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Bed side tests of Pulmonary function

Bed side tests of Pulmonary function. Vineet and ravi. Pulmonary function tests have been used traditionally in the preoperative assessment before any major surgery. INDICATION Determination of any significant impairment of lung function. Degree and severity of impairment

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Bed side tests of Pulmonary function

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  1. Bed side tests of Pulmonary function Vineet and ravi

  2. Pulmonary function tests have been used traditionally in the preoperative assessment before any major surgery. INDICATION • Determination of any significant impairment of lung function. • Degree and severity of impairment • Characterize any pulmonary dysfunction physiologically as obstructive or restrictive • Identify the site of airway obstruction • Evaluate the risk of procedures on lung • To assess prognosis • Evaluate airway hyper-reactivity .

  3. Snider’s Match Blowing test • Mouth wide open • Match held at 15 cm distance • Chin supported • No head tilting • Match stick and mouth at the same level

  4. Can not blow out a match • MBC < 60 L/min • FEV1 < 1.6L • Able to blow out a match • MBC > 60 L/min • FEV > 1.6L

  5. Modified Snider’s test • 3 inches MBC > 40 L/min • 6 inches MBC > 60 L/min • 9 inches MBC > 150 L/min • FORCED EXPIRATORY TIME • FET < 3 Sec (Restrictive lung ) • FET > 6 sec (Obstructive lung )

  6. SEBERESE’S SINGLE BREATH COUNT • Patients is asked to take a deep breath followed by counting 1,2,3……….. till the time he cannot hold breath . • Shows trend of deteriorating or improving pulmonary function in pre & op . post op patients

  7. SEBARESE ‘S BREATH HOLDING TEST • Subject is asked to take a normal tidal inspiration and hold breath • (N) ≥ 40 Sec • < 15 Sec is a C/I for elective surgery

  8. COUGH TEST • Observe for ability to cough, strength and effectiveness • Wet productive cough candidate for pulm complications • Inadequate cough FVC < 20 ml/kg • FEV, < 15 ml / kg

  9. DE BONO’S WHISTLE TEST • Wide more tube which has a whistle at the end and an adjustable leak hole in the side . The whistle shows when the rate of airflow through the whistle exceeds a certain value. WRIGHT’S PEAK FLOW METER. • Values < 200 L/ min in surgical candidates suggest impaired cough efficiency • (N) Males – 450 – 700 L/min • Females – 300 – 500 L/min

  10. SPIROMETRY WITH POCKET SIZED SPIROMETERS • VC & FEV, Can be readily performed • BED SIDE PULSE OXIMETRY • Useful & rapid index of pulmonary gas exchange ABG • Most commonly used measures of gas exchange are the partial pressures of 02 & co2 in arterial blood. • These pressures do not measure the quantity of 02 & co2 in blood but the driving press. of the gas

  11. BLOW AGAINST THE HAND. • Place your hand against the patients month with slight resistance and ask the patient to blow I: E RATIO

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