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A Protocol for Screening

Screening for COPD: A Protocol

We can measure lung age and FEV1 to establish lung health using a
Microspirometer e.g. Pulmolife or Vitalograph 6

It takes 3 minutes

Aim: To find patients with early signs of airways obstruction in their lungs,
in order to make them aware, and then carefully monitor their progress
which will, hopefully prevent further deterioration

Find the missing patients who might have COPD

In order to increase prevalence of COPD in your practice, offer screening to all patients
over 35, current or ex-smokers of more than 1 pack a day for 15 years Use Increasing the
Prevalence of COPD USMOKE+ sheet

Screen those in the asthma, diabetic and cardiac clinics during routine reviews,
as they may have COPD as well.

Minor illness surgeries and new patient checks also offer good opportunitiesPatients
offered a lung health check should be in good health (no cough or cold, chest
infection, pneumothorax, unstable angina, surgery, heart attack or stroke in the last
3 months).

Programme the microspirometer with male / female, accurate height measurement (metric),
age and ethnicity

The patient must be seated with both feet flat on the floor

1.    Ask the patient to fill up their lungs as much as is possible

2.   Put the mouthpiece in the mouth, behind the teeth and making a tight seal
with the lips so no air can escape

3.   Then blow the air out through the mouthpiece as hard and fast and
smoothly as possible until the machine bleeps – Pulmolife takes 1 second.
Vitalograph takes 6 seconds

4.   Make a note of the readings before moving on to the next blow

5.   3 blows should be done and the best reading of the 3 recorded on patients record

The normal range of FEV1 is between 80 – 120%

If the FEV1 is less than 90% of predicted, the ratio of FEV1/FEV6 (vitalograph only) is less than
75% of predicted or the patient is symptomatic, full spirometry testing will be required at another

time, so refer to a clinician with responsibility who will arrange for full postbrochodilator
spirometry to aid the diagnosis.

Infection control – a new disposable mouthpiece must be used for each client, the Spirometer is to
be wiped clean using an antimicrobial wipe between each client.

Brendan Tutt,
23 Jan 2016, 09:26