The American College of Occupational and Environmental Medicine (ACOEM) became the latest group to recommend nose clips for all spirometry maneuvers. The use of nose clips “prevents extra breaths through the nose,” they wrote in the May issue of Journal of Occupational and Environmental Medicine.
The study is the College’s guidance statement for spirometry in occupational and environmental health settings. In it, the authors illustrate how technical errors can be introduced in spirometry test results when nose clips are not used.
Figure 12 in the study illustrates extra breaths through the nose that invalidate the test. Furthermore, most spirometers cannot identify this error, according to the study’s authors.
The flow-volume curve shows multiple maneuvers and the volume-time curve shows increasing steps at the end of the test. Delete the test since the FVC is erroneously elevated and will be reported as the highest value for the FVC. The resulting falsely reduced FEV1/FVC will produce an erroneous â€œobstructive impairmentâ€ pattern. This error is not identified by most spirometers, so health care professionals need to visually recognize and delete it. The best solution is to have the subject wear nose clips.
The ERS and ATS maintain that nose clips may be preferable to manual occlusion and recommend the use of nose clips during FVC, MVV, VC, IC and other spirometry maneuvers.
Should you need an additional incentive to use nose clips, A-M Systems is offering a 10 percent discount off the retail price. If you already use nose clips in your clinic, this may be a great time to stock up and save.
Enter coupon code “NOSECLIP10” during checkout to receive your discount. (Expires 12-31-2011.)