Learn How to Use Your Orcawave Spirometer

Orcawave User Instructions

The Orcawave is a state-of-the-art portable spirometer specifically designed for workplace lung capacity and lung function testing.

Simply follow the steps set out in the instructions below to learn how to use and get the most from your Orcawave portable spirometer.

Steps Before Testing

Process Inputs & Referenced Documents For Spirometry

  • Referral letter from employer
  • Job specification
  • Bookings
  • Medical surveillance protocol
  • Occupational Health & Safety Act No. 85 of 1993
  • Mines Health & Safety Act No. 29 of 1996
  • SANS 10248
  • COID circular instruction 195

Process Steps For Spirometry

Quality Control in the Workplace

  • Written and updated protocols, policies and procedures
  • Clean, comfortable waiting rooms, bathroom/toilets
  • Well ventilated and illuminated test room, with washbasin, disposable towels and pedal bin
  • Waste bin that complies with SANS 10248 medical waste regulations
  • Medical height rod and weight scale that are calibrated annually
  • Air conditioners, air extractors and UV lights must be frequently serviced

Daily Calibration Check

  • Use a 3-liter calibration syringe with a valid, annually calibrated certificate.
  • Check leaks, linearity volume accuracy and BTPS (body temperature, pressure, water vapor saturated) correction.
  • Always calibrate before the first spirometry test is conducted for the day and repeat this process whenever:
     
    • The room temperature rises or falls by more than 2 degrees during the day
    • After a thunderstorm or a power failure
    • The unit is moved to another room, site or if the unit was switched off
    • High volume of maneuvers is performed, and at least every 4 hours
    • A new batch of disposable sensors are used, or the sensor is replaced
    • After sterilisation
  • Switch the Orcawave spirometer on and wait for 5-10 minutes before use
  • Use an Orca Weather Station to monitor ambient conditions accurately.
    These include:
     
    • Room temperature
    • Humidity
    • Barometric pressure
    • Altitude
  • Always enter ambient conditions before calibration
  • Record the date and time, site details and name of the technician
  • Ensure that the Orcawave spirometer to be attached to the calibration syringe is secured and tightly sealed
  • Using a 3-liter calibration syringe, deliver three flow strokes: slow, medium and fast which must reach accuracy requirements of +- 3.5% to be appropriate
  • Observe calibration values for accuracy and precision measurements
  • Acceptable ranges is 2.90 to 3.11 liters of the reading
  • Store and print the calibration tracing to support the validity of your spirometry results
  • Store the calibration syringe in close proximity of the spirometer and out of direct sunlight or very hot or cold environments

Preparation of the Subject Prior to Testing

To achieve better results, it is necessary to advise the subject to avoid the following:

  • Wearing restrictive clothing
  • Smoking within one hour before testing
  • Alcohol within four hours before testing
  • Vigorous exercises within thirty minutes before testing
  • Using a short- or long-acting bronchodilator for four hours and 12 hours respectively prior to testing.
  • Eating a heavy meal within two hours before testing

Subject Information to be Captured

  • Full name and surname
  • File number unique to subject
  • Age/date of birth
  • Height (preferably barefoot). Note any deformities
  • Weight (loose, light clothing)
  • Gender
  • Predicted values
  • Ethnic group
  • Ethnic correction (ECCS 1983/1993 minus 10% for non-caucasian persons)
  • Current occupation
  • Note current work-related exposure, if any
  • Medical and occupational history
  • Current medication
  • Smoking history
  • Testing position, standing or seated

Instructions for Subjects

  • Explain and ask the subject whether they understand the procedure before conducting the test
  • Using words and examples, the technician must demonstrate to the subject how to:
  • Attach the nose clip to lightly seal the nostrils
  • Adopt an upright posture with the chin slightly elevated
  • Empty the lungs, take a deep breath and fill the lungs completely
  • Position the mouthpiece ensuring and open circuit, and sealing lips
  • Blow/Blast out hard and fast continuously, followed by a fast-maximal inspiration

Spirometry Testing Procedure

  • Switch on the laptop at the power button
  • Open eMoyo-EMR Spirometry software
  • Once the software has been launched, the window on the next page will pop up.
  • Fill in the fields and select your preferred language, then start the procedure by clicking “Go”.
  • Ensure that your Orcawave Spirometer is plugged into your computer, then navigate to the Settings toolbar and click on “Maintain”.
  • Click on the “Cal-Check” button to launch the calibration window.
  • Please Note: If you do not have an Orca Weather Station plugged into your PC, you will be prompted to provide environmental data. Enter the environmental data and Click “Next” to continue.
  • Once you have correctly set the calibration parameters, you can connect your Orcawave spirometer to the 3L calibration syringe

Calibration Procedure

The calibration procedure consists of performing 3 strokes:

  • To begin the calibration procedure, click the “Play” button . The following message will pop up “Please wait while preparing for the test. Do not start blowing yet.”
  • You will perform a total of 3 calibration strokes. Please take note of the following when performing the calibration strokes:
     
    • Important: You must always complete the full syringe stroke from end-stop to end-stop. Make sure you push the syringe in fully, and pull it fully out on each stroke.
    • For the 1st calibration stroke: do a “strong-and-fast inhale” (approximately 10 L/s) and a “strong-and-fast exhale” (approximately 10 L/s) in one action.
    • For the 2nd calibration stroke: do a “weak-and-slow inhale” (hover slightly below baseline) and a “weak-and-slow exhale” (hover slightly over baseline) in one action.
    • For the 3rd calibration stroke: alternate between “strong-and-fast” and “weak-and-slow” (vary between 2 L/s to 10 L/s).
  • Perform the first calibration stroke, ensuring that your Orcawave is oriented in a good position, as seen in the bottom right section of the 3D Tilt viewer. Click “Stop” when you are done performing the stroke. You will then be prompted to accept the test. If you are satisfied with the calibration stroke, click “Yes”. If you would like to repeat the calibration stroke, click “No”. This will allow you to repeat the calibration stroke.
  • Repeat this process for strokes 2 and 3. As you perform and accept the calibration strokes, their graphs will appear in the right quadrants of the V-F plane. Additionally, the values for the following parameters will be displayed in the top-left quadrant: FVC, FIVC, FEV1, FEV1%, FEV6, FEV1/FEV6, FEF25, FEF50 FEF7, PEFR, PIFR.
  • Save the calibration by clicking the “Save” button.
  • You can now exit the calibration window and go back to the Home Screen.

Entering Client Information & Conducting Tests

  • It will be useful to create patient profiles for each patient you test. You can create a new patient by selecting a folder from the Folders on the Home Screen.
  • Since you have not yet created any patients, the Patients list will be empty at first.
  • Click the “Add Patient” button to proceed to the next step. You will now be able to enter patient data to this patient profile.
  • You can now perform tests on the patient you have created by clicking the “+ Note / Test” button.
  • If you wish to create a new patient, click the “Records” button in the top left of the Settings toolbar. Note that the previous patient that you have created will now be in the Patients list.
  • Finally, select the “Spirometry: Orca FVC” test from the list to proceed to the test.
  • If you have not connected the Orca Weather Station to your PC, you will be prompted to enter data for the environmental parameters.
  • Once the values have been entered, click on “Next” in the top left of the window.
  • You will now be required to enter patient data such as Height (in centimetres), Gender and Ethnicity.
  • When you click “Next”, it will take approximately 5 seconds for the device to initialise.
  • Once the device has been initialised, the test window will pop up.
  • With the patient ready and in the appropriate position, press “Play” to begin the first attempt. Take note of the orientation of the device, as seen on the 3D Tilt window.
  • A blue ring indicates correct orientation, while red indicates incorrect orientation.
  • Wait for eMoyo-EMR software to initiate the test (this should take about 3 seconds).
  • The patient can perform the test attempt by blowing at maximum effort, followed by breathing in at maximum effort.
  • Once the test is completed, you will be prompted to accept the test.
  • We will now repeat the previous step for 3-6 additional attempts.
  • You may now save your consultation by clicking on the Save button.

Interpreting Orcawave Results

  • Acceptability and reproducibility criteria for pulmonary function testing (refer to COID circular instruction 195) and interpretation of results utilise the following three lung-function values in Occupational Health. (All three values are utilised. If any of the three values fall outside the following range, the interpretation category would then be with the lower category value).
     
    • FVC
    • FEV
    • FEV/FVC
  • Normal
     
    • FEV 80% and above (amount of lung capacity exhaled in first second)
    • FVC 80% and above lung capacity
    • FEV/FVC 75% and above index between the above two values
  • Action Level
     
    • FEV less than 69% but above 60%
    • FVC less than 69% but above 60%
    • FEV/FVC less than 65% and above 60%
    • Any drop of 10% on previous pulmonary function test
  • Abnormal
     
    • FEV below 60%
    • FVC below 60%
    • FEV/FVC below 60%
    • Any drop of 15% or more on previous pulmonary function test