This Focus Area will highlight select information provided by leading experts in their respective fields. Contributors are listed alphabetically.
NOTE: Any product mentioned is not an endorsement of that product and only serves to clarify the intended message.
Contributor Brief Bios
+ Jeffrey M. Haynes RRT, RPFT, FAARC, FCCP, is currently the Clinical Coordinator, Pulmonary Function Laboratory at the Elliot Health System located in Manchester, New Hampshire, USA. Jeffrey has lectured throughout the United States, has published extensively in peer-reviewed journals, on pulmonary diagnostics topics, is highly regarded as a researcher and being a leader in this field. He also regularly posts videos to his popular YouTube® channel, “PFT Tutor with Jeffrey Haynes”.
+ Garry W. Kauffman, MPA, FACHE, RRT, FAARC, is currently the founder and owner of Kauffman Consulting, LLC, located in North Carolina, USA. His Respiratory Care career provided him with a chance to serve in clinical, educational, and administrative roles in a variety of healthcare organizations and venues. Garry is nationally recognized for numerous peer-reviewed journal publications, as author/coauthor of respiratory care textbooks, and as a frequent speaker. His focus continues to be on communicating the value of respiratory care services, delivered by respiratory therapists, by connecting the science of respiratory care, documenting outcomes secondary to respiratory care services, and implementing improved operational and clinical protocols to improve quality, safety, satisfaction, and financial performance.
+ Carl D. Mottram RRT, RPFT, FAARC, is Associate Professor of Medicine – Emeritus at the Mayo Clinic, in Rochester, MN, USA and President – PFWConsulting LLC. Carl has lectured extensively throughout the United States and internationally and has published numerous book chapters and articles in peer-reviewed journals. He is the author and editor of “Ruppel’s Manual of Pulmonary Function Testing” and is highly regarded as being a leader in pulmonary diagnostics.
+ Additional Biographies to be added in this section
Topics
I. Height Measurement for Pulmonary Function Testing
Jeffrey M. Haynes
Video Link: https://youtu.be/QvdFh9GdBUE?si=11udC3wgI7xI1HwM
Description: Height is a key demographic used by reference equations to determine normal ranges for patients undergoing pulmonary function testing. This video will review how to accurately measure height and perform basic quality control on height measuring devices.
II. PFT Spirometer Calibration Myths
Jeffrey M. Haynes
Video Link: https://youtu.be/HvfCp0fJ9WQ?si=1gvHR8Wflhvr8XfQ
Description: This video discusses common myths associated with spirometer calibration and cal verification, important components pulmonary function testing quality assurance.
III. Using z-scores to Interpret Pulmonary Function Test (PFT) Data
Jeffrey M. Haynes
Video Link: https://youtu.be/bHTt6A4PadU?si=g3o5YgLSWXGLSPjI
Description: The 2022 European Respiratory Society/American Thoracic Society (ATS/ERS) PFT interpretation standards recommended that z-score be used to grade PFT results. This video will provide a concise definition of z-scores, and guidance on how z-scores are used to determine whether or not a measured PFT value should be categorized as normal or abnormal.
IV. Spirometry: Excessive Back Extrapolated Volume What Is It And How Can I Correct It?
Jeffrey M. Haynes
Video Link: https://youtu.be/XFEDvHOBgqk?si=103PT8u4JLZ_mK5z
Description: This video will cover a common error encountered during spirometry testing: excessive back extrapolated volume. The presentation will explain what back extrapolated volume error is, how to identify it and coaching strategies to help your patient avoid this error.
V. Should You Always Report the Largest FEV1?
Jeffrey M. Haynes
Video Link: https://youtu.be/qN1Wc8aYNrc?si=bI2YPT7aC_tZ-7Xd
Description: Computer software will always report the largest acceptable FEV1; however, the largest FEV1 is not always the true FEV1.
VI. Submaximal Inhalation Error (FIVC > FEVC) During Spirometry Testing
Jeffrey M. Haynes
Video Link: https://youtu.be/yiB-2bF5daY?si=TaXsER_kVb0i7yrU
Description: This video reviews a common error during spirometry testing: submaximal inhalation error. This video will show how to identify this error and reviews ways to correct it.
VII. What Should You Do When PFT Values Appear Too Good To Be True?
Jeffrey M. Haynes
Video Link: https://youtu.be/zGAbOYFheuE?si=tZU1B1pzqC6kdj0Q
Description: This video reviews the steps that should be taken when PFT values are higher than normal. Only through careful investigation can determine whether the reported values are accurate or erroneously high.
VIII. Methacholine Challenge Testing
Jeffrey M. Haynes
Video Link: https://youtu.be/pH6EVI4rLl0?si=_7Kf8TSCD1ryU-1c
Description: This video will explain the how and why’s about performing methacholine challenge testing in accordance with the 2017 ERS technical standards. In my practice I don’t follow all of the ERS recommendations but I will explain why. Many laboratories follow old and outdated protocols, this presentation will get you up-to-speed with current practice.
VIIII. 6 Minute Walk Test (6MWT)
Jeffrey M. Haynes
Video Link: https://youtu.be/yP6_9Hn3034?si=KEm86nOe87_yEApn
Description: The six minute walk test(6MWT) provides valuable information regarding functional capacity, prognosis, and the response to treatment. The 6MWT is not complicated, but is often not performed correctly which can greatly affect the results. This video will review the proper way to perform the 6MWT according to the ERS/ATS technical standards.
IX. Biologic Control Testing
Jeffrey M. Haynes
Video Link: https://youtu.be/7anNXgFL4xY?si=LGFY16R6TtThenTj
Description: This video reviews the importance of performing biologic control testing in the pulmonary function laboratory. I also review how to set up and manage a biologic control program.
X. Is There Only One Way to Measure Vital Capacity During Lung Volume Testing?
Jeffrey M. Haynes
Video Link: https://youtu.be/ZyHzkTuUixA?si=B8xcVP9ncpwTCcE8
Description: Vital capacity is a critical determinant of lung volumes and subdivisions. The 2023 ERS/ATS lung volume testing technical standards recommend one method to measure vital capacity. In this video, I will try to convince you that this is not the best approach.
XI. Reducing Pain Associated with Arterial Blood Gas (ABG) Puncture
Jeffrey M. Haynes
Video Link: https://youtu.be/q7IfVbQL0kg?si=EYsjdf8Us-1sNec2
Description: This video will show the effectiveness of ice application in reducing the pain associated with arterial blood gas (ABG) puncture
XII. Diffusing Capacity (DLCO) Simulation
Jeffrey M. Haynes
Video Link: https://youtu.be/t1cyeCyiQC0?si=RADHUKqJkbOgWt4z
Description: This video shows an easy method for performing DLCO simulation with a standard 3L calibration syringe. DLCO simulation is an important feature of a pulmonary function laboratory quality assurance program. Web address to Westgard QC tools for plotting DLCO simulation data: https://www.westgard.com/qctools…
XIII. Diffusion Capacity (DLCO) Using The Morgan Scientific ComPas2 Software
Jeffrey M. Haynes
Video Link: https://youtu.be/9H3vNHjxDQk?si=ou7j7GQNreZ8bAdy
Description: This video will review performing DLCO simulation testing using a 3L calibration syringe with the Morgan Scientific ComPAS2 software. There is valuable information about DLCO simulation even for those who aren’t using the ComPAS2 software
XIV. Is This Asthma, Vocal Cord Dysfunction, Or Both?
Jeffrey M. Haynes
Video Link: https://youtu.be/iJuN0WvuXBM?si=xTC8rElPbPfh2D_Q
Description: This is a quick report about a patient with asthma who developed debilitating shortness of breath despite multiple asthma medications. Exercise laryngoscopy revealed inducible laryngeal obstruction, commonly referred to as vocal cord dysfunction.
XV. Value-Based Respiratory Care
Garry W. Kauffman
Video Link: https://youtu.be/zrphtQKs09c?si=kPagfPgeMkQMbusG
Description: The days of obtaining reimbursement for every procedure, test, and intervention are only distant memories. Counting procedures and billable service units are examples of “counting what we can count” and must be replaced with “doing what counts”. This video will address the changing health care system, with attention to the current and forecasted demands on health care professionals and professional opportunities within the evolving health care system.
XVI. Pulmonary Lung Function Test Interpretation
Carl D. Mottram
Video Link: https://youtu.be/Ou8Umud3aNs?si=gfsRJ9H6MnRxpfPM
Description: This video overviews key components of the “ATS/ERS technical standard on interpretive strategies for lung function tests” as well as addressing reference sets with a focus on race and ethnicity.
XVII. Respiratory Oscillatory An Alternative Method to Assess Airway Caliber
Carl D. Mottram
Video Link: https://youtu.be/EbRuswg0gwg?si=7LaMH5b6TPfROua6
Description: This video reviews the underlying physiology behind respiratory oscillametry, overviews the ERS technical standards and case studies are presented.
XVIII. Lung Volumes by Body Plethysmography “Unraveling the Mysteries of the Box”
Carl D. Mottram
Video Link: https://www.youtube.com/live/emYwtSXCzU8?si=Q-0Xl_G11EFaEmFF
Description: This video overviews technical aspects of total body plethysmography as well as clinical applications of testing.
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