Delete Curve; Coach: Blast FASTER. Cough in ... (1-800-232-4636) TTY: 1-888-232-6348 email:
Get Valid Spirometry Results EVERY Time 12 FLOW (L/S) (BTPS)
VOLUME (L) (BTPS)
6
A Valid Test has: 3 or More Good Curves and Repeatable FVC and FEV1*
Sharp peak
Flat (plateau) before 15 seconds long
5 4
Smooth curve 3 2
10
1
8
Smooth descent to baseline
6 4 2
Vertical rise
Steep climb
0 0
1
2
3
4
5
6
7
8
9
10
11
12
0
13
0
1
2
3
4
5
Green = Good Curve Red = Error
6
VOLUME (L) (BTPS)
TIME (sec)
HOW TO CORRECT TEST ERRORS
0
0 0
1
2
3
4
5
6
7
8
9
10
11
12
13
0 0
1
2
3
4
5
6
0 0
VOLUME (L) (BTPS)
TIME (sec)
1
2
3
4
Incomplete Inhalation Coach: Take a DEEPER breath
4 3
Curves have same shape but are different sizes
2 1
10 8 6 4
0
1
2
3
4
5
6
7
8
9
10
11
Gap
2
0 12
0
13
0
10
1
1
2
3
4
5
1
2
3
4
5
6
7
8
9
10
11
12
6
13
1
2
Curve dips
2 1
1
2
3
4
5
2 1
1
2
3
4
5
6
7
8
9
10
11
12
13
3
4
5
8 6 4
0
1
2
12
5
10
4 3
Abruptly flattens
2
6
1
2
3
4
5
6
7
8
9
10
11
12
13
3
4
5
6 4
2
3
4 3 2 1
OR Curve drops down 1
2
3
4 5 TIME (sec)
6
7
8
8 6 4 2
9
0
12
13
0
2
3
4
5
6
VOLUME (L) (BTPS)
7
8
Curve tilts
3
4
5
6
4
5
1
2
3
4
5
6
7
8 6 4 2
8
9
10
11
12
0
13
0
1
2
3
4
5
6
VOLUME (L) (BTPS)
Curve moves backwards
5 4 3
Curve drops down
2 1 0
6
Flat line extends to right
Curve flattens out
6
0
1
2
3
4
5
6
7
8
9
10
11
12
13
0
1
2
3
4
5
6
VOLUME (L) (BTPS)
TIME (sec)
Extra Breaths Correction: DELETE CURVE; Use nose clips and lips tightly sealed
Extra breaths
6
12
5 4
1 or more extra breaths look like miniature additional curves
3 2 1
1
2
3
4
5
6
7
VOLUME (L) (BTPS)
8
9
10
TIME (sec)
11
12
13
14
15
16 17
18
Extra breaths
10 8 6 4 2 0
0
TIME (sec)
2
VOLUME (L) (BTPS)
0
1
1
Leak Correction: Check equipment and connections
VOLUME (L) (BTPS)
5
Difficult to see on this curve
10
Continues to climb – NEVER flattens
11
TIME (sec)
VOLUME (L) (BTPS)
FLOW (L/S) (BTPS)
12
10
10
0
Positive Zero Flow Error Correction: No airflow through sensor when spirometer zeroing Hold sensor upright during test
VOLUME (L) (BTPS)
6
Curve ends early
FLOW (L/S) (BTPS)
VOLUME (L) (BTPS)
7
9
12
14 8
8
2
6
Drops straight down
1
7
3
0
0
6
4
0
TIME (sec)
Negative Zero Flow Error Correction: No airflow through sensor when spirometer zeroing Hold sensor upright during test
5
5
1
8
0 1
4
6
2 0
3
VOLUME (L) (BTPS)
6
4
TIME (sec)
2 2
6
0
6
Difficult to see on this curve 1
8
Inconsistent Effort Coach: One continuous blast and keep blowing
10
0
Curve dips
2
Glottis Closure or Breath Holding Coach: Initial BIG BLAST then RELAX and keep blowing
VOLUME (L) (BTPS)
TIME (sec)
3
VOLUME (L) (BTPS)
0 0
4
0 0
TIME (sec)
4
13
12
Does not flatten for 1 second
3
0
Smaller peak and curve wobbles
8
0 0
11
4
6
2
0
10
5
VOLUME (L) (BTPS)
5
FLOW (L/S) (BTPS)
VOLUME (L) (BTPS)
12
2
9
TIME (sec)
VOLUME (L) (BTPS)
6
Curve wobbles
8
12
Partially Blocked Mouthpiece Coach: Position mouthpiece between teeth and on top of tongue; secure dentures
3
7
0
TIME (sec)
4
6
6 VOLUME (L) (BTPS)
5
5
10
No Plateau Before 15 Seconds Coach: Keep blowing until told to stop
12
Ga p FLOW (L/S) (BTPS)
VOLUME (L) (BTPS)
6
2
5
FLOW (L/S) (BTPS)
Slow take off
1
4
12
FLOW (L/S) (BTPS)
2
2
6
6
FLOW (L/S) (BTPS)
1
3
8
VOLUME (L) (BTPS)
Slow climb
4
4
VOLUME (L) (BTPS)
2
Rounded or flat peak
6
10
Peak shifted to right
FLOW (L/S) (BTPS)
3
8
5
FLOW (L/S) (BTPS)
4
12
VOLUME (L) (BTPS)
10
6 FLOW (L/S) (BTPS)
5
VOLUME (L) (BTPS)
12 FLOW (L/S) (BTPS)
VOLUME (L) (BTPS)
6
Cough in First Second Delete Curve; Correction: Try a drink of water
Hesitation; Slow Start; Large Extrapolated Volume Delete Curve; Coach: Blast FASTER
Poor Initial Blast Coach: Blast air out HARDER
0
1
2
3
4
5
6
VOLUME (L) (BTPS)
Delivering on the Nation’s promise: Safety and health at work for all people through research and prevention. To receive documents or more information about occupational safety and health topics, please contact NIOSH:1-800-CDC-INFO (1-800-232-4636) TTY: 1-888-232-6348 email:
[email protected] or visit the NIOSH Web site at www.cdc.gov/niosh For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting www.cdc.gov/niosh/eNews. For more information about NIOSH-Approved Spirometry Training go to http://www.cdc.gov/niosh/topics/spirometry/training.html H T OF HEALTH & EN
DHHS (NIOSH) Publication No. 2011-135
M RT
Centers for Disease Control and Prevention National Institute for Occupational Safety and Health
DE PA
U.S. Department of Health and Human Services
S AN UM
ERVICES
US
A
