be wiped thoroughly with antibacterial wipes to avoid touch-contamination from subject to subject.
The goal here is to prevent the transmission of any infections to subjects and staff during testing. Direct infection transmission can happen by direct contact with certain surfaces such as mouthpieces, nose clips, handheld spirometers, chair arms etc. On the other hand, indirect transmission occurs by aerosol droplets that the subject creates by breathing into the spirometer, and also expelled into the air between maneuvers.
The operator must be diligent about washing their hands and using hand sanitizer before contact with each subject. The use of disposable gloves (a new set for each subject) is another option.
The subject also should be given an approved disinfectant before entering the testing room to prevent infection by touch.
The hygiene of the equipment is ensured by the use of in-line disposable filters and mouthpieces. All disposable items like gloves, filters, nose clips etc. should be disposed of at the end of each session.
Also, if needed or preferred, the reusable airway can be changed between subjects too. This is not a requirement as the airway covers all the surfaces with which the subject's breath contacts, but if extra measures are preferred, it can be removed for later cleaning and different airways can be used for different subjects.
- “Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement.” American Journal of Respiratory and Critical Care Medicine, 2019.