June 14, 2011 by dailybolusoflr
Another study published this year about the equivalent efficacy of MDI with spacer versus nebulization for the delivery of albuterol. This study was for adult patients with mild to moderate asthma. Again, equivalent outcomes and if you need RT to deliver nebs (some hospitals do), certainly less staff resources!
The Journal of Emergency Medicine, Vol. 40, No. 3, pp. 247–255, 2011
Delivery with MDI with spacer in this study (similar to others) involved the following:
1. Instruct the patient how to breath with the MDI (ie. Inhaling slowly after the actuation is released into the chamber)
2. Deliver 6 actuations (puffs!) into the chamber one by one.
3. After EACH actuation, the patient takes 5-6 slow deep breaths, inhaling the medication.
If you are stuck without a spacer, you can also use a 0.5 or 1 Liter soda bottle, cut a hold in a flat surface that allows just the size of the MDI to enter and have the patient breathe through the opening that you drink from.
Linda Regan, MD FACEP
Program Director, Emergency Medicine Residency
Johns Hopkins Medical Institutions