Medical assistant's role in respiratory examinations and diagnostics

Medical assistants in primary care, urgent care, and pulmonary departments work with patients with respiratory conditions. Medical assistants in occupational health are also involved with performing spirometry for pre-employment physicals. The following sections describe the medical assistant’s role in examinations, diagnostic procedures, and treatments.

Assisting with the examination

Preparing a patient for a respiratory examination includes having the patient disrobe to the waist. The patient should put on a gown with the opening in the front or back, depending on the provider’s preference. To assess the status of the respiratory system, the provider uses inspection, palpation, percussion, and auscultation on the anterior thorax, then repeats the process on the posterior and lateral thorax. The medical assistant is responsible for assisting the provider throughout the examination and providing privacy and support for the patient.

Assisting with diagnostic procedures

The Medical Assistant should become familiar with lists of common diagnostic procedures for respiratory diseases. In addition, the medical assistant should also know lists common medical laboratory tests for respiratory system diseases. Some diagnostic procedures are done in the clinic, whereas others are done in other departments (e.g., medical laboratory and radiology). The medical assistant may be responsible for coaching patients on diagnostic procedures done in other departments. As with other diagnostic procedures, the medical assistant should coach the patient regarding the following:

• Patient preparation (e.g., dietary restrictions and medications to hold)
• Location and time of the test
• What to expect during the procedure
• Any follow-up required after the procedure

The medical assistant performs the following diagnostic procedures.

Peak flow rate measurement

The peak flow meter measures the amount of air exhaled. A peak flow rate is measured using a manual or digital peak flow meter in an ambulatory care or home setting (see Figure 41.8A–B). It is used to diagnose acute conditions and manage chronic diseases, such as asthma. When a patient is performing a peak flow rate test, it is important that the medical assistant obtain three adequate readings.

For chronic disease management, providers encourage patients to use peak flow meters at home. The providers create asthma action plans for the patients to follow. Based on the patient’s peak flow rate at home, the patient follows the directions on the plan.

Spirometry

Spirometry evaluates lung function as it is affected by respiratory, cardiac, and neuromuscular diseases. It can be ordered if the provider identifies abnormalities in the respiratory system. A spirometer can evaluate the amount of air you exhale and inhale. It looks at how quickly the air is exhaled and the rate at which air is breathed in. Several different tests can be done with spirometry.

With spirometry testing, it is important that the medical assistant enter accurate patient data into the spirometer computer. Besides the patient’s name, medical record number, and date of birth, the medical assistant may need to enter the person’s sex, age, race, height, and weight. The patient’s current height and weight need to be obtained prior to the spirometry. The computer pulls stored data and creates a “normal” person for those characteristics. After the patient has completed the test, the computer will print out the patient’s results compared with the “normal” person’s. This helps the provider identify areas of concern.

Image 058 Image of Spirometry

When performing the spirometry procedure, the following steps should be taken:

• Adults should exhale 6 seconds, and children should exhale 3 seconds for the forced vital capacity (FVC). For patients with obstructive breathing patterns, the FVC may take up to 15 seconds.
• Give patients at least 30 seconds between blows. Have patients indicate when they are ready for the next blow.
• Do a minimum of three blows and a maximum of eight blows (unless otherwise indicated by the facility’s protocols).
• Make sure to follow the operators’ manual for the machine you are using.
• Be encouraging yet respectful of patients when coaching them through the procedure.