The Respiratory Physiology Department

Please note that some of our more specialist tests are only performed at the Royal Stoke site.

The Respiratory Physiology Department provides lung function testing for inpatients and outpatients across both the Royal Stoke and County Hospital sites.  We provide support and services for specialist respiratory clinics, with the investigations assisting in the diagnosis and management of lung disease and abnormalities.  Our services are also used by a wide variety of other medical or surgical specialities to help plan for surgical procedures, monitor the effect of drugs or before interventions and treatments. 

Royal Stoke Ambulatory Oxygen Therapy (AOT) 

  • The body requires more oxygen when active and therefore a person’s oxygen level may drop during exercise.

 

  •  Some patients with lung conditions may not need oxygen whilst they are at rest or walking short distances but may require supplementary oxygen when they are more active. This is called Ambulatory Oxygen Therapy (AOT).

 

  •  AOT is delivered using portable equipment that most patients can carry or pull using a trolley.

 

  • It is for patients whose oxygen levels drop during activity and want to improve their exercise tolerance and complete activities outdoors.

 

  • AOT shows significant improvements in patient respiratory health status, as well as improving quality of life and exercise tolerance.

 

  • When using AOT, you may still feel breathless due to the condition of your lungs and the activity that you are completing.

 

  •  More information about managing breathlessness will be provided by the Respiratory Team and your Consultant.

When is AOT needed?

You may be referred to the Respiratory Team for an appointment for an oxygen ambulatory assessment by your consultant or nurse specialist if you have chronic lung conditions and oxygen levels drop to less than 85% when exercising but is at normal levels at rest. 

Ambulatory Oxygen is not a treatment for breathlessness or anxiety and is not suitable for:

  • Housebound patients.

 

  • Patients that use large walking aids or use a wheelchair outside as the patient is required to carry the equipment themselves whilst being moderately active.

 

  • Smokers.  This is due to safety risks that are associated.

 

Preparing for the AOT assessment

The assessment needs to be accurate and so the patient must be clear of any infections for 6 weeks before the appointment.  If you have experienced any infections, you will need to reschedule your appointment.  Please tel: 01782 675452 (Royal Stoke).

Please continue to take any medication for your respiratory system such as inhalers or tablets before attending your appointment.

Please remove any nail polish you have.  This will ensure that the probe equipment used is able to measure your blood oxygen accurately.    

Please wear comfortable clothing and footwear as you will be required to complete a 6-minute walk test which measures how far you can walk during this time.

  • The Walk test includes monitoring your heart rate and oxygen levels either by a finger or ear probe.

 

  • You may be asked to repeat the walking test to see how much supplementary oxygen you require.

 

  • Please see the exercise test leaflet for further information.

After the AOT assessment

If the assessment results require ambulatory oxygen, a prescription will be given to you and explained including when you will be required to use it at your appointment.  Information on backpacks and trolley bags to use to transport your oxygen will also be discussed.

The physiologist will complete the Home Oxygen Order Form (HOOF) form and send this to the oxygen provider depending on the area you live.  Either Baywater or Air Liquide will contact you about your oxygen delivery to arrange delivery within 48 hours of your assessment.

AOT should not be used when you are ay rest and only when you are active. Supplementary oxygen can be harmful if not used correctly.

Replacing oxygen cylinders

If your oxygen cylinders are running low, please contact your provider on the numbers at the bottom of the leaflet which will normally be replaced on the next working day.  Please ensure that you get in touch with your provider before you completely run out.

Your oxygen flow rate is calculated to be safe and sufficient for you and should not be changed without medical advice/guidance.  If you are feeling more breathless than normal this may be a sign that you are unwell, so please seek medical advice.

Travelling with Oxygen in the UK

Please make sure that if you are going on holiday in the UK as an oxygen therapy patient that you plan well in advance.  Always inform the travel companies and insurers that you use home oxygen therapy.

Please contact your oxygen provided (Baywater) who can arrange for any oxygen equipment to be delivered to your holiday address which is free of charge.

Travelling with Oxygen abroad

If you plan to fly, please speak to your Respiratory Consultant about your fitness to fly before you book your flight.

The doctor will decide if you require a fit to fly assessment as your prescription may be changed during the flight.

Oxygen will need to be privately arranged and you may be required to pay for this service.

Safety when using Oxygen

Using oxygen is safe when used correctly.  Instructions include:

  • DO NOT smoke or let anyone smoke (including e-cigarettes/vapes) near you when you are using your oxygen therapy.    Smoking will aggravate the condition and oxygen is highly flammable.

 

  • Keep away from naked flames and heat.  Keep your cylinders and your concentrator away from any fires (at least 3m from open fires and 1.5m from closed fires), heaters or cookers.

 

  • Turn your oxygen off when not in use.  Oxygen may build up in the material and make it more flammable.

 

  • Avoid oil-based creams.  Some lotions contain paraffin or oil which can react when used with oxygen therapy.  Use a water-based cream such as KY Jelly.

Contact Numbers

Staffordshire/Cheshire patients   www.baywater.co.uk.

Oxygen equipment queries:  Baywater    tel: 0800 373580

Cheshire East patients:                uk.healthcare.airliquide.com

Oxygen equipment queries            Air Liquide tel: 0800 637737

Prescription queries:             Respiratory Physiology: 01782 675456

Test queries:                            Respiratory Physiology: 01782 675452

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

Capillary Blood Gas (CBG) Sampling

  • If the sample collected is from your earlobe, it is called a capillary blood gas test. 

 

  • A blood gas test is used to measure how much oxygen and carbon dioxide is in your blood. 

 

  • By measuring the levels of the two gases in your blood the consultant can tell how efficiently your lungs are working.

During the blood gas test

  • A physiologist will apply a special spray to your earlobe that helps increase blood flow.  This makes your ear go red and feel hot.

 

  • The blood vessels in your ear lobe will then contain about the same amount of oxygen as blood taken from your artery.

 

  • After a few minutes, the physiologist can take a sample by scratching your ear lobe and catching the blood droplet that forms. 

 

  • The sample is then taken and analysed via a machine in the department. 

 

  • After checking the sample, a second sample may be taken. 

Preparing for the test

  • Please do not wear any earrings to the test. 

 

  • There are no other specific preparations that need to be made.

 

After the test

  • The results are uploaded to your hospital account. 

 

  • The consultant will review and discuss the test results with you. 

 

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

Following a referral from your doctor or consultant, you will need to take part in some tests which will show how well your heart and lungs are working.

There are 3 different tests you may need to take part in, and these will depend on your diagnosis and symptoms.  They include:

  • Cardio-Pulmonary Exercise Test (CPET).  Royal Stoke site only.

 

  • A 6-Minute Walk Test (6MWT).  Either Royal Stoke or County site.

 

  • Exercise Induced Asthma Test (EIA). Royal Stoke site only.

 

You may experience shortness of breath and fatigue during the exercise test however this is required to ensure that we gain accurate outcomes/results.  Adequate rest and recovery time will be given.

You may experience some muscle soreness on the days following the test.

Exercise tests are required so that:

  • Any breathing problems can be determined when not at rest.

 

  • Causes identified if other tests completed have been inconclusive. 

 

  • Effectiveness of treatment can be monitored.

 

  • A patient’s fitness before having surgery can be assessed.

 

Preparing for the exercise tests

Please contact the Royal Stoke on 01782 675452 if you have had any of the tests requested and you have experienced any of the listed symptoms below.  Your appointment may need to be re-scheduled, or adjustments made for your appointment.

  • Musculoskeletal problems or injuries preventing you from exercising.

 

  • Recent heart attack.

 

  • Uncontrolled high blood pressure.

 

  • Recent chest infection requiring antibiotics/steroids in the last 6 weeks. 

Please read the appointment letter to check if any medication you are on should be withheld (particularly for the EIA).  Please also make sure you:

  • Bring a list of any medications you are taking with you. 

 

  • Wear comfortable clothing and flat shoes that will not slip off easily. 

 

  • Eat a light meal at least 2 hours before the appointment.

 

  • Do not smoke, have any caffeine or alcohol on the day of the test.

 

  • Do not exercise before the test.

 

  • Remove nail varnish/false nails.

 

  • Bring any walking aid you have, to enable you to walk safely, such as a walking stick or walking frame. 

 

  • If you are on oxygen when you exert yourself, please bring this with you to the appointment. 

 

Cardiopulmonary Exercise Test (CPET)

Please allow 1 hour for the appointment, however you will not be exercising for the whole hour.

Before the exercise test

  • You will be given all the information about the test and have an opportunity to ask any questions you may have.

 

  • The Physiologist will perform a baseline spirometry test (lung function) and take a blood sample from your ear (see CBG information).

 

  • You will then be fitted with an ECG, oximeter, BP cuff along with a mask to measure your breathing. 

 

During the exercise test      

  • The test is completed on a static exercise bike.  You will be cycling for approximately 8-12 minutes against the incremental load.

 

  • Your heart rate and BP will be monitored for a few minutes once you have completed as much exercise as possible.

 

  • Your heart, lungs, BP and oxygen saturation (using. a pulse oximeter) are monitored during the exercise to an incremental workload.  This will feel like you are cycling up a hill.

 

6-Minute Walk Test (6MWT)

The test will take 15 minutes to complete including recovery.

Before the exercise test

You will be given all the information about the test and have an opportunity to ask any questions you may have.

During the exercise test

  • You will walk up and down a room for 6 minutes to the length of either 9, 10 or 7m.  This will depend on if your appointment is at Royal Stoke or County Hospital.

 

  • The test measures how far you can walk at your own pace in 6 minutes. 

 

  • While you walk your heart rate and oxygen levels are monitored by the Physiologist using either a finger or ear probe (pulse oximeter). 

 

  • You can stop at any point to rest and have as many rests as you require during the allocated time.

 

Exercise Induced Asthma (EIA) Test

Please allow 1 hour for the appointment, however you will not be exercising for the whole hour.

Before the exercise test

You will be given all the information about the test and have an opportunity to ask any questions you may have.

A baseline spirometry breathing test (link to spirometry) will be taken.

During the exercise test

  • The test is completed using a treadmill for 6-8 minutes and will identify if there are changes in your airways.

 

  • The Physiologist will aim to get your heart rate up to 80-85% of its maximum.

 

  • You will be monitored by using a heart rate strap around your chest.

 

  • You will be asked to perform breathing tests at different time intervals for up to 30 minutes.  The time intervals will depend on the results from the breathing test each time it is performed.

 

  • If necessary, you will be given inhaled medication, and the spirometry test will be repeated after 15 minutes. 

Results

The results will not be discussed at your appointment.

The test report will be uploaded to your hospital record on your day of testing so that the referring doctor/consultant has time to review. 

Any results will be discussed with you at your next appointment.

 

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

Long Term Oxygen Therapy (LTOT) is a term used to describe supplementary oxygen which is used at home for at least 15 hours a day and used lifelong.  An assessment is required to understand how it affects you.

Oxygen therapy is only given to patients who have low oxygen levels at rest.  It is not a treatment for breathlessness or anxiety.

LTOT can help to improve life expectancy, quality of life. improve a patient’s sleep, as well as helping organs to function better.  People with chronic respiratory conditions often must work harder to get all the oxygen that their body needs.

  • Lower oxygen levels in your blood happen if your lungs cannot keep up with the bodies demand for oxygen which may make you feel breathless or tired especially when mobilising or exerting yourself.

 

  • Some people who have low blood oxygen levels may not feel breathless at all and equally, some people feeling breathless may have normal oxygen levels.   

 

  • Supplemental oxygen can be given if you have low oxygen levels and the assessment will help us to work out the right amount of oxygen for you as too much oxygen can be dangerous. 

LTOT Assessment

Please contact the department on 01782 675452 if you have had a chest infection during the last 6 weeks as the test may have to be rearranged.  The assessment may include up to 2 visits.

First Visit.   

A small blood sample will be taken from your earlobe to check oxygen levels whilst you are breathing normal room air (21%).

Second Visit.

If your oxygen levels are low on the first visit, you will be asked to come in for a second visit approximately 3 weeks later to repeat the test. If on the second visit your oxygen levels are still low, you may be asked to breathe some supplementary oxygen. The amount of oxygen will be adjusted until you are breathing the correct amount 

You will be advised after the assessment if oxygen levels need to be rechecked.

You will be asked to give consent to order oxygen.

 

Replacing oxygen cylinders

If your oxygen cylinders are running low, please contact your provider on the numbers at the bottom of the leaflet which will normally be replaced on the next working day.  Please ensure that you get in touch with your provider before you completely run out.

Your oxygen flow rate is calculated to be safe and sufficient for you and should not be changed without medical advice/guidance.  If you are feeling more breathless than normal this may be a sign that you are unwell, so please seek medical advice.

Travelling with Oxygen in the UK

Please make sure that if you are going on holiday in the UK as an oxygen therapy patient that you plan well in advance.  Always inform the travel companies and insurers that you use home oxygen therapy.

Please contact your oxygen provided (Baywater) who can arrange for any oxygen equipment to be delivered to your holiday address which is free of charge.

Travelling with Oxygen abroad

If you plan to fly, please speak to your Respiratory Consultant about your fitness to fly before you book your flight.

The doctor will decide if you require a fit to fly assessment as your prescription may be changed during the flight.

Oxygen will need to be privately arranged and you may be required to pay for this service.

Safety when using Oxygen

Using oxygen is safe when used correctly.  Instructions include:

  • DO NOT smoke or let anyone smoke (including e-cigarettes/vapes) near you when you are using your oxygen therapy. Smoking will aggravate the condition and oxygen is highly flammable.

 

  •  Keep away from naked flames and heat.  Keep your cylinders and your concentrator away from any fires (at least 3m from open fires and 1.5m from closed fires), heaters or cookers.

 

  • Turn your oxygen off when not in use.  Oxygen may build up in the material and make it more flammable.

 

  • Avoid oil-based creams.  Some lotions contain paraffin or oil which can react when used with oxygen therapy.  Use a water-based cream such as KY Jelly.

Contact Numbers

Staffordshire/Cheshire patients   www.baywater.co.uk.

Oxygen equipment queries:           Baywater    tel: 0800 373580

Cheshire East patients:                uk.healthcare.airliquide.com

Oxygen equipment queries            Air Liquide tel: 0800 637737

Prescription queries:                       Respiratory Physiology tel: 01782 675456

Test queries:                                    Respiratory Physiology tel: 01782 675452

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

What is a FeNO test?

This is a measurement of the amount of nitric oxide in your breath and produces a score which gives a value to the level of inflammation and aids the diagnosis of asthma.   

Preparing for the test

On the day of your appointment:

  • Check your appointment letter for any medication you are required to withhold. 

 

  • Please wear comfortable and unrestrictive clothing.

 

  • Do not smoke or have any alcohol.

 

  • Please do not eat a large meal.

 

  • Do not do any form of heavy exercise.

During the test

You will be asked to take a deep breath in through the machine and then blow out into the room at a steady pace for 10 seconds.  The machine has a visual display shown below, so you can gage the speed that you are required to blow.

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

You have been referred for Lung function tests to assess your breathing and determine how well your airways and lungs are working.  The lung function tests will 


•    Help aid and monitor your diagnosis.


•    Measure how well you breathe/ventilate.


•    Establish how well you move air in and out of your lungs and determine how efficiently oxygen travels through your lungs to your bloodstream.


Breathing tests are performed to:
•    Determine the cause of breathing trouble, shortness of breath, wheeze or cough.


•    Confirm a diagnosis of a lung condition/disease.


•    Measure the severity of lung disease.


•    Monitor progress and symptoms of the condition.


•    Evaluate a person’s lung function before surgery. 


•    Monitor the effectiveness of prescribed treatments. E.g. nebulisers or inhalers.


Preparing for the lung function test


It is normal to be asked to attend your tests alone.  If you feel you need some support from a relative or require a chaperone at your appointment, please contact us at Royal Stoke on 01782 675452 or at County on 01785 887544.


If you are suffering from a chest infection or are taking a course of anti-biotics or steroids, please contact the department to re-arrange your appointment or ask for advice from the physiologist before attending your appointment.


On the day of your appointment:


•    Check your letter for any medication that you are required to withhold.  If you take any tablets/medication for your respiratory system, please bring a copy of your prescription with you to ensure we have a full medication history. 


•    Wear comfortable and unrestrictive clothing.


•    Refrain from smoking or consuming any alcohol. 
•    Refrain from eating a large meal. 


•    Refrain from undertaking any form of heavy exercise. 


•    Please allow enough time for your appointment.  The full tests will last up to 1 hour but may also include an additional assessment.  If this includes a test of your response to an inhaler, please allow for a further 30 minutes.  If you are only having a spirometer test, this will only take 15 minutes.


You will be informed if there is any need for a second test which will measure improvement.


During the lung function test


The Physiologist conducting the tests will explain all the test procedures and why they are needed.  You will also be given lots of encouragement to do your best as they are maximal effort tests. 


You will be asked to sit in an upright position within the lung function equipment or opposite the equipment in a chair with arms.  The various tests that may be carried out include:


Slow vital capacity (SVC)


•    You will be asked to breath in and out of the machine using a special mouthpiece.   The SVC will show how much air your lungs can inhale and exhale in a relaxed state.  


•    You will be asked to take a big breath in and blow this out at a steady pace, like a sigh. You will be asked to do this several times.


Static lung volumes (body plethysmography)

This will tell us the size of your lungs.    


•    You will be asked to sit inside a cubicle with the door closed throughout the test. The door is not locked and can be opened voluntarily at any point if required.


•    You will wait for one minute to allow the temperature to settle and then be asked to breathe slightly quicker than normal on the mouthpiece whilst holding your cheeks and with a peg on your nose.


•    After 30 to 60 seconds a shutter will block the mouthpiece for two seconds.  During this time, you will be asked to pant softly against the blockage. 


•    After two seconds, the shutter will lift, and you will then be asked to breathe normally.  


•    This measurement is repeated a few times to ensure we have accurate results. 


Gas transfer


Gas transfer measures the ability of a gas to transfer from your lungs to your bloodstream and thus determining how efficient your lungs are working. 


•    You will be asked to breathe normally on the mouthpiece, with your lips creating a tight seal and a peg on your nose. 


•    You will then be instructed to blow all the air out of your lungs until they are completely empty. 


•    You will then be asked to take a breath in until your lungs are as full as possible and hold your breath for up to 10 seconds. 


•    You will then blow out till empty, keeping your lips tight throughout.
 
Spirometry 


The Physiologist completing your lung function tests will explain all the tests procedures to you and give you lots of encouragement.  It is the most common lung function test and is used to look at tightening in your airways.


•    It measures the amount of volume as well as flow of air that you can inhale and exhale forcibly. 


•    The measurement is completed several times to ensure that we gain accurate results. Some patients may only attend for this one test. 


Bronchodilator Response


You may have been asked to complete a trial with a bronchodilator (medication that looks to open your airways) by your doctor.  The test will provide baseline spirometry (as above) and the medication being administered.  The spirometry test is repeated 15 minutes later. 


Side effects of the lung function test


•    During the breathing tests, you may feel lightheaded after blowing rapidly.
•    The test may also stimulate your cough, but this is normal. 
•    You may experience temporary shortness of breath, but adequate rest will be provided as these are tests that require maximal effort. 
•    There should be no aftereffects from having your lung function, however you may feel tired once the tests have been completed.  
•    You can resume normal activities after your test.


Results


Results are not discussed at your appointment.  The test report is uploaded to your hospital record of the day of your testing for review at your next appointment.

Contact details:

Royal Stoke Hospital                    01782 675452

County Hospital                             01785 887544

 

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

What is a Mannitol test?

Your doctor may have referred you for a bronchial challenge test, also known as Mannitol Challenge.   This test helps to identify if you have hypersensitive airways as well as helping to diagnosis asthma.

Sometimes symptoms can be triggered by exercise and include:

  • Coughing

 

  • Wheezing

 

  • Chest tightness

 

  • Mucus excess

Preparing for the test

On the day of your appointment:

  • Please wear comfortable and unrestrictive clothing.

 

  • Do not smoke or have any alcohol.

 

  • Do not do any form of exercise.

 

  • Do not eat a large meal 2 hours before the test.

 

  • Do not drink caffeinated drinks such as tea, coffee, coca cola.

 

  • To make sure that the test can take place, please make sure you follow the medication guidance in this leaflet.

During for the test

The test will take approximately 1 hour.  The test can sometimes cause a dry cough or slight wheeze, however this is nothing to worry about as these are the symptoms we are looking for to see how your airways react.

  • A spirometer will be used to complete a breathing test to assess your lung function. (see spirometry section as part of lung function). 

 

  • A low concentration dose of Mannitol via an inhaler will then be administered.

 

  • The spirometry test will then be repeated to see how this has affected your airways. 

 

  • The process above is then repeated several times to different doses, followed by a spirometry attempt. 

Medication Guidance

Please follow the medication guidance on of when to stop taking your inhaler before your lung function test.

Short-acting bronchodilators – Relievers

How long to stop medication before lung function tests.

Drug Name

Brand Name

Stop 8 hours before

Inhalers and Nebules

Salbutamol

Terbutaline sulphate

Salamol, Ventolin, Airomire

Bricanyl

Stop 12 hours before

Inhalers and Nebules

Ipratropium bromide

Atrovent

Long-acting bronchodilators – Preventers

How long to stop medication before lung function tests.

Drug Name

Brand Name

Stop 24 hours before

Inhaler medication

Formoterol

Salmeterol

Oxis, Foradil

Serevent

Stop 36 hours before

Inhaler medication

Tiotropium bromide

Aclidinium Bromide

Glycopyrronium Bromide

Umeclidinium Bromide

Olodaterol

Indacaterol

Spiriva, Braltus, Zonda

Eklira Genuair

Seebri Breezhaler

Incruse Ellipta

Striveri Respimat

Onbrez

Long-acting bronchodilators – Preventers – Within Combination Inhalers

How long to stop medication before lung function tests.

Drug Name

Brand Name

Stop 72 hours before

Inhaler medication

Formoterol

Duoresp spiromax, Fostair, Flutiform, Symbicort, Fobumix

Salmeterol

Seretide, Sereflo, Sirdupla, AirFluSal, Combisal

Tiotropium

Spiolto Respimat

Aclidinium

Duaklir Genuair

Glycopyrronium

Ultibro Breezhaler, Trimbow

Umeclidinium

Anoro Ellipta, Trelegy Ellipta

Olodaterol

Spiolto Respimat

Indacaterol

Ultibro Breezhaler

Vilanterol

Anoro Ellipta, Trelegy Ellipta, Relvar Ellipta

Other

Stop 8 hours before

Inhaled non-steroidal anti-inflammatory agents

Sodium cromoglycate Nedocromil sodium

Stop 4 days before – anti-histamines

Cetirizine, Fexofenadine, Loratadine

Stop 4 days before

Leukotriene receptor antagonists

Montelukast, Zafirlukast

Stop 12 hours before

Leukotriene receptor antagonists

Beclomethasone(Qvar/Clenil)

 

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

What is a Hypoxic challenge test?

This test assesses whether you need supplementary oxygen when flying.  In an aeroplane the cabin pressure is reduced from 21% at ground level to 15% in the air.  It can mean that some people therefore require extra oxygen to be able to fly.

Preparing for the test

On the day of your appointment:

Please take all your medication including inhalers as normal.

The text will last up to 90 minutes depending on whether oxygen is required.

 

During the test

 

  • Some spray will be put on your ear lobe to increase the blood flow.

 

  • A blood sample will then be taken to check the amount of carbon dioxide and oxygen in your blood when you are at rest.

 

  • Using a facemask, you will then breathe a reduced oxygen mixture of 15%.  This simulates the conditions of being in the air on an aeroplane.

 

  • Your blood oxygen levels and heart rate will be monitored for 20 minutes.

 

  • Whilst you are breathing the 15% oxygen, a second blood sample will be taken.  This may be taken sooner if your oxygen level drops too much.

 

  • If during the test your blood oxygen levels go down, extra oxygen may be added to see if your blood oxygen levels return to normal.

After the test

The report is sent back to the consultant/doctor who requested it who will complete any paperwork needed for the airline.  Please bring any paperwork issued from your airline with you to your appointment.  The cost for this is currently £184.00 up to April 2025 as it is assessed as a private patient tariff.

Further information   

European Lung Foundation (ELF)

442 Glossop Road, Sheffield, S10 2PX.     0114 322 0635
Email the European Lung Foundation

Asthma + Lung UK
18 Mansell Street, London, E1 8AA.   0300 222 5800
Email Asthma + Lung UK

 

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

What are respiratory muscle weakness tests?

Muscles which control your breathing.

Preparing for the tests

On the day of your appointment:

Check your letter to for any medication that you are required to withhold otherwise, please take your medication as normal. 

  • Wear comfortable and unrestrictive clothing.

 

  • Refrain from smoking or consuming any alcohol.

 

  • Refrain from eating a large meal.

 

  • Refrain from undertaking any form of heavy exercise. 

During the tests

You may be asked to complete some of the tests which include:

  • Sniff nasal inspiratory pressure (SNIP)

 

  • A small bung will be placed into the opening of your nostril, and you will be asked to sniff in as hard as possible.

 

  • You will be asked to do this in both nostrils which you may need to repeat several times.

Cough peak expiratory flow (CPEF)

  • This is a measurement of how strong your cough is.

 

  • You will be asked to cough into a standard peak flow meter which will be repeated several times.

Mouth inspiratory pressure (MIP)

  • You will wear a nose peg and breath through a tube attached to a computer. 

 

  • You will be asked to blow out until your lungs are empty and then suck in as hard as you can against a slight blockage. 

 

  • You may be asked to do this several times.

 

Mouth expiratory pressure (MEP)

  • You will wear a nose peg and breath through a tube attached to a computer. 

 

  • You will be asked to support your lips and cheeks with your hands. 

 

  • You will then need to take a big breath in and then blow out as hard as you can against a slight blockage. 

 

  • You may be asked to do this several times.

After the test

  • The results are uploaded to your hospital account. 

 

  • The consultant will review and discuss the test results with you. 

 

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.

 

What are SPTs?

SPTs help determines whether you have an allergy to a certain allergen (substances which can cause an allergic reaction).  An allergy is when the immune system responds to an allergen such as pollen or pet hait.

Preparing for the test

Please to do not take any antihistamines for 4 days before your appointment as they may interfere with the tests. 

These include loratadine (Clarithyn), Cetirizine (Zirtek) and Chlorphenamine (Piriton). 

During the test

  • The test is performed on the forearm and is tested for 10 allergens.

 

  • This includes testing for positive control which checks your immune system response in the right way.

 

  • The negative control checks you are not allergic to the solution the allergens are mixed with.

 

  • A drop is added of each solution to the skin.

 

  • The skin under the droplet is then pricked with a lancet to scratch the top layer of the skin which allows the solution to get under the surface of the skin.

 

  • Any excess solution is then wiped away.

One of the following will occur:

A positive reaction – the skin under the drop of allergen becomes red and itchy.  A white, raised swelling called a weal is surrounded by a red area and takes about 15 to 20 minutes to reach a maximum size.  The size of the weal is measured.  This means that you are likely to be allergic to the substance in the solution.  The weal will fade in a few hours.

A negative reaction – the skin under the drop of allergen remains normal. This means that you are not likely to be allergic to the substance in the solution.

After the test

A report will be uploaded to your hospital record and discussed with you at your next appointment.

Contact details

If you have any questions or worries about the tests, please contact:

Royal Stoke Hospital 01782 675452

County Hospital           01785 887544

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

Click here to view the PDF version of this information.