Spirometry

Paediatric spirometry guideline of the South African Thoracic Society: Part 1

“…[13] Personal information such as height, weight, age, gender and racial group should be recorded for each patient. [11,14] This information is necessary for the use of appropriate reference equations. The recently updated Global Lung Initiative (GLI) reference equations are the most comprehensive and should be used as they take into account the impact of racial differences in different population groups worldwide.…”

“…in patients with severe spinal or thoracic cage abnormalities -the arm span may be used as an estimate of height. [10,11,17] A skilled and trained technician who is used to working with children and a comfortable and safe environment are important factors in achieving successful spirometry in children. [3] Children need adequate training and practise prior to being tested.…”

“…The standing position should be avoided as this may lead to larger FVC values, especially in obese patients. [19] A nose clip should be worn, [2,11,20] but is not necessary if it does not fit properly or if it causes discomfort or anxiety; however, use, or lack thereof, should also be documented. A finger pinch of the nose is acceptable as long as this forms an adequate seal to the nose.…”

“…[9] [4] and Lange et al [11] neutral position with neither hyperextension nor flexion. [2,21] The patient's mouth must be closed tightly around the mouthpiece and there must be no air leak from this seal.…”

“…In these cases, manual assistance may be mandated to obtain a good seal. [11] There should be no chewing, vocalisation, swallowing, coughing or occlusion of the mouthpiece with the tongue, lips or teeth. [2] Children should not engage in vigorous exercise prior to testing.…”