Laura Glenn talks to Dr Paul Hamor about performing, interpreting and discussing spirometry results with patients.
Paul Hamor is a Respiratory and Sleep Physician. He has a long involvement in Prevocational and Undergraduate medical education. Paul has interests in the formulation of education programs, presentation skills, delivering best evidence based practice to the ward, as well as change methodology. He also is a strong advocate for work life balance and has been looking at the prevention and management of junior doctor burnout and programs to promote resilience.
With Dr Paul Hamor, Respiratory and Sleep Physician at Royal Prince Alfred Hospital, New South Wales, Australia
Junior doctors are often required to perform, interpret and discuss spirometry results of their patients for example in the Emergency Department or patients who require a respiratory consult where baseline spirometric testing is needed.
Case 1 – You are a junior doctor in a surgical team and are asked to do pre operative assessment including an anesthetic and respiratory review on a patient who has been admitted for a hernia repair. The patient has a background of COPD and sleep apnoea. The Respiratory Registrar has asked for baseline spirometry prior to reviewing the patient.
Assessing these components will allow us to initiate appropriate management or even delay of surgery as appropriate.
Flow volume loops gives us an indication of the generation of flow through the respiration cycle. The patterns of the flow volume loop can be indicative of certain respiratory conditions as demonstrated in the diagram below.
This allows us to make inferences into their respiratory disease. It may demonstrate a problem with diffusion such as in emphysema or pulmonary fibrosis that may impair gas exchange
Case 2 – You are a junior doctor working in the ED department. You pickup a patient from triage who has a 2 day history of worsening shortness of breath, fevers and a cough, on a background of COPD. The patient’s vitals are; RR24, Oxygen Sats 92% on room air, BP 140/85, HR 88 temp 37.9. Your impression is that the patient has an exacerbation of his COPD and you ask fora respiratory consult. The respiratory registrar asks for a chest x-ray and spirometry.
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