Welch Allyn SP-2 Service manual

SP-2 Hand-Held Spirometer

Cardio Menu

Service Manual

Introduction 2
Procedure Overview 4
Main Menu 5
Entering Patient Data 6
Selecting the Test 9
Taking a Test 12

Forced Vital Capacity (FVC) Test 12
Slow Vital Capacity (SVC) Test 13
MVV Test 13

Screen Information 14

Curves 14
Tabular 15

Post-Medication Tests 16
Memory 17

Menu 19

Displaying Test Data From a Stored Patient 20
Obtaining a Printout 21
Spiro Settings (User Identification) 22
Spiro Settings (Printout) 23

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

Section 1

Spiro Settings (Device) 24

Normals 25

Changing the Mouthpiece 26
Calibration 28

Calibration Procedure 29

Explanation of Measured Values 32
Care & Maintenance 34

Self-test 34
Lifed Items 34
Cleaning the Unit 35
Batteries 35

Spirometry Tips - How To Do It and Common
Pitfalls and Problems 36

How to Do It 36
FVC 37
FEV1 38
Patient-Related Problems 39

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Introduction

The SP-2 Hand-Held Spirometry Unit features three

pulmonary function testing modes for the
measurement of inspiratory and expiratory values.
The large LCD screen instantly show pulmonary
test results and provides a clear and comprehensive
result analysis in a number of different formats. All
tests and settings are initiated via an easy to use
interface.

The sensor mouthpiece is a disposable, single
patient sensor/filter assembly eliminating the need
to clean the sensor after each use.

All functions and settings are selected via menus
displayed on the LCD with direct test function
menu options for measuring the following:

n FVC Forced Vital Capacity

n SVC Slow Vital Capacity

n MVV Maximum Voluntary Ventilation

(Option)

1. Battery Compartment

Two, 1.5V non rechargeable AA batteries

2. 12 Alpha numeric keys

For text / numerical input e.g. patient data, calibration data etc.

3. Three Direct Function keys:
Print / Send. This key initiates transmission over the infrared interface

to a compatible printer using the standard data association protocol.
LCD Backlight Key - The middle key is the ON/OFF control for the

LCD backlight. The backlight is automatically switched off after
approximately 10 seconds.

The START/STOP (and ON/OFF) key has three functions:

n Switches the unit on.
n When the unit is switched on and in test mode, this key starts /

stops a measurement.

n When the unit is switched on and not in test mode, this key

switches the unit off (press for 2-3 seconds).

4. Four (menu navigation/selection) Function keys:
LEFT / RIGHT keys - The functions of these keys depends on the

menu displayed and is shown in the bottom line of the LCD line. In
general however, the left softkey selects the functions and the right key
acts in a similar way to the 'enter' key in a PC. See following pages.

The UP and DOWN keys move the cursor in the menu fields to
highlight the menu options. These two keys can also act as extra
function keys - in this case the function is shown in the bottom line of
the LCD line.

5. LCD

6. Infrared Data Interface (not seen)

7. Disposable Mouthpiece

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SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

Page 3

Procedure Overview

Main Menu

1. Press the ON key. The Introduction screen is displayed:

09:53

04.05.00

MENU PATIENT

Press the left soft key to enter the MAIN MENU Press the right soft key to enter the patient screen

(Page 5) (Page 6)

Battery Indicator - Displayed when

battery life is limited - change the
batteries as soon as possible.

When this symbol flashes, it
indicates critical battery voltage.
Tests can be completed but all other
functions ( e.g. printing, backlight)
are inhibited - change batteries
immediately.

Softkey Line - Defines the left / right
softkey functions

Page 4

Main Menu

If using the option for the first time select the required spiro settings and Spiro Standard. Select 'Settings' from

the main menu to display the Spiro settings - details of all spiro settings are given on the following pages. All these
settings are stored when the unit is switched off.

PATIENT
TEST
MEMORY
CALIBRATION

SETTINGS

EXIT ENTER

EXIT/MENU Return to introduction screen/main menu

Details of all settings are detailed later.

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

CURSOR UP /DOWN Move cursor (highlight bar) up/down

ENTER Select highlighted item

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Entering Patient Data

2. From the introduction screen press the RIGHT soft key to enter patient data.
(From the main menu, highlight 'patient' and press the RIGHT soft key).

Pat-Name: Gender: M (M/F)
DAVID OVER Height: 71.7 ins
Pat-Number: Weight: 179 lbs
123-456-00 Ethnic: C (C/H/B/A)
Born: Smoker: Y (Y/N)
05-04-43 (mm-dd-yy) Room: 5

MENU ENTER MENU ENTER

3. Select a new patient or change existing patient
data with the up/down soft keys and press the
RIGHT soft key to confirm.

For a required character, a key must be pressed one or
more times dependant on whether in a numerical or letter
field. For example in an alpha numeric field (e.g. patient
name) the '2' key is:
1st press 'A'; 2nd press 'B'; 3rd press 'C'; 4th '1'; 5th 'A'
etc.

In a numeric field the number comes first.

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NEW PATIENT

CHANGE DATA

MENU Return to main menu

Toggle between choices

Delete last character entered
or Toggle between choices

ENTER Enter details / Go to next line

Entering Patient Data

Each printout is complete with the name and other information concerning the patient. Before beginning a
recording, the patient data should be entered. The following parameters have to be entered:

Pat-Name: Alpha-numeric field
Pat-Number: Alpha-numeric field
Born: Enter patients` data of birth in the order shown (defined in system

settings)

Gender: Select `M` (male) or `F` (female). Use up/down toggle

keys to change.

Height: Height in centimeters (numeric field)

(or inches (scaled to 1/10 inch), depending on unit setup)

Weight: Weight in kilograms (numeric field)

(or pounds, depending on unit setup).

Ethnic: Enter patients race - either:

W/B: `W` for White, `B` for Black
or C/H/B/A: `C` for Caucasian, `H` for Hispanic, `B` for Black;

`A` for Asian. Use up down toggle keys

Smoker: Enter `Y` (yes) or `N` (no). Use up/down toggle keys

to change.

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Room: Alpha-numeric field

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

Page 7

Procedure Overview

4. Insert a new disposable sensor.

See page 26

WARNING

THE DISPOSABLE MOUTHPIECE IS DESIGNED FOR ONE­TIME USE TO MINIMIZE THE DANGER OF CROSS
CONTAMINATION - DO NOT USE THE MOUTHPIECE FOR

MORE THAN ONE PATIENT.

5. Calibrate the Unit
The unit must be calibrated

n At the beginning of each day

n When a significant temperature or pressure

difference occurs

The calibration procedure is detailed later.

Page 8

Selecting the Test

6. From the main menu Select the Test Option

PATIENT

TEST

MEMORY
CALIBRATION
SETTINGS

EXIT ENTER MENU ENTER

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

FVC TEST

SVC TEST

MVV TEST

PRE
POST

EXIT/MENU Return to introduction screen/main menu

CURSOR UP /DOWN Move cursor (highlight bar) up/down

ENTER Select highlighted item

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Taking a Test

7. For all tests the procedure is the same
The message `

before the measurement:

hold the sensor still

*** press START ***

appears on the display.

8. Press the START / STOP key once

The device must be held upright and quite still
and no air should be breathed into the device
for at least one second before the START key is
pressed.

As soon as the patient starts to breath into the
Mouthpiece, the unit begins to record the flow.
The corresponding curve is represented on the
display. The break-off point for the
measurement is reached automatically (or
when the Stop key is pressed).

Page 10

Taking a Test

Audible indications are given for each test as
follows:

FVC A beep is given at the end of exhalation

(indicating that inhalation (if required)
can begin), and at the end of the test.

SVC A beep is given when no flow is detected

(end of test) or in any case after 30
seconds.

MVV A beep is given after 12 secs (end of test).

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SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

Page 11

Taking a Test

WARNING: FALSE MEASUREMENTS CAN RESULT WHEN THE SENSOR IS NOT HELD VERTICALLY - ENSURE THAT THE UNIT IS HELD UPRIGHT WHEN

TAKING TESTS.

CAUTION: The SP-2 is a sensitive measuring device and must always be handled with care. Do not allow it to be dropped or

subjected to any sudden blows.

Forced Vital Capacity (FVC) Test

For this test the patient must exhale as quickly as possible from the time of starting the test.

Note: The FVC test employs the `Back extrapolation` method. If the extrapolated volume is too large (>0.15 liters or 5% of FVC),

then a warning appears on the display

To carry out the test for Forced Vital Capacity (FVC), highlight the `FVC` option in the test menu (previous page) and press the Enter key.
The corresponding coordinate presentation appears on the display.

The patient must exhale as quickly as possible from the time of starting the test so be sure that he understands what is required of him. If
inspiratory measurements are required, the exhalation can be immediately followed by a maximum inhalation. The inspiration results will be
given on the printout.

The coordinates represent the graph on which the curve will be drawn with the respiratory volume in liters being represented on the
vertical axis and the time in seconds on the horizontal axis.

ALSO SEE `SPIROMETRY TIPS` AT THE END OF THIS BOOK

Page 12

Taking a Test

Slow Vital Capacity (SVC) Test

The patient should breathe normally 3 times and then inhale to the
maximum extent of total lung capacity and then expire to the
maximum extent. Make sure that the patient understands what is
required of him.

MVV Test

The patient should breathe as deeply and as rapidly as possible
over a period of 6 to 12 seconds.

WARNING CARE SHOULD BE EXERCISED WHEN

PERFORMING THIS TEST AS THERE IS A
DANGER OF HYPERVENTILATION. ENSURE
THAT THE PATIENT IS SITTING DOWN.

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SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

Page 13

Screen Information

Curves

TEST RESULT

TEST Return to test menu

No function in this screen

No function in this screen

Page 14

RESULTS Display the results

Screen Information

Tabular

Once the test is completed, the measurement results are calculated.

To display the results in Tabular form, select RESULT (right key from the graph display).

Separate result tables are given for each test (FVC, SVC and MVV). The FVC screen displayed below is typical.

FVC

MEAS PRED %Pred
FVC 4.31 4.82 87
FEV1 3.50 4.532 79
FEV1/FVC 8.23 9.36 76
FEV3/FVC - - - - -­FEF.2-1.2 - - - - -­FEF25-75% - - - - - -

TEST CURVE

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

TEST Return to test menu

Previous result page / Next result page. Toggle through all calculated results.
The last page gives the interpretation.

CURVE Return to Test

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Post-Medication Tests

In order to carry out post-medication tests for comparison, select the `POST` from the test menu.

NOTE: THE POST OPTION IS ONLY AVAILABLE WHEN A `PRE` TEST HAS BEEN CARRIED

OUT. WHEN A POST MEASUREMENT IS NOT POSSIBLE THE MENU OPTION IS
DIMMED. ON SWITCH ON, THE `POST` OPTION IS AVAILABLE FOR THE LAST
PATIENT BEFORE THE UNIT WAS SWITCHED OFF.

FVC
SVC
MVV

PRE

POST

MENU ENTER

The post-medication tests are carried out in the same way as the premedication tests. The printout
following post-medication tests will give the curves of both pre and post-medication tests (the post
medication curve is dashed). The measurement results are shown as the best results (pre/post), results as
a percentage of those predicted, (both pre and post) and the percentage change (i.e. difference) between
pre and post-medication results.

Page 16

TO MINIMIZE THE DANGER OF CROSS INFECTION, DISPOSE OF THE

MOUTHPIECE IMMEDIATELY AFTER ALL TESTS HAVE BEEN CARRIED OUT.

Memory

The memory allows approximately 50 recordings (dependent on size and parameters specified when the
recording was taken) to be stored, displayed and printed.

The results of the current patient are automatically stored when a new patient is entered. When the
unit is switched off, the current patient and test results are remembered and are available the next
time the device is switched on.

When no more recordings can be stored the message `MEMORY FULL` is displayed. Old recordings
must be deleted before further recordings can be stored. Enter the memory screen from the main menu:

PATIENT
TEST

MEMORY

CALIBRATION
SETTINGS

Frederick Burt 24.05.00
Jones John 27.05.00

Smith Fred 12.06.00

* Overerly Jan 24.06.00
* Wyle Helen 24.06.00

MENU TAG

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

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Memory

MENU Go to Memory menu

UP Highlight previous patient

DOWN Highlight next patient

TAG Mark / Unmark highlighted

patient for deleting (see
next page). Tagged
recordings are indicated by
an asterisk before the name.

Page 18

Memory

Menu

Frederick Burt 24.09.99
Jones John 27.09.99

Smith 12.10.99

MENU ENTER

VIEW

DELETE

CANCEL

MENU Go to Main menu

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

UP Highlight previous menu entry
DOWN Highlight next menu entry

ENTER When View selected - reads highlighted recording.

(see next page)
When Delete selected enters further menu options
for the deletion of all or only tagged recordings.
When cancel selected - returns to memory screen.

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Displaying Test Data From a Stored Patient

1. From the memory menu, highlight the required patient and select the view option
as described previously.

2. Wait a few seconds for the program to display and retrieve the selected patient data.

Pat-Name:

ABROTH DAVID

Pat-Number:

123-456-00

Born:
05-04-43 (mm-dd-yy)

MENU ENTER

PATIENT

3. Return to the main menu and select the test option.

4. The test screen is displayed:

before the measurement:

hold the sensor still

*** press START ***

TEST

MEMORY
CALIBRATION
SETTINGS

Page 20

MENU RESULT

5. Select RESULT to display the test results for the selected test. Note that the stored
tests can only be displayed in tabular form.

Obtaining a Printout

Printing is carried out via any printer that has an infra red connector.
To obtain a printout of the currently displayed recording:

1. Point the unit towards the printer and press and release the
Print / Send key.

2. A beep indicates when the data has been downloaded to the
printer and the SP-2 can be withdrawn.

The graphs are printed according to the print settings defined and
will always include the following:

n The patient data.

n The selected norm values.

n The date of last calibration.

n The diagnostic statement (if enabled in Settings menu).

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

n The date and time of the printout.

n The software version.

The print settings are detailed in the following pages.

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Spiro Settings (User Identification)

The settings menu option defines all the general settings. Settings made here are remembered when the unit is switched off. For normal use,
the settings are made when the unit is first commissioned. However, the settings can be easily changed at any time for comparison
purposes or individual preference.

The user identification is given on all printouts. To define the user identification select the user id option.

PATIENT
TEST
MEMORY
CALIBRATION

SETTINGS

User Identification
WELCH ALLYN SCHILLER

USER ID

PRINTOUT
DEVICE
CLOCK

MENU Go to Main menu

ENTER Confirm displayed user ID

MENU ENTER

Page 22

Spiro Settings (Printout)

In the printout settings screen the information given on a printout is defined.

PATIENT
TEST
MEMORY
CALIBRATION

SETTINGS

USER ID

PRINTOUT

DEVICE
CLOCK

MENU Go to Main menu

CURSOR go to next line above

CURSOR go to next line below

CHOICE Change highlighted setting

Select between:
Format : Meas1 Measurement 1 or All (best three measurements)
FVC-Graph : Yes yes; no
Flow Graph No yes; no
Diagnosis : Yes
Lung Age : No

1

yes; no

2

yes: no

PEF (l/min) : No yes; no

MENU CHOICE

Notes:1 Diagnosis: The diagnosis statement (printed or not printed) is in accordance with the defined `normals` (see next

page and Section 2).

2

Lung Age: The lung age (printed or not printed) is the calculated nominal age of the patient`s lungs according to

the results obtained and the defined `normals` (see next page and Section 2). The value given is
calculated using the actual FEV1 value against predicted FEV1 value for the age of the patient. No value
will be given if the patient age is less than 18 years or if poor FEV1 test results have been obtained.

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

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Spiro Settings (Device)

PATIENT
TEST
MEMORY
CALIBRATION

SETTINGS

Normals : Knudson Normals according to software and language - See section 2
Ethnic : C/H/B/A W/B; C/H/BA
FVC-Type Flow - Loop Vol = f(t); Flow = f(Vol); Flow - loop
Report-Type : Best Best; meas 1
Unit : in/lb/oF in/lb/oF; cm/kg/oC
Date : mm-dd-yy dd-mm-yy; yy-mm-dd; mm-dd-yy
Language : English Language options according to software

MENU CHOICE

USER ID
PRINTOUT

DEVICE

CLOCK

Select between:

MENU Go to Main menu

CURSOR go to line above

CURSOR go to line below

CHOICE Change highlighted setting

Page 24

Spiro Settings (Device)

Normals

The Normal value standards are given at the end of this section- Diagnosis and Norm Value Tables.

DIAGNOSIS ACCORDING TO `ITS` RECOMMENDATIONS IS AVAILABLE WHEN CRAPO KNUDSON, OR

COMPOSITE IS SET.

Volume = f(t) Flow = f(vol) Flow - loop

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

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Changing the Mouthpiece

Align mouthpiece guides with guide
slots in the sensor

Page 26

Changing the Mouthpiece

WARNING

THE DISPOSABLE MOUTHPIECES ARE DESIGNED FOR ONE­TIME USE TO MINIMIZE THE DANGER OF CROSS
CONTAMINATION. DO NOT USE THE MOUTHPIECE FOR
MORE THAN ONE PATIENT.

1. Remove disposable mouthpiece by gently but firmly pulling it away from the device.

2. Discard the complete assembly.

3. Position new disposable mouthpiece and gently but firmly click it in position.

NOTE: The disposable mouthpiece can only be positioned in one direction and no force

4. Calibrate the sensor and unit as detailed following.

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

is necessary to insert it on the device. Ensure that the orientation is correct by
checking the guide protrusion in sensor against the guide slot in the device.

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Calibration

To calibrate, enter the calibration screen from the main menu:

THE UNIT MUST BE CALIBRATED WITH THE FIRST PULMONARY FUNCTION TEST OF THE

DAY AND AFTER EVERY SIGNIFICANT TEMPERATURE CHANGE.

We additionally recommend that the device is calibrated before each new patient, that is every time the disposable

Mouthpiece is changed.

PATIENT
TEST
MEMORY

CALIBRATION

SETTINGS

The following screen is displayed:

Temperature : 21 oC
Measured Vol. : 0.00 l
Syringe Vol. : 6.00 l

Deviation : -- %
Last calib. : 25.05.00

BTPS Factor : 1.090
Gain Factor : 1.002

MENU CALIB. VERIFY

Page 28

MENU Return to main menu.

CALIB Start calibration procedure and enter details

(temp., vol. etc.), as detailed on the following
pages. The calibration is accepted when the
actual volume, and the volume calculated
by the SP-2, is within a predefined limit.
When a deviation greater than the limit is
recorded, a message is displayed that the
mouthpiece (screen) must be changed.

VERIFY Verify calibration. The procedure is exactly

the same as for CALIB (above), but the actual
volume, and the volume calculated by the
SP-2, must be within 3%. If this procedure is
not within 3%, the unit must be recalibrated
using the CALIB option above.

Calibration

Calibration Procedure

To calibrate the unit proceed as follows:

1. Connect the calibration pump to the sensor. Ensure that there
are no air leaks.

2. Press the up or down key (CALIB) to commence calibration.

3. Enter the ambient temperature and press enter to confirm.

Temperature : 21 oC
Measured Vol. : 0.00 l
Syringe Vol. : 6.00 l

Deviation : -- %

hold sensor still

*** press START ***

MENU

4. Wait 1 second.

5. Press the START/STOP key .

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

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Calibration

6. Keeping the unit still, pump 3 to 6 liters of air through the Mouthpiece.
While pumping, the unit records the volume being pumped through the
Mouthpiece and indicates it on the display.

7. Press the START/STOP key when finished pumping.

8. Enter the reference volume of air (depending on the size of the calibration
pump and times of pumping; e.g. a 2 litre pump pumped 3 times = 6
liters). Confirm with ENTER.

9. The message `Calibration OK` appears on the display.

If the message `EXCESSIVE DEVIATION! exchange screen` appears on
the screen after a calibration, it indicates that the difference between the
measured volume and the entered volume is too great. Check the
temperature setting, the syringe volume and the entered syringe volume
and recalibrate.

Page 30

Calibration Details

Last Calibration date of last calibration
BTPS Factor calculated BTPS (=> Body Temperature, Ambient Pressure,

Saturated with water vapor) value. This value compensates for the

difference in inhaled and exhaled humidity. The unit is set for
measuring exhaled volume (100% humidity, Temp 36.8o), and so
when inhaled volume is measured this factor is applied. The SP-2
uses ambient temperature to calculate the BTPS factor. This is
sufficient for accurate FIVC calculation. The formula used is as
follows:

Calibration Factor calculated value between measured and effective calibration air

Temperature ambient temperature in oC (or oF) dependent on device setting.
Measured Volume air volume measured by the system from the calibration pump.
Reference Volume entered air volume depending on the size of the calibration pump

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

BTPS = 0.033 +

273.15 + 36.8

273.15 + Tu

Where: Tu is the ambient temperature in degrees centigrade

0.033 is the equivalent to 760mmHg at 22oC

273.15 is degrees absolute

volume.

and times the air was pumped through the sensor; e.g. pumping 2
liters 3 times amounts to 6 liters (the recommended volume with a 2
litre pump is 4 liters and with a 3 litre pump 6 liters).

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Explanation of Measured Values

FVC Forced (expiratory) Vital Capacity. Volume achieved by the quickest possible exhalation after a maximal

inhalation.

FEV

0.5/1.0/3.0

Forced expiratory volume. Lung volume in liters, measured after 0.5, 1.0 or 3 seconds forced expiration.
FEV1 / FVC forced expiratory air volume measured in the first second as a percentage of forced vital capacity.
FEF Forced Expiratory Flow Respiratory. Flow in terms of differing lung volumes measured in liters per

second.

FEF
FEF
FEF
FEF
FEF
FEF

25-75%

75-85%

25%

50%

75%

0.2-1.2

flow speed of the expired air by 25 to 75% of the forced vital capacity (FVC).

flow speed of the expired air by 75 to 85% of the forced vital capacity (FVC).

flow speed of the expired air by 25% of the forced vital capacity (FVC).

flow speed of the expired air by 50% of the forced vital capacity (FVC).

flow speed of the expired air by 75% of the forced vital capacity (FVC).

averaged flow between 0.2 and 1.2 liters of the forced expired vital capacity.

PEF Peak Expiratory Flow.
MEF Maximal Expiratory Flow.
MEF
MEF
MEF

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75%

50%

25%

flow speed of the expired air by 25% of the forced vital capacity (FVC).

flow speed of the expired air by 50% of the forced vital capacity (FVC).

flow speed of the expired air by 75% of the forced vital capacity (FVC).

MEF

MEF

MEF

75%

50%

25%

= FEF
= FEF
= FEF

25%

50%

75%

Explanation of Measured Values

ERV Expiratory Reserve Volume. Possible further expiration starting from the normal expiration level.
IRV Inspiratory Reserve Volume. Possible further inspiration starting from the normal inspiration level.
TV Tidal Volume. Expirational and inspirational volumes during normal respiration.
SVC Slow Vital Capacity. Lung volume measured from a complete expiration following a deep inspiration.
MV Expired or Minute Ventilation. Volume of expired air in liters per minute measured over a minimum of one

minute.

MVV Maximum Voluntary Ventilation. Maximum volume of air which can be moved on expiration while breathing

as deeply and as rapidly as possible.

RR Respiration Rate.
FMFT Forced Mid-expiratory Flow Time. Time difference between the 25% and 75% points of the FVC.
FIVC F o rced Inspiratory Vital Capacity. Inspiration volume achieved between a maximal expiration and a

maximal inspiration.

FIV

1.0

FIV

/ FIVC forced inspiratory air volume measured in the first second as a percentage of forced inspiratory vital

1.0

forced inspiratory air volume in liters measured in the first second.

capacity.

FIV

/ FVC forced inspiratory air volume measured in the first second as a percentage of forced expiratory vital

1.0

capacity.

PIF Peak Inspiratory Flow. Maximum inspiratory flow speed in liters / second.
FIF (=MIF) Fo rced (Maximum) Inspiratory Flow. Maximum inspiratory flow in liters.
FIF

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

50%

(=MIF

) flow speed by 50 % of the forced inspiratory vital capacity.

50%

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Care & Maintenance

Self-test

A self test is initiated by the unit every time it is switched on. A table giving
information for the service staff is displayed if an error is detected. To obtain
a printout press the IrDA key when the table is displayed.

The unit should undergo a technical safety check every 12 months. This
safety check should include the following:

° Visual inspection of the unit.

° Calibration of the sensor as detailed on page 26.

The test results must be documented.

Lifed Items

There are no lifed items in the SP-2 Hand-Held Spirometry Unit

Page 34

Care & Maintenance

ONLY THE DEVICE ITSELF CAN BE CLEANED - DO NOT ATTEMPT TO CLEAN
THE DISPOSABLE MOUTHPIECE.

DO NOT, UNDER ANY CIRCUMSTANCES, IMMERSE THE UNIT INTO A
CLEANING LIQUID OR STERILIZE WITH HOT WATER, STEAM, OR AIR.

Cleaning the Unit

The unit can be cleaned with a soft damp cloth on the surface only. A standard
hospital grade disinfectant may be used. Where necessary a domestic non-caustic
cleaner can be used for grease and finger marks.

Batteries

° Battery life for the two AA 1.5V alkaline batteries is 6 months under normal

° Check batteries at least once a month for corrosion.
° Remove batteries if the unit is going to be stored for more than a month.
° Dispose of batteries properly. Welch Allyn Schiller recommends that local

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

CAUTION:

use defined as 10 patient sessions per week.

government recycling policy is followed.

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Spirometry Tips - How To Do It and Common Pitfalls and Problems

How to Do It

To ensure an acceptable result, the FVC manoeuvre must be performed with maximum effort immediately following a
maximum inspiration; it should have a rapid start and the spirogram should be a smooth continuous curve.

To achieve good results, carefully explain the procedure to the patient, ensuring that he/she is sitting erect with feet
firmly on the floor (the most comfortable position). Note that for child patients, vital capacity can be greater in the
standing position. Apply a nose clip to the patients nose (this is recommended but not essential) and urge the
patient to:

° breathe in fully;

° seal his/her lips around the mouthpiece;

° blast air out as fast and as far as you can until the lungs are completely empty;

° breathe in again as forcibly and fully as possible.

If only peak expiratory flow is being measured then the patient need only exhale for a couple of seconds. Essentials
are:

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° a good seal on the mouthpiece and

° very vigorous effort right from the start of the manoeuvre and continuing until absolutely no more air can be

exhaled.

° no leaning forward during the test.

Spirometry Tips - How To Do It and Common Pitfalls and
Problems

Remember, particularly in patients with airflow obstruction, that it may take many seconds to fully exhale. It is also important to
recognize those patients whose efforts are reduced by chest pain or abdominal problems, or by fear of incontinence, or even just
by lack of confidence. There is no substitute for careful explanation and demonstration - demonstrating the manoeuvre to the
patient will overcome 90% of problems encountered and is critical in achieving satisfactory results. Observation and
encouragement of the patients performance are also crucial. Be sure to examine the spirogram for acceptability and reproducibility,
(correction factors to the measurements for BTPS are automatic during calibration (see Calibration section).

Attention to fine detail in the performance of the breathing manoeuvre is critical to obtaining reliable results.

At least three technically acceptable manoeuvres should be obtained, ideally with less than 0.2 L variability for FEV1 (and FVC)
between the highest and second highest result. Quote the largest value. The American Thoracic Society (ATS) provides the
following guidelines for manoeuvre performance.

FVC

° Minimum of 3 acceptable blows
° A rapid start is essential: this is defined as a back-extrapolated volume of <5% of FVC or 0.15 L, whichever is greater.
° At least 6 second expiration
° End of test - no change in volume for at least 1 second after exhalation time of 6 seconds; or FET >15 seconds; or stopped

for clinical reasons
° Spirometer temperature between 17 and 40 degrees Celsius; measure spirometer temperature to one degree Celsius
° Use of nose clip is encouraged
° Sitting or standing
° Reproducibility: the highest and second highest FVC should agree to within 0.2L

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

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Spirometry Tips -How To Do It and
Common Pitfalls and Problems

FEV1

° As for FVC

° Take largest FEV1 even if not from the same curve as the best FVC

° Zero time determined by back-extrapolation - extrapolated volume

should be <5% of FVC or 0.15 liters, whichever is greatest

° Smooth, rapid take off with no: hesitation, cough, leak, tongue

obstruction, glottic closure, Valsalva or early termination

° Reproducibility: the highest and second highest FEV1 should agree

to within 0.2L

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Spirometry Tips -How To Do It and Common Pitfalls and Problems

Patient-Related Problems

The most common patient-related problems when performing the FVC manoeuvre are:

° Submaximal effort

° Leaks between the lips and mouthpiece

° Incomplete inspiration or expiration (prior to or during the forced manoeuvre)

° Hesitation at the start of the expiration

° Cough (particularly within the first second of expiration)

° Glottic closure

° Obstruction of the mouthpiece by the tongue

° Vocalization during the forced manoeuvre

° Poor posture.

Once again, demonstration of the procedure will prevent many of these problems, remembering that all effort-dependent measurements
will be variable in patients who are uncooperative or trying to produce low values.

Glottic closure should be suspected if flow ceases abruptly during the test rather than being a continuous smooth curve. Recordings
in which cough, particularly if this occurs within the first second, or hesitation at the start has occurred should be rejected. Vocalization
during the test will reduce flows and must be discouraged - performing the manoeuvre with the neck extended often helps.

SP-2 User Guide
Art. No. 71022-0000 Welch Allyn Schiller ©2000

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