Respiratory Medicine
Respiratory Medicine is a medical specialty that involves the care of patients with all forms of respiratory disease.
We provide inpatient and outpatient consultative and diagnostic services. Services we offer include:
- consultative advice and management for all respiratory conditions
- a full spectrum of lung function tests
- diagnostic tests such as bronchoscopy and pleural procedures.
If you have a respiratory problem, please see your GP who will assess, investigate and treat your condition and if necessary, can refer you to the Respiratory Outpatient Clinic.
In an emergency, please go to your nearest emergency department.
Specialist services
Patients can be referred for lung function tests without consultation if that is appropriate. Most patients referred for consultation will undergo lung function testing at the time of their appointment.
Our physicians have developed special interests which include respiratory infectious diseases, bronchiectasis, tuberculosis and non-tuberculous mycobacterial infections (including MAC), lung cancer, pleural diseases, research on aerosols and interventional bronchoscopy.
We have close links with radiologists who have a special interest in Respiratory Medicine.
RPH does not have a thoracic surgery service or services that treat lung cancer (medical or radiation oncology). However, RPH does provide a rapid access outpatient clinic service for suspected lung cancer and a multi-disciplinary team thoracic oncology meeting with well-established links to treating surgeons and physician in other institutions.
RPH has a regular multi-disciplinary team meeting for interstitial lung diseases.
RPH does not have an outpatient sleep service or a sleep study laboratory. Public patients being referred for sleep disordered breathing can be referred to Fiona Stanley Hospital, SJOG Midland, Sir Charles Gardner Hospital or Joondalup Health Campus.
Why do we measure lung function?
- It tells us how your lungs are working and helps in ongoing monitoring
- It helps in the diagnosis of different lung diseases
- It helps for the planning of your treatment.
Big blow test (Spirometry)
Spirometry is a test used to see if there is any narrowing in your airways. Lung conditions like asthma can cause shortness of breath by narrowing the airways, so that airflow through the lungs is reduced. In this test, we measure how fast you can empty your lungs and how much air you can blow out.
The process:
- Take a big deep breath in
- Blow out as hard and fast as you can until you are empty
Giving Medication (Bronchodilator)
To see if your airway narrowing can be reversed, you may be asked to repeat the spirometry test after breathing in a reliever drug such as Ventolin.
How big are your lungs? (Plethysmography)
We do lung volume measurements to see how much air is in your lungs when you take a big breath in to the top. The “Box” is a chamber similar in size to a telephone booth, which you sit in with the door closed. We measure changes in pressure as you pant, which relates to lung volume.
The process:
- Breathe normally with your hands on your cheeks
- A shutter will close, blocking the air
- Gently pant (suck and blow) against the closed shutter keeping your lips tight around the mouthpiece
How well does oxygen go into your body? (Diffusing Capacity)
The diffusing capacity test (or DLCO) looks at your gas exchange (how easily the air you breathe in travels into your lungs and into your bloodstream). We use this information to assess the severity of lung conditions such as emphysema or pulmonary fibrosis.
The process:
- Breathe out until you are empty
- Take a big breath in of a special gas mixture
- Hold your breath for 10 seconds
- Breathe out
6 Minute Walk Test
The six-minute walk test looks at any impairment you may have when you go about your daily tasks. The test can help us to see if you need oxygen at home.
The process:
- Wear a monitor (in a sling) so that we can see your oxygen and heart rate during the test
- Walk up and down a hallway as many times as you can in 6 minutes
Do you need extra oxygen to fly? (High Altitude Test)
When you fly in a plane, there is a lower level of oxygen in the air you breathe. If you have a lung or heart condition and are planning to fly, you may become unwell in this low oxygen environment.
A high altitude simulation test will allow us to work out if you need extra oxygen on board the aircraft. During the test, should your oxygen levels fall too low, we will give you extra oxygen. Based on your oxygen levels throughout the test, we will see what level of extra oxygen you may need for your flight.
The process:
- Sit with a mask positioned over your nose and mouth
- Breathe normally, you will be breathing in a lower level of oxygen (equivalent to when you are on the plane) and your oxygen levels will be monitored
- You will also be asked to do a small stepping exercise to see if this effects your oxygen levels (for example if you need to get up and go to the toilet during your flight)
Royal Perth Hospital have developed instructional lung function videos to help patients (in particular Aboriginal patients) and healthcare professionals understand the requirements for lung function tests.
Big blow test (Spirometry)
How big are your lungs? (Plethysmography)
How well does oxygen go into your body? (Diffusing Capacity
Do you need extra oxygen to fly? (High Altitude Test)
Urgent respiratory outpatient referrals
For urgent outpatient appointment referrals or advice, referring practitioners can telephone 9224 2244 and ask to page the on-call Respiratory Registrar.
Routine outpatient referrals
Routine referrals to the Respiratory Clinic are made via standard outpatient referral forms (external link) to:
Central Referral Service (external link)
Address: GPO Box 3462, Midland WA 6056
Fax: 1300 365 056
For further information please see routine referrals to RPH Outpatients.