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Teaching time for metered-dose inhalers in the emergency setting
Yuka Numata1, Jean Bourbeau, Pierre Ernst
1Respiratory Epidemiology Unit, McGill University, Montreal, PQ, Canada.
Chest
|August 13, 2002
Summary
Teaching patients to use metered-dose inhalers (MDIs) with a delivery enhancement device (DED) is feasible in emergency settings for asthma and COPD. Shorter teaching times were linked to higher oxygen levels and prior DED use.
Area of Science:
- Pulmonary Medicine
- Emergency Medicine
- Respiratory Care
Background:
- Metered-dose inhalers (MDIs) are underutilized in acute care due to concerns about patient technique.
- Effective use of MDIs requires proper patient education and device handling.
Purpose of the Study:
- To evaluate the time needed to teach patients correct MDI use with a delivery enhancement device (DED) in an emergency setting.
- To identify patient factors influencing the duration of MDI/DED training for asthma and COPD exacerbations.
Main Methods:
- Prospective evaluation within a randomized clinical trial comparing MDI/DED to wet nebulizers.
- Inhaler-use education provided via a standardized protocol.
- Teaching time, patient characteristics, and satisfaction were recorded.
Main Results:
- 61 asthma and 32 COPD patients received MDI/DED training; 5 required alternative treatment.
- Median teaching time for successful MDI/DED use was 6.5 minutes for 88 patients.
- Shorter teaching times correlated with higher oxygen saturation, prior DED use, and initial nebulizer treatment.
Conclusions:
- Successful MDI/DED training and self-administration are achievable in emergency care settings.
- A simple protocol can facilitate MDI/DED education.
- Initial wet nebulizer treatment may aid subsequent MDI/DED teaching.