Respiratory Function Testing During COVID-19
Respiratory function testing is key to the diagnosis, management and monitoring of respiratory disease and as an assessment of surgical risk. The required tests will depend upon the underlying clinical problem, but, for the majority of patients, it will involve breathing into equipment. This often produces a cough and as such is potentially an aerosol generating procedure (AGP) with the need for appropriate precautions. Useful tests such as blood gases and simple field exercise tests; i.e. shuttle walk test and 6 minute walk tests are not deemed to be AGPs (unless the patient is coughing), but precautions are still necessary, along the lines of standard PPE used in the out-patient setting together with standard infection control procedures (SICPs). This document addresses predominantly adult testing, but several aspects are applicable to children.
Sleep Services During COVID-19
Sleep services comprise of a series of diagnostic and treatment functions for a wide spectrum of sleep disorders. These services are run by physiologists/scientists together with a range of specialties including respiratory, neurology, anaesthesia and others. They consist of testing and treating patients with either (i) sleep breathing disorders or (ii) purely sleep disorders.
The sleep breathing disordered services are high volume services with some 12,000 diagnostic sleep tests per month, many to exclude or confirm the diagnosis of obstructive sleep apnoea. As for general respiratory physiology, such services closed early and several treatments are associated with infection control issues caused by aerosol generating procedures (AGPs) such as administration of CPAP and NIV.
The issues faced from this are considered within this guidance document.