Facility Components

Sleep disorders testing uses polysomnography (PSG) — a comprehensive recording of the biophysiological changes that occur during sleep. PSG monitors many body functions, including brain activity (electroencephalography), eye movements (electrooculography), muscle activity or skeletal muscle activation (electromyography), and heart rhythm (echocardiography). Sleep studies are usually performed at night, when most people sleep, although some people with circadian rhythm sleep disorders may be tested at other times of day. A polysomnogram records a minimum of 12 channels requiring at least 22 wire attachments to the patient, which converge into a central unit connected to a computer system for displaying, recording, and storing the data. The channels vary depending on the physician’s request. During sleep, multiple channels can be displayed continuously and a small infrared video camera can be positioned in the room so that the technician can observe the patient on a monitor from an adjacent control room.

This article is an update of a previous post.

The ability to record diagnostic images digitally and upload them to a picture archiving and communication system (PACS) has largely been a radiology-oriented system since the technology was formally introduced in the early 1980s. Enterprise imaging is the next evolutionary step in image storage and management. It will take the responsibility for imaging management away from radiology and place it in the hands of the enterprise-wide information technology function. The path to enterprise archiving of images is being paved by vendor-neutral archives (VNAs) that enable easier integration of data from disparate systems throughout the hospital — such as radiology, cardiology, pathology, orthopedics, and obstetrics — and make these data available in one place via the electronic health record. This evolution will have the capability to store and exchange clinical content in DICOM (digital imaging and communications in medicine) and non-DICOM formats. As a result, all clinical data will be available, easily accessible, and useable and not contained in departmental silos but on a monitor from an adjacent control room.

This article is an update of a previous post.

Pulmonary function testing measures the function of lung capacity and lung and chest wall mechanics to determine whether or not the patient has a lung problem. Pulmonary function testing is commonly referred to as “PFT” and such tests are usually performed by Certified or Registered Pulmonary Function Technologists (CPFT or RPFT) who are credentialed by the National Board for Respiratory Care (NBRC). When a patient is referred for pulmonary function testing, it means that a battery of tests may be carried-out including simple screening spirometry, static lung volume measurement, diffusing capacity for carbon monoxide, airways resistance, respiratory muscle strength, and arterial blood gases. Spirometry is the standard method for measuring most relative lung volumes; however, it is not capable of providing information about absolute volumes of air in the lung. Thus a different approach is required to measure residual volume, functional residual capacity, and total lung capacity. Two of the most common methods of obtaining information about these volumes are gas dilution tests and body plethysmography.

Body plethysmography is a very sensitive lung measurement used to detect lung pathology that might be missed with conventional pulmonary function tests. This method of obtaining the absolute volume of air within one’s lungs may also be used in situations where several repeated trials are required or where the patient is unable to perform the multibreath tests. The technique requires moderately complex coaching and instruction for the patient.

Read more