Who Performs Pulmonary Function Tests? Qualified Professionals and Standards

Pulmonary function tests (PFTs) require standardized technique and quality control. Performance is restricted to trained, certified personnel.

Primary Performers

• Registered/Certified Respiratory Therapists (RRT/CRT): Most common; specialized PFT training in RT programs; national board exams (NBRC).
• Pulmonary Function Technologists (CPFT/RPFT): ATS/ERS-certified; advanced competency in spirometry, lung volumes, DLCO, bronchial challenge.

Supervision & Interpretation

• Medical director: Board-certified pulmonologist (or internist/anesthesiologist with pulmonary training).
• Interpretation: Physician (pulmonologist) — integrates clinical context, pattern recognition, quality grading (ATS/ERS criteria).

Other Qualified Personnel (Setting-Dependent)

• RNs, PAs, NPs with documented PFT competency training and ongoing QA.
• Exercise physiologists (for CPET).
• In research: study coordinators with protocol-specific certification.

Quality Assurance (ATS/ERS Standards)

• Daily calibration (3-L syringe)
• Between-subject QC
• Technique coaching (repeatability: best 2 FVC/FEV1 within 150 mL)
• Equipment validation, software updates
• Technologist competency assessment annually

Why It Matters

Poor technique → misdiagnosis (obstruction vs. restriction), inappropriate treatment, disability determination errors. Standardization saves lives and resources.