Update on operational guidance for respiratory function testing during COVID-19 restrictions

Sep 6, 2021


Update on operational guidance for respiratory function testing during COVID-19 restrictions

The TSANZ and ANZSRS have received a number of requests for guidance on respiratory function testing in
the current environment. At this point in time the most prudent advice we can give would be to seek
guidance from your local infection control department or nearest TSANZ accredited respiratory laboratory.
Unfortunately, we are not in a position to provide definitive advice to individual laboratories, beyond the
general advice we developed earlier in the pandemic (see below). Primarily this is because the local
restrictions are varied and rapidly changing, the environments in which members work can be very
different and patient demographics and local clinical practice also vary significantly.

We have recently called for expressions of interest to develop a joint TSANZ – ANZSRS position paper on
the performance of respiratory function testing during COVID-19 that is applicable across a broad range of
situations facing us in Australia and New Zealand at any one time. The aim of TSANZ and ANZSRS is to offer
broad guidance that will be applicable across different locations during every stage of this pandemic, and
we urge everyone to consider being involved.

Prior to the update being released we have summarised our previous advice below, as it applies to those
areas in which significant government restrictions limiting general movement are in place:

• Lung function testing should only be performed where deemed clinically essential.
• All patients attending for lung function tests should be pre-screened for COVID symptoms and
temperature checked prior to testing to ensure they are afebrile.
• Lung function testing should NOT be performed in patients who are febrile, who have an escalating
acute respiratory condition, or are known to be COVID 19 positive or suspected COVID 19 positive.
• Tests for patients awaiting COVID 19 test results must be delayed until confirmed negative.
• Where lung function testing is deemed essential, requested investigations should be kept to a
minimum to inform clinical decision making.
• Bronchial provocation testing (BPT) should be avoided at this time.
• Minimum of Tier 1 PPE with face shields are recommended for persons performing tests where inline
filters can be used on breathing pathway of testing equipment.
• Tier 2 PPE (including the use of N95 masks) is recommended where inline filters are not available or
where high levels of ventilation (CPET) or coughing are expected.
• In situations where the application of this advice is unclear laboratories should defer to local health
authority guidance.

In the meantime, we encourage members to reach out and discuss with their colleagues potential options
that may apply to your local environment and clinical practice. Respiratory Laboratories that have received
TSANZ accreditation are a fantastic source of advice and information, and you can be assured that they
operate at the highest standard. You can find a full list of accredited laboratories here.

Warm regards