1. Bed side tests of Pulmonary function
Vineet and ravi

2. Pulmonary function tests have been used traditionally in the preoperative assessment before any major surgery.
INDICATION
Determination of any significant impairment of lung function.
Degree and severity of impairment
Characterize any pulmonary dysfunction physiologically as obstructive or restrictive
Identify the site of airway obstruction
Evaluate the risk of procedures on lung
To assess prognosis
Evaluate airway hyper-reactivity .

3. Snider’s Match Blowing test
Mouth wide open
Match held at 15 cm distance
Chin supported
No head tilting
Match stick and mouth at the same level

4. Can not blow out a match Able to blow out a match MBC < 60 L/min
FEV1 < 1.6L
Able to blow out a match
MBC > 60 L/min
FEV > 1.6L

5. Modified Snider’s test
3 inches MBC > 40 L/min
6 inches MBC > 60 L/min
9 inches MBC > 150 L/min
FORCED EXPIRATORY TIME
FET < 3 Sec (Restrictive lung )
FET > 6 sec (Obstructive lung )

6. SEBERESE’S SINGLE BREATH COUNT
Patients is asked to take a deep breath followed by counting 1,2,3……….. till the time he cannot hold breath .
Shows trend of deteriorating or improving pulmonary function in pre & op . post op patients

7. SEBARESE ‘S BREATH HOLDING TEST
Subject is asked to take a normal tidal inspiration and hold breath
(N) ≥ 40 Sec
< 15 Sec is a C/I for elective surgery

8. COUGH TEST
Observe for ability to cough, strength and effectiveness
Wet productive cough candidate for pulm complications
Inadequate cough FVC < 20 ml/kg
FEV, < 15 ml / kg

9. WRIGHT’S PEAK FLOW METER.
DE BONO’S WHISTLE TEST
Wide more tube which has a whistle at the end and an adjustable leak hole in the side .
The whistle shows when the rate of airflow through the whistle exceeds a certain value.
WRIGHT’S PEAK FLOW METER.
Values < 200 L/ min in surgical candidates suggest impaired cough efficiency
(N) Males – 450 – 700 L/min
Females – 300 – 500 L/min

10. SPIROMETRY WITH POCKET SIZED SPIROMETERS
VC & FEV, Can be readily performed
BED SIDE PULSE OXIMETRY
Useful & rapid index of pulmonary gas exchange
ABG
Most commonly used measures of gas exchange are the partial pressures of 02 & co2 in arterial blood.
These pressures do not measure the quantity of 02 & co2 in blood but the driving press. of the gas

11. BLOW AGAINST THE HAND.
Place your hand against the patients month with slight resistance and ask the patient to blow
I: E RATIO