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12 Posts

Posted:  26-Oct-2013 08:24
Can I ask what everyone does for reversibility testing?  I'm having a battle over spacers with my pm, everything I've read and courses I've done always says use single patient use.  But my pm won't allow it.  Even our local respiratory physiologist says wash in warm soapy water!  So I've been forced to sterilize between use... at least that's better than the hospital.
Wonder what cqc will make of that. 

111 Posts

Posted:  26-Oct-2013 17:15
I only use for single patient. try and replace stock with individual px from pt just used it on and ask pt if they agree to this, works for most patients as most of them are happy with this as don't pay for their prescriptions. if I get a pt who does pay then I order them through our surgery stock instead. I would hate to use a spacer previously used by someone else, but luckily for me its not made an issue in my surgery.

12 Posts

Posted:  26-Oct-2013 18:05
I'm using the spacer for reversibility and usually the patient still pays for their scripts.  I've tried doing a script per patient, but find they don't collect it.  My pm won't pay for single use, not that we use a huge amount. I'm just banging my head against the wall over this.  :-(

4 Posts

Posted:  27-Oct-2013 13:10
I've heard there are disposable ones on the market, but not sure they are any good. Perhaps that is a way of solving the cost issue.

5 Posts

Posted:  28-Oct-2013 07:51 Log in to like this post
Hi all the courses I've done say its fine to reuse the volumatic as long as washed in between patient use. We do numerous spirometry a week so would be very expensive if had a new one for each patient (this is the nurse manager who controls the budget in me ) but I agree as a infection control issue it would be ideal to have a new one per patient.

242 Posts

Posted:  08-Feb-2014 09:16
I understand volumatics should be single use but at present we are cleaning them. Im sure we are not the only ones doing this. Does anyone have a prptocol for this? Is milton generaly used? Thanks

20 Posts

Posted:  08-Feb-2014 18:25

I have 3 or 4 and soak them all in very hot soapy water, rinse well and leave to dry, As the above comment  i do so much reversability it would cost a fortune. I am sure there must be articles on this. You could then present the evidence to the  partnership and let them make the decision rather than worrying about it i guess. You can only do your best in these situations/dilemmas

good luck

242 Posts

Posted:  09-Feb-2014 18:08
Thanks. Any other comments out there? If you use milton, do you rinse aftrr?

457 Posts

Posted:  10-Feb-2014 09:43
We were also told by infection control that washing and rinsing in hot soapy water is adequate.

159 Posts

Posted:  10-Feb-2014 10:32
I no longer do reversibility in practice, I give the patient Qvar 200mcg for 6 weeks or a trial of oral steroid 30mg a day for 14 days then repeat spirometry.

20 Posts

Posted:  11-Feb-2014 21:04
milton is ok according to what i have read and on many protocols. single use ones not reliable enough again according to what i have read recently.  gps in our practice dont like giving steroids for trial purposes.... but is an idea. milton also for inspiratory meters also ( 10-15 min soak for both)

83 Posts

Posted:  02-Apr-2015 18:41 Log in to like this post
Any links to your reading please gill BIG issue at prsent in practice

1259 Posts

Posted:  02-Apr-2015 19:03
Single use or what about chucking them in the dishwasher on a hot wash-got to be better than rinsing in the sink!


183 Posts

Posted:  03-Apr-2015 10:42
Dishwasher - what dishwasher?!

Personally like Prissy I no longer do reversibility testing with spirometer - if clinical history is more likely to be asthma then I will prescribe a peak flow meter & salbutamol qds prn to record bd for two to three weeks; if thinking along the lines of COPD then take full history and prescribe adequate bronchodilation with either saba and/or lama and ensure patient uses saba qds day before and every two hours before spiro on day of test.

Reversibility - how much - if you read all the different evidence!


31 Posts

Posted:  17-Jan-2018 10:21
Anyone found anymore infor regarding reusing the spacers

1283 Posts

Posted:  18-Jan-2018 21:14
single use only. our surgery will do a script for the patient who brings it in for test

71 Posts

Posted:  19-Jan-2018 11:56 Log in to like this post
we had out cqc last year and i had contacted infection control prior to this, and a catergoric no to reusing spacer, single use only, we issue spacer on script to pt
we are an inner city practice, but even so i would not like to have any instrument used on me that has been used by someone else

407 Posts

Posted:  19-Jan-2018 12:19
Those that do scripts: do you issue the script when an appt is booked? how is this managed? do you have anyone who doesn't collect the scripts because of the cost?

(Just devils advocate, please don't take this personally, it is not directed at anyone in any way, it's a scenario. Do you use a fork or spoon when you are eating out and do you dry yourself with a towel in a hotel?)

71 Posts

Posted:  19-Jan-2018 13:30
the gp has to issue the script, were this can fall down is that they have not been told the importance of attending with the spacer and mdi
but reception staff are told of the booking procedure, and they carry the can for errors in booking

75 Posts

Posted:  22-Jan-2018 07:13
n/a.....i have been through the same issues as you over the years and told ok to re-use spacers but unfortunately it is not. The volumatics are single patient use and therefore should not be shared as they cannot be adequately cleaned in between. Limited evidence out there. The dispozAble ones are a good option, about a £1 each but there would be no defence to our practice if we were to be any issues with cross infection with sharing spacer. Just my opinion.

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