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The Thoracic Society of Australia & New Zealand and Australian and New Zealand Society of Respiratory Science LTD(TSANZ/ANZSRS) released their jo9int position statement in June 2022, recommending the measures that should be met when reintroducing spirometry into the practice such as (but not limited to):
- Inline viral/bacterial filters reduce but do not eliminate aerosols and must be used with all spirometry devices
- Contact your spirometer distributor / representative to enquire about availability of an inline filter for your specific spirometer device – do not proceed to testing if an inline filter is not available for your device
- Ensure the patient is afebrile prior to commencing lung function testing
- Ensure lung function testing is performed in a well-ventilated single room, minimising furniture, and other equipment – open the windows or have 12 air exchanges per hour. It is preferable that the room is exhausted to the outside. In the absence of adequate ventilation, strategies such as leaving rooms unoccupied between tests or use of HEPA filtration systems to supplement room ventilation are strongly encouraged.
- References:
https://www.anzsrs.org.au/about/anzsrs-publications/position-statements - Spirometry – https://www.youtube.com/watch?v=a0wyvc_Bog4
A ventilation assessment should be provided by a qualified professional service provider for the purpose of a ventilation audit, HVAC health check or assistance with items identified in the self-assessment ventilation guidance. A specialist engineer or Occupational Hygienist will supply the clinic with a certificate of air exchanges for each room/area.
Mechanical ventilation
- purchase and installation of spare parts to ensure the existing ventilation system operates effectively.
- upgrading or replacing filters in a ventilation system, such as installing a HEPA filter capable of 4-6 Air Changes per hour (ACH).
- Repairs, servicing or cleaning of an existing heating, ventilation, and air conditioning (HVAC) system or air conditioning unit.
Natural ventilation
- This requires using windows or doors to create greater air flow.
Augmented ventilation
- Purchase an air purifier using a high-efficiency particulate air (HEPA) filter for the premises.
Other measures
- Extractor fans can enhance the effects of other ventilation strategies.
- Electric fans to promote air movement if there are existing ventilation strategies in place.
- Wall mounted split systems and cassette units that do not have a function to bring fresh air into a space are only eligible if they are used in conjunction with other natural and mechanical ventilation.
References:
https://www.health.vic.gov.au/covid-19-ventilation-principles-strategies-to-reduce-aerosol-transmission-community-workplace
https://www.who.int/publications/i/item/9789240021280