The decision to withhold long- and short-acting bronchodilators before testing is a clinical one determined by the referring healthcare professional. It is very important to document what medication, the type and dosage, and when it was last taken prior to testing so that the test can be interpreted correctly. Short-acting inhaled drugs (e.g. salbutamol or ipratropium bromide) should not be used within 4 hours of testing. Long-acting beta-agonists should be stopped for 12 hours prior to the test. If medication has been taken, the operator should record the name, dosage and the time of last administration of any medication that may alter lung function, particularly bronchodilator medication.
Performing the test
Wash hands and ask subject to wash hands Conduct baseline spirometry Ensure 3 acceptable and repeatable baseline blows are recorded Explain the procedure to the subject Explanation about the effects of the bronchodilator which include possible tachycardia, sensation of the heart beating in their chest. These are normal effects but are not experienced by all subjects Ensure that the above washout timeframes have been adhered to
Administer the bronchodilator
Administer 4 metered doses of a salbutamol bronchodilator (400ug) 100ug at a time, with 30 second rests between doses via a valved spacer (A lower dose can be used if there is a concern about any effect on heart rate). This is achieved as follows:
Assemble the spacer Remove inhaler cap Hold inhaler upright and shake well Insert inhaler upright into spacer If the spacer is being used for the first time after having been disinfected (this should happen for each new subject), prime it by spraying 4 puffs of Salbutamol into the closed chamber
Administer the medication to the subject
Put mouthpiece between teeth (without biting) and close lips to form good seal Breathe out gently, into the spacer
Keep spacer horizontal and press down firmly on inhaler canister once so that a dose of 100ug of salbutamol is given
Breathe in slowly and deeply to fully inflated lungs Hold breath for 10 seconds before exhaling While holding breath, remove spacer from mouth Breathe out gently Remove inhaler from spacer. Wait 30 seconds Repeat all steps starting above for a second time, then a third then a fourth time Replace inhaler cap Four separate doses (total dose 400ug) are delivered at 30 second intervals. (A lower dose can be used if there is a concern about any effect on heart rate) Wait a minimum of 15 minutes for SABA to take effect
Post bronchodilator spirometry
After 15 to 30 minutes retest the subject Ensure 3 acceptable and repeatable blows are recorded Ask the subject to remove the mouthpiece and discard in the biohazardous waste bag Wash hands and ask subject to wash his hands Wipe the spirometer with a disinfectant wipe Evaluate the results by comparing the best pre and the best post FEV1 (and or FVC) for a change of 12% and 200mls
In-person Training
Specifically for bookings for a group of minimum 10 learners
The training program includes a pre-learning phase that allows participants to familiarize themselves with foundational concepts before engaging in in-person interactions with the facilitator.
Following the pre-learning phase, participants will have the opportunity to meet with the facilitator in a physical classroom setting. This direct interaction is crucial for addressing any questions or concerns that may have arisen during the self-study period.
Additionally, the physical classroom component is designed to facilitate hands-on practical training. This aspect of the program allows participants to apply theoretical knowledge in real-world scenarios, enhancing their understanding and retention of the material. Working under the guidance of an experienced facilitator, learners can practice skills, collaborate with peers, and gain valuable insights that are difficult to achieve through online learning alone.
Overall, this structured approach—combining pre-learning with direct facilitator contact and practical classroom experiences—ensures a comprehensive and effective learning journey that accommodates various learning styles and maximizes participant engagement.
Blended Learning
Self-pased learning combined with weekly online contact sessions with a facilitator and in-person practical training days
This combination allows learners to work through the theory at their own pace while still interacting with instructors on a weekly basis through regular question and answer online contact sessions.
The online part is flexible, letting learners study whenever it works best for them.
Live sessions help build a sense of community and support.
The in-person classes are important for hands-on learning, giving learners the chance to practice their skills with guidance from experienced mentors.
This well-rounded approach improves learning by meeting different learning styles and preferences.
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