Referrer - Ashford Thoracics

PULMONARY FUNCTION AND CONSULTATION REFERRAL

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Type of Referral:

Urgent

Routine

PFT only

Consultation with:

Requests:

Full lung function test

Spirometry with bronchodilator

Mannitol challenge test

Skin allergy test

6 minute walk test

Sleep study with initial consultation

Clinical History

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Patient’s Pre-test instructions:

DO NOT SMOKE 4 hours before your test
Check the following table for respiratory medications not to be taken before your test.
If you become short of breath, wheezy or feel unwell, take your prescribed medication and contact our clinic. Please call us if you have any concerns or queries

TEST	MEDICATION	DO NOT USE FOR
– Spirometry – Full Lung Function test	Ventolin, Bricanyl Airomir, Asmol, Zampreon, Salbutamol	8 Hours
	Qvar, Pulmicort, Flixotide, Arnuity, Alvesco, Atrovent (Ipratropium)	12 Hours
	Seretide, Symbicort, Flutiform, Cipla, Spiromax Duoresp, Serevent, Oxis, Flixotide, Breo Ellipta, Fostair, Cipla	24 Hours
	Spiriva, Spiolto, Onbrez, Bretaris, Brimica, Anoro, Breo, Incruse, Trelegy, Trimbow, Enerzair, Atectura, Breztri Aerosphere	48 Hours
Mannitol Challenge Test	Ventolin, Bricanyl Airomir, Asmol, Zampreon, Salbutamol	8 Hours
	Qvar, Pulmicort, Flixotide, Arnuity, Alvesco, Atrovent (Ipratropium)	12 Hours
	Seretide, Symbicort, Flutiform, Cipla, Spiromax Duoresp, Serevent, Oxis, Breo Ellipta, Fostair, Cipla	24 Hours
	Spiriva, Spiolto, Onbrez, Bretaris, Brimica, Anoro, Breo, Incruse, Trelegy, Trimbow, Enerzair, Atectura, Breztri Aerosphere, ALL Anti-histamines	72 Hours
	Singulair/Montelukast tablets	4 Days
6 Minute walk test	Please use all medications as usual including inhalers Remove nail polish
Skin Allergy Test	All anti-histamines	4 Days
	Codral and Sudafed	24 hours