A well-executed test starts at the point where the X-axis crossed the Y-axis and increases rapidly to the top or Peak Expiratory Flow. From there it declines more slowly in a more or less straight line to the X-axis. It is recommended to let the expiration follow by another complete inspiration to obtain a closed flow-volume loop., A frequent variation of the normal flow-volume loop is the so-called 'shoulder': a bulge to the outside, high on the curve. This shoulder is usually seen in spirometry loops from young females., Coughing. Many patients get a coughing reflex during the forced expiration. The closure of the glottis causes the flow to suddenly fall to zero and rise again., Expiration Too Slow. The peak flow is not within the first 100 milliseconds and the top is rounded ad not pointed., Expiration Too Slow. A dent is seen in the rising part of the loop, where the patient 'hesitated'., Expiration Too Slow. Patient hesitated at the start of the flow-volume loop: kink in curve, Incomplete Expiration. Correct execution of the manoeuvre requires that the lungs are fully emptied. If the patient does not empty their lungs, the right part of the loop will make a sudden fall to the X-axis. The total expired volume (FVC) is underestimated., Larger Inspiration Than Expiration. The importance of the second complete inspiration after the forced expiration lies in the quality control of the loop: if the patient inhales a larger volume after the forces expiration one knows that the lungs where not completely filled before the test. The end of the loop lies left of the Y-axis., Expiratory Time Not Sufficient. The patient expired less than 2 seconds: the test should be repeated or stated on the report that the patient was unable to achieve 6 seconds.,

Common Technical Errors - Spirometry

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