Where the clinical requirement for spirometry outweighs the risk of cross infection, you may test patients who are infected with a disease that can be transmitted between individuals. Patients with a known communicable disease such as HIV, TB or MRSA require precautions to ensure infection is not spread.

Arrange their test for the end of the day where the equipment can be completely sterilised and surfaces cleaned after their test

Thorough hand-washing techniques, as with every patient, are necessary and disposable gloves should be available when handling and cleaning equipment exposed to saliva, sputum and especially blood from infected patients.

Face masks and negative pressure ventilation may be appropriate where particular patients are likely to cough during testing. This works to prevent airborne particles leaving the room when doors open to reduce the risk of spread of infection to the rest of the hospital.

These facilities are not always possible so a degree of clinical judgement is necessary before commencing with the test; a referral to a specialist laboratory with these facilities may be appropriate.