Welch Allyn PneumoCheck Operating Instructions Manual
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Welch Allyn PneumoCheck Operating Instructions Manual

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Summary of Contents for Welch Allyn PneumoCheck

  • Page 1 Welch Allyn Printer/Charger Operating Instructions...
  • Page 2 Please read these instructions thoroughly before using your Welch Allyn PneumoCheck Spirometer and Printer/Charger. **Welch Allyn gratefully acknowleges the assistance of Paul L. Enright, M.D. of the Mayo Clinic in Rochester, Minnesota for his assistance in preparing and reviewing sections of this manual.

  • Page 3: Table Of Contents

    Welch Allyn CONTENTS Introduction to Spirometry............. .l Indications for Spirometry ............. .2 Parts of the Welch Allyn PneumoCheck Spirometer....3 Preliminary Operating Instructions ..........4 The FVC Test ................... Quick FVC Reference Chart ............5 Description..................Measurement Parameters .............6 Obtaining Good FVC Results ............
  • Page 4 Appendix B - Maneuver Quality Messages ........49 Appendix C - Predicted Normal Values ........51 The Ideal Study ................51 Predicteds Available on Your PneumoCheck ......51 Racial Differences ...............52 Calculating Predicted Values Manually ........52 Reference Tables: Knudson, 1983 1 2 2 1 2 1 * .................

  • Page 5: Introduction To Spirometry

    The Welch Allyn PneumoCheck is a hand-held spirometer specifi- cally designed to perform FVC and MVV spirometry tests easily and accurately. In order to properly use your PneumoCheck and to obtain useful test results, you should be familiar with the basic principles of...

  • Page 7: Parts Of The Welch Allyn Pneumocheck Spirometer

    PARTS OF THE WELCH ALLYN PNEUMOCHECK SPIROMETER (#61000) PNEUMOTACH ASSEMBLY MOUTHPIECE ON/OFF LIQUID ---I SWITCH CRYSTAL DISPLAY BODY OF PNEUMOCHECK (ORANGE) SPEAKER FOR PNEUMOTACH AUDITORY SIGNALS ASSEMBLY BODY OF PNEUMOCHECK CHARGING JACK DATA/CHARGING CONTACT...

  • Page 8: Preliminary Operating Instructions

    If the instrument has not been stored at room temperature, allow 45 minutes for the temperature of the instrument to stabilize. Visually check the screen of the PneumoCheck (see p. 41) and check the calibration (see p. 31). Instruct the patient about what is expected and how to perform a good test (see p.

  • Page 9: The Fvc Test

    THE FVC TEST QUICK FVC REFERENCE CHART How To Use Your PneumoCheck and Printer/Charger Enter Age, Height, Race, Sex into Printer/Charger Instruct and Demonstrate Correct Visually Check Screen of PneumoCheck Switch PneumoCheck ON, wait for SELECT and press TEST Place PneumoCheck into Printer/Charger...

  • Page 10: Description

    DESCRIPTION The most frequently performed spirometry test is the forced expira- tory vital capacity test, or FVC. It is commonly used for basic pulmo- nary function testing as well as managing patients with chronic obstructive pulmonary disease (COPD), asthma, emphysema, bronchitis, or other lung diseases.
  • Page 11 Peak Expiratory Flow, the highest rate of airflow (in liters/second) during the FVC maneuver. Once an acceptable FVC maneuver has been completed, the test results can be compared to established norms and a course of action determined. The norms are based on the height, age, race and sex of the patient.

  • Page 12: Obtaining Good Fvc Results

    However, you must know how to properly teach your patients to perform good tests or your PneumoCheck will continually find fault with maneuvers and you and your patient will quickly become frustrated.
  • Page 13 Unacceptable conditions include: slow or hesitating start air leaking around the mouthpiece coughing during the first second of the maneuver mouthpiece obstruction by tongue, lips, or teeth quitting too soon When the maneuver has been completed, observe the quality message. If a message appears indicating an unacceptable maneuver (see p.
  • Page 14 Example of Acceptable (GOOD FVC) Effort: RACE: 2 SEX: M ACTUAL NORM %NORM ABN 1 0 . 8 1 IS:02 K n u d s o n 1 9 8 3 NORMS : G o o d FVC m a n e u v e r . FVC X l S E C...
  • Page 15 Examples of Unacceptable Efforts: ACTUAL NORM %NORM RBN ACTUA L NORMS: Crapo 198 1 NORMS: Knudson 1983 t e r m i n a t i o n F V C . S l o w F V C s t a r t : brgin fastor. t o o s h o r t : b l o w...

  • Page 16: Doing An Fvc Maneuver

    UNSTEADY message appears. Should an UNSTEADY message appear, depress the TEST button to start FVC again. The PneumoCheck then displays the message DO FVC 1, and beeps. The patient may sit or stand, but position should be noted,,. A sitting position is often preferred for stability.
  • Page 17 The mouth should be opened wide enough to avoid any obstruction by the teeth or tongue. The PneumoCheck will then display BUSY while calculating test results. It will then provide a series of messages. The first message appears automatically, and gives an indication of the patient’s effort.

  • Page 18: Doing Multiple Tests On A Patient

    5%. The best effort is then used to assess patient status. No more than eight maneuvers should be obtained to avoid fatiguing the patient. This is easily accomplished with your Welch Allyn PneumoCheck as it will automatically: 1. Assess acceptability.
  • Page 19 The PneumoCheck will determine whether the maneuver just performed should replace the maneuver that was previously stored as BEST test. In making this determination, the PneumoCheck first looks at the quality control messages for the new maneuver. A “good” maneuver is one that has no identifiable faults, such as a cough in the middle of the maneuver or a hesitating start (see p.
  • Page 20 Match Criteria The previously stored best maneuver and the new maneuver are compared: MATCH will be displayed if both FVC values are within 5% of each other and both FEVl values are within 5% of each other. If both FVC values and both FEVl values are not within 5% of each other: NO MATCH will be displayed if the new maneuver is 5% less than the previously stored BEST.

  • Page 21: Interpretation Of Results

    INTERPRETATION OF RESULTS The PneumoCheck Printer/Charger will place a star beside values which are abnormal, ,,. If the FEVl/FVC ratio is abnormally low, an obstructive disorder is indicated. Use the FEVl to grade the severity of the obstruction: An FEVI above 80% of predicted indicates a Borderline Obstruction.
  • Page 22 SPECIAL NOTES: A normal spirometry test does not preclude the existence of lung cancer or the very early stages of many of the restrictive lung disorders. If both the FEVl and FEVl/FVC ratio are normal, some pulmonary specialists will examine the FEF 2575% (MMEF). If it is low, the patient may have a ‘slight obstruction.’...
  • Page 23 INTERPRETATION OF FVC RESULTS FLOW CHART, ,, s Borderline FEV 1 above 80% Y Obstruction of predicted? FVC above 60% of predicted? above 60% __) Mifd Obstruction of predicted? FVC above 50% of predicted? above 40% of predicted? Severe Obstruction FVC below 80% of predicted? And low vital capacity, cannot...

  • Page 24: The Mvv Test

    THE MVV TEST DESCRIPTION The MVV or Maximal Voluntary Ventilation is another type of spirom- etry test. When doing an MVV, the patient is required to breathe in and out as deeply and as rapidly as possible for a period of 12 to 15 seconds.

  • Page 25: Obtaining Good Mvv Results

    Check still so that an accurate reference can be made. If the PneumoCheck is moved during this time, the STEADY message will remain until the PneumoCheck is held quite still for at least three seconds, or until an UNSTEADY message appears.

  • Page 26: Doing Multiple Tests On A Patient

    The patient should continue until the PneumoCheck beeps (15 seconds after the start of the maneuver). Patient should not block the back end of the pneumotach.

  • Page 27: Parts Of The Pneumocheck Printer/Charger

    PARTS OF THE PNEUMOCHECK PRINTER/CHARGER (#76100 OR #76105) PNEUMOCHECK DATA - STOP --.-i INDICATOR BUTTON PAPER SLOT (GREEN)

  • Page 28: Printer/Charger Operating Instructions

    Leave the power switch of the PneumoCheck spirometer in the ON position after a test to print a report. Turning the Pneumo- Check OFF will clear the memory of all data.

  • Page 29: Short Form/Long Form

    SHORT FORM OR LONG FORM (Switch 3) Choose between the Short Form,and the Long Form report by using the third switch. The Long Form includes a respiratory history questionnaire which allows you to record the patient’s respiratory history: SHORT FORM LONG FORM NAME : NAME :...

  • Page 30: Entering Patient Data

    BEST FVC This value cites, per ATS recommendations,,, the largest single FVC value from all acceptable maneuvers. BEST FEV1 This value cites, per ATS recommendations,,, the largest single FEVl value from all acceptable maneuvers. ENTERING PATIENT DATA Set the AGE and HEIGHT values by pressing the switches above or below each number.

  • Page 31: Printing

    PRINTING Place the PneumoCheck in the Printer/Charger well with the display facing you. When the instrument is properly seated, the orange charging indicator on the PneumoCheck will become illuminated. LIQUID CRYSTAL DISPLAY CHARGING INDICATOR (ORANGE) DATA - INDICATOR (GREEN) POWER -...

  • Page 32: Paper Feed

    PAPER FEED To feed extra paper, depress the FEED button. Paper will continue to feed as long as the button is depressed. PAPER JAMS If the paper has wrapped around the gray rubber pinch roller several times, feed the paper backwards: Depress the STOP button and the FEED button simultaneously, then release the STOP button.

  • Page 33: Stopping The Printer

    Place the new roll of paper in the printer well, insuring that spindle is located behind retaining blocks, and that the paper feeds forward from the bottom of the roll. Insert edge of paper under the gray rubber pinch roller until paper exits top of printer.

  • Page 34: Error Conditions

    STOP button to clear the problem. If the error recurs, the Printer/Charger may need servicing. 3 FLASHES - Data received from the PneumoCheck is invalid. Press STOP, and retransmit data by removing the Pneumo- Check from the Printer/Charger well temporarily. If the error recurs, turn the PneumoCheck OFF, clear the Printer/Charger by pressing STOP again, and retest the patient.

  • Page 35: Calibration Check And Recalibration

    Examine the screen of your PneumoCheck daily. Blockage of the screen indicates the need for cleaning the screen (see p. 41) fol- lowed by a calibration check.

  • Page 36: Calibration Check

    2. Make sure that nothing is blocking the back end of the pneumotach. 3. Flush the syringe back and forth through the PneumoCheck several times to equilibrate the temperature. 4. Pull the syringe plunger back as far as it will go.
  • Page 37 This forward stroke should take l-2 seconds. The PneumoCheck will then display BUSY while calculating test results, and will then display TEST.MODE. To review the result press the DATA button. Results between 2.91 liters and 3.09 liters indicate an accurate instrument (+3% of...

  • Page 38: Recalibration

    (see ATS recommendation on p. 31). With the PneumoCheck OFF, connect the 3.0 liter syringe (stored at the same temperature as your PneumoCheck) to the pneumotach, portion of the PneumoCheck. Make sure that nothing is blocking the back end of the pneumotach.
  • Page 39 Once three maneuvers have been completed, the Pneumo- Check will calculate the average volume of the three maneuvers. Each maneuver is then compared to this calculated average, and if all three are within 0.5% of the calculated average, the calibration value is automatically updated and displayed as CF=xxxx, followed by, the message GOOD CAL If any of the calibration maneuvers were not within 0.5% of the dalculated average, a triple beep will occur and the message...

  • Page 40: Quick Calibration Check And Recalibration Reference Charts

    QUICK CALIBRATION CHECK AND RECALIBRATION REFERENCE CHARTS Doing a Calibration Check Doing a Recalibration Attach syringe to PneurnoCheck Attach syringe to PneumoCheck Flush syringe through PneumoCheck several times TEST.MODE Follow messages to PULL.BACK and DO CAL twice more CF=XXXX followed by GOOD CAL...

  • Page 41: Battery Maintenance

    BATTERY MAINTENANCE The PneumoCheck will remain charged and ready for use if returned to Printer/Charger when not in use. BATTERY RECHARGING The nickel cadmium batteries in the PneumoCheck will provide approximately 8 hours of continuous operation on a full charge.
  • Page 42 To recharge: Plug the charging transformer into a receptacle of appropriate voltage, frequency and plug configuration. Place the PneumoCheck on its back and plug the output cord of the transformer into the charging jack of the PneumoCheck. SPECIAL NOTES Slight heating of the PneumoCheck during charging is normal.

  • Page 43: Battery Replacement

    Using a coin, loosen the two set screws on the bottom of the PneumoCheck (these screws will loosen, but cannot be removed). PNEUMOTACH ASSEMBLY Remove the pneumotach assembly from the top of the PneumoCheck. To remove the batteries, turn the PneumoCheck upside down and tap lightly.
  • Page 44 5. Insert new batteries according to diagram inside battery compartment. 6. Replace the pneumotach assembly and tighten the two screws on the bottom until the pneumotach is securely in place. 7. Recalibrate the PneumoCheck (see p. 34). REPLACE W I T H ALLYN NO.72500 WELCH BATTERIES ONLY.

  • Page 45: Cleaning And Sterilization

    CLEANING AND STERILIZATION PNEUMOTACH The screen in the pneumotach mouthpiece should be visually inspected before each use. If sputum or other foreign matter becomes lodged in the screen, it can cause erroneous readings. To clean the screen, remove the mouthpiece and scrub it with a small brush. Then check calibration (see p.

  • Page 46: Body Of Pneumocheck

    THE PNEUMOTACH HAS BEEN REMOVED/REPLACED. BODY OF PNEUMOCHECK The body of the PneumoCheck may be cleaned by wiping with a dry cloth or a cloth that has been lightly dampened with 70% Isopropyl alcohol. Care should be taken to prevent seepage of liquid into the instrument.

  • Page 47: Accessories

    ACCESSORIES 61050 Pneumotach Assembly. 610064-501 Pneumotach Mouthpiece 56100 Thermal Paper 5 Rolls/Box, 12 Boxes/Case. 56120 Disposable Mouthpieces, Pediatric 1OOlBag, 5 Bags/Case. 56121 Disposable Mouthpieces, Adult 1 0O/Bag, 5 Bags/Case. 56130 Disposable Nose Clips 1OO/Box, 4 Boxes/Case. 61010 Hose for 3.0 Liter Syringe. 61020 3.0 Liter Calibration Syringe Only.

  • Page 48: Warranty

    Welch Allyn or its authorized PneumoCheck distributors or agents. Welch Allyn will either repair or replace any components found to be defective or at variance from manufacturer’s specifications within this time at no...

  • Page 49: Appendix Apneumocheck Messages

    PNEUMOCHECK STATUS MESSAGES The following is a tabulation of the various messages that may be displayed on the PneumoCheck’s Liquid Crystal Display: The PneumoCheck has accessed the best FVC test BEST FVC from memory. The PneumoCheck has accessed the best MVV test BEST MVV from memory.
  • Page 50 PneumoCheck uses a more accurate (and lengthy) approach than in the STEADY mode. The RETRIM message will be displayed for about 45 seconds. The PneumoCheck is transmitting an FVC test to the SEND FVC Printer/Charger. The PneumoCheck is transmitting an MVV test to SEND MVV the Printer/Charger.
  • Page 51 NOTE: Encountering either the TEMP.LIM or TRIM.LIM messages during normal operation may indicate a possible hardware failure. In this event, turn the PneumoCheck switch to OFF then ON again. Should this error persist, return your instrument to Welch Allyn. TX FAIL Transmission failure.

  • Page 52: Pneumocheck Error Messages

    The liquid crystal display will show the word ERROR and a number, e.g. “ERROR 2” when there is a problem with the instrument. When an error message occurs, turn the PneumoCheck OFF and then ON again to reset the microprocessor. Then check the calibra- tion and recalibrate if necessary.

  • Page 53: Appendix B - Maneuver Quality Messages

    APPENDIX B MANEUVER QUALITY MESSAGES BADSTART More than 5% or 0.1 liters of exhalation occurred before the back extrapolated starting point (ATS specification,,). To correct this, the patient should blast out harder at the beginning of the maneuver. BAD.STOP The flow stopped abruptly. To correct this, the patient should keep blowing longer until all air has been expelled.
  • Page 54 One or more of the calibration maneuvers differed RETRYCAL from the average by more than 0.5%. The existing calibration factor is not updated. TOO.SHORT the maneuver was less than 3 seconds During FVC: long. The patient should inhale more deeply and exhale longer.

  • Page 55: Appendix Cpredicted Normal Values

    The PneumoCheck printer will provide predicreds for the following height range: 85-214 cm or 33-84...

  • Page 56: Racial Differences

    0.85 (except for FEVi/FVC). CALCULATING PREDICTED VALUES MANUALLY The PneumoCheck Printer/Charger calculates predicted values automatically, and an asterisk is placed in the ABN column if the actual parameter falls below the lower limit of normal (LLN).
  • Page 57 Next, find the table entries for a male 20 years old, and calculate the FVC. FVC = (0.0739 x 20 years) + (0.0590 x 182.9 cm) - 6.8865 FVC = 1.478 + 10.79 - 6.8865 or FVC = 5.38 liters This patient would have an abnormally low FVC if his actual FVC was less than the “lower limit of normal”, which is calculated using the entry from the LLNF column as follows:...

  • Page 58: Knudson, 1983 1 2 2 1 2 1

    NORMAL VALUES - KNUDSON, 1 9 8 3 C O N S T A N T LLNF Male, 6-11 0.749 0.0409 -3.3756 0.780 -2.8142 FEVl 0.0348 0.850 RATIO -0.0813 100.4389 0.439 -2.3197 MMEF 0.0338 -2.711 0.078 -8.06 0.166 0.798 -6.8865 0.0739 0.0590 0.812...
  • Page 59 CONSTANT LLNF (AGE) (HEIGHT) Female, 1 l-1 9 yrs 0.0699 0.0416 -4.4470 0.749 -3.7622 FEVl 0.0694 0.0351 0.818 RATIO 0.6655 -0.1909 109.9739 0.805 M M E F 0.1275 0.0279 -2.8007 0.562 -3.916 0.157 0.049 -2.196 Female, 20-39 yrs 0.0444 -3.1947 -0.0169 0.769 FEVl...

  • Page 60: Knudson, 1976

    NORMAL VALUES FOR KNUDSON, 1976,, CONSTANT LLNF (HEIGHT) Male, 8-24 yrs -0.892 0.078 0.050 -5.508 -4.808 0.045 0.046 -0.858 FEVl -0.140 103.64 -11.02 -0.087 RATIO MMEF 0.000 0.059 -5.334 -1.530 -2.711 -8.060 0.166 0.078 Male, 25-78 yrs -5.459 -0.986 -0.029 0.065 -0.027 -4.203...

  • Page 61: Morris, Crapo, Et Al., 1981 14 4

    NORMAL VALUES FOR MORRIS, CRAP0 et al., 1981 ,4 CONSTANT LLNF Male, 15-91 yrs -4.650 -1.115 0.0600 -0.0214 -2.190 -0.842 0.0414 -0.0244 FEVl 110.49 -8.280 -0.1300 -0.152 RATIO 2.133 -1.666 0.0204 MMEF -0.0380 Female, 17-84 yrs -0.676 0.0491 -3.590 -0.0216 -0.561 0.0342 -1.578...

  • Page 62: European Community For Coal And Steel 16 6

    NORMAL VALUES FOR EUROPEAN COMMUNITY FOR COAL AND STEEL CONSTANT LLNF Male, 25-70 yrs -0.026 0.0576 -4.34 -1 .ooo FEVl -0.029 0.0430 -2.49 -0.836 RATIO -11.76 MMEF -0.043 0.0194 2.70 -1.706 -0.043 0.0614 0.15 -1.984 Female, 25-70 yrs -0.026 0.0443 -2.89 -0.705 FEVl...

  • Page 63: Appendix Dtechnical Specifications

    APPENDIX D TECHNICAL SPECIFICATIONS The PneumoCheck Spirometer complies with the recommendations of the American Thoracic Society as they apply to both the spirometer and the printer/charger. PNEUMOCHECK 0.5 to 20 ma at 7.2 VDC Power Consumption: 12 ma DC Charging Rate: 6.0 - 6.3 VDC...

  • Page 64: Printer/Charger

    PRINTER/CHARGER 100/l 20 VAC, 50/60 Hz Operating Voltage Range: Power Consumption: 60 Watts max. Thermal type, 4.36" wide (110 mm) Printer Paper: with core Operating Temperature: 15 to 35 C (59 to 95 -20 to +40” C (-4 to 104°F) Storage Temperature: Printed Flow Rate Range (Flow/Volume Curve):...

  • Page 65: Appendix Eglossary

    APPENDIX E GLOSSARY American Thoracic Society. The ATS is a scientific organization whose members are active in pulmonary research and the care of patients with lung diseases. The ATS is interested in promoting the accurate and appropriate use of spirometers and has recommended a set of standards for spirometers: “ATS Statement on Standardization of Spirometry 1987”,,.
  • Page 66 FEF 2575% Forced Expiratory Flow between the 25% and 75% volume points or Mean Mid Expiratory (MMEF) Flow, expressed as average flow during the middle half of the maneuver. FEFmax See PEF Forced Expiratory Volume (timed) in liters. The FEVl volume of air that is exhaled during the first second of an FVC maneuver.
  • Page 67 Maximal Voluntary Ventilation, expressed in liters per minute. The largest volume of air inhaled or exhaled over a timed period, typically 12 to 15 seconds, which is then extrapolated to one minute. The maneuver should imitate the rapid breathing of strenuous exercise. Peak Expiratory Flow Rate in liters per second.

  • Page 68: Appendix Fbibliography

    APPENDIX F BIBLIOGRAPHY Morris JF, Temple W. “Spirometric ‘Lung Age’ estimation for motivating smoking cessation.” Preventive Med. Camilli AE, Burrows B, Knudson RJ, Lyle SK, Lebowitz MD. “Longitudinal changes in FEVI in adults - Effects of smoking and smoking cessation.” Am Rev Respir Dis American Thoracic Society.
  • Page 69 Knudson RJ, Lebowitz MD, Holbert CJ, Burrows B. “Changes in the normal maximal expiratory flow-volume curve with growth and aging.” Am Rev Respir Dis 127:725-734, 1983. Knudson RJ, Statin RC, Lebowitz MD, Burrows B. “The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age.”...
  • Page 70 This manual applies to: Printer/Charger software version 3.2...
  • Page 71 Welch Allyn Welch Allyn, Inc. State Street Road, P.O. Box 220 Skaneateles Fails, NY 13153-0220 (315) 6854560 Part No. 610140-3...

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