PDF: Lung function testing: COVID-19 advice

Caution: Lung function testing (including spirometry, peak flow and other breathing tests) generates aerosolised droplets, and may increase the risk of transmission of respiratory viruses to healthcare workers.

Please make sure that lung function testing is needed at this time for your patient. Remember that asymptomatic patients may be infected with acute respiratory viral illnesses (including COVID-19). Prior to lung function testing, patients should be asked screening questions to assess their risk of having COVID-19, including any new acute respiratory symptoms such as fever, cough, runny nose, sore throat, and loss of sense of smell. Lung function testing should not be performed in patients who have new acute respiratory viral symptoms.

Remember

  • Lung function testing is an important objective clinical diagnostic tool.
  • During the COVID-19 pandemic, testing should only be performed where indicated.
  • Lung function testing should be performed using contact and droplet precautions.
  • All testing needs to be performed using a bacterial/viral filter.
  • During the COVID-19 pandemic, when lung function testing is required outside of the laboratory setting, it should be performed in a negative pressure or single room. If this is not possible and testing needs to occur in the inpatient ward environment, please ensure curtains are drawn around the bed area to reduce the likelihood of any aerosolised droplet dispersion.
  • During testing where possible, staff should be positioned ≥1.5 metres away and out of the ‘blast zone’ or line of cough.
  • During the COVID-19 pandemic, ‘lung function tests using aerosol generating protocols should be performed only when necessary and with caution. If bronchial challenge tests are required, please refer to High Risk Respiratory Therapies - Nebulisers. Asthma can be assessed with spirometry, including bronchodilator reversibility.
  • Local sites should also consider local COVID-19 prevalence data when making decisions about screening questions and the recommencement of local COVID-19 prevalence data.

Document information

Developed by

  • Dr Catherine Farrow CRFS (Senior Scientist in charge, Respiratory Function Laboratory, Westmead Hospital, Woolcock Institute of Medical Research)
  • Dr John Brannan CRFS (Chief Scientist, John Hunter Hospital)
  • John Harrington (Clinical Nurse Consultant Airway Disease, John Hunter Hospital. ACI Respiratory Network Nursing Co-Chair)
  • Jay Flack (Chief Scientist, St George Hospital)
  • Mary Roberts (Clinical Nurse Consultant, Westmead Hospital)
  • Phillip Munoz CRFS (Senior Scientist, Royal Prince Alfred Hospital)
  • Rocco Mico (Respiratory Services Manager/Physiotherapist, Northern NSW LHD)
  • Helen Kulas (Respiratory Network Manager, Agency for Clinical Innovation).

Consultation

  • Professor Peter Wark (Senior Staff Specialist, John Hunter Hospital. COVID-19 Respiratory community of practice Clinical Lead. ACI Respiratory Network Nursing Co-Chair)
  • Clinical Excellence Commission
  • Professor Christine Jenkins AM (Professor of Respiratory Medicine, Faculty of Medicine, UNSW Sydney. Clinical Professor and Head, Respiratory Discipline, University of Sydney. Senior Staff Specialist, Department of Thoracic Medicine, Concord Hospital. Chair of the board of the Lung Foundation of Australia).

Endorsed by

Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning, NSW Ministry of Health.

Reviewed by

  • Dr Catherine Farrow CRFS (Senior Scientist in charge, Respiratory Function Laboratory, Westmead Hospital, Woolcock Institute of Medical Research)
  • Dr John Brannan CRFS (Chief Scientist, John Hunter Hospital)
  • John Harrington (Clinical Nurse Consultant Airway Disease, John Hunter Hospital. ACI Respiratory Network Nursing Co-Chair)
  • Jay Flack (Chief Scientist, St George Hospital)
  • Mary Roberts (Clinical Nurse Consultant, Westmead Hospital)
  • Phillip Munoz CRFS (Senior Scientist, Royal Prince Alfred Hospital)
  • Rocco Mico (Respiratory Services Manager/Physiotherapist, Northern NSW LHD)
  • Helen Kulas (Respiratory Network Manager, Agency for Clinical Innovation)
  • Professor Vanessa McDonald (University of Newcastle)
  • Professor Peter Wark (HNELHD, HMRI).

For use by

All NSW Health clinical staff administering lung function testing during the COVID-19 pandemic.

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Page Updated: Tuesday 21 July 2020
Contact page owner: Health Protection NSW