Podcast 616: MDIs for the Win

Podcast 616: MDIs for the Win

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Contrary to many assumptions, meter-dose inhalers (MDIs) are as effective as nebulizers in pediatric and adult patients
  • Nebulizers are associated with higher rates of tremor, tachycardia; they cost more and are associated with longer ED stays
  • Though it may take some convincing, in a patient that is physically able, using an MDI with spacer appears to be the better option - and that was even before COVID.

References

Snider MA, Wan JY, Jacobs J, Kink R, Gilmore B, Arnold SR. A Randomized Trial Comparing Metered Dose Inhalers and Breath Actuated Nebulizers. J Emerg Med. 2018 Jul;55(1):7-14. doi: 10.1016/j.jemermed.2018.03.002. Epub 2018 Apr 30. PMID: 29716819.

Brocklebank D, Ram F, Wright J, Barry P, Cates C, Davies L, Douglas G, Muers M, Smith D, White J. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature. Health Technol Assess. 2001;5(26):1-149. doi: 10.3310/hta5260. PMID: 11701099.

Dhuper S, Chandra A, Ahmed A, Bista S, Moghekar A, Verma R, Chong C, Shim C, Cohen H, Choksi S. Efficacy and cost comparisons of bronchodilatator administration between metered dose inhalers with disposable spacers and nebulizers for acute asthma treatment. J Emerg Med. 2011 Mar;40(3):247-55. doi: 10.1016/j.jemermed.2008.06.029. Epub 2008 Dec 11. PMID: 19081697.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Jaksot(1146)

Podcast #497: Does my patient with CP have ACS?

Podcast #497: Does my patient with CP have ACS?

Author: Dylan Luyten, MD Educational Pearls: While certain aspects of the history, exam, and EKG may increase likelihood of ACS, there is no one element that performs well on its own Elements of the...

15 Elo 201915min

Podcast # 496: Hallucinogens

Podcast # 496: Hallucinogens

Author: David Holland, MD Educational Pearls: Hallucinogenics have been used for a variety of cultural and religious reasons for thousands of years In the 1960's a Harvard professor began experimenti...

12 Elo 20197min

Podcast # 495: Trauma in the Elderly

Podcast # 495: Trauma in the Elderly

Author: Rachel Brady, MD Educational Pearls: Elderly patients (>65 years old) have a higher trauma mortality compared to younger patients, even though they have lower mechanisms of injury  Elder trau...

6 Elo 20196min

Podcast #494: A Standard Toxicology Approach

Podcast #494: A Standard Toxicology Approach

Contributor: JP Brewer, MD Educational Pearls: Obtaining collateral is often vital to determine the potential drugs accessible to the patient - this may include After this, use ancillary sources such...

2 Elo 20197min

Podcast # 493: One Pill for the Kill

Podcast # 493: One Pill for the Kill

Contributor: JP Brewer, MD Educational Pearls: Because of their smaller size, there are a variety of adult-dose pills that are potentially toxic to children. The most common categories of medication...

31 Heinä 20196min

Podcast # 492: Pain While on Buprenorphine

Podcast # 492: Pain While on Buprenorphine

Contributor: Don Stader, MD Educational Pearls: Buprenorphine is a partial Mu-agonist and binds with higher affinity than most opioids Pain management with opioids therefore can be difficult in patie...

26 Heinä 20194min

Podcast # 491: Buprenorphine for Withdrawal

Podcast # 491: Buprenorphine for Withdrawal

Educational Pearls: Buprenorphine is a semi-synthetic derivative of the opium poppy FDA approved for the treatment of opiate use disorder and chronic pain Benefit in emergency department use is the c...

24 Heinä 20194min

Podcast # 490: Canadian Syncope Rule

Podcast # 490: Canadian Syncope Rule

Contributor: Don Stader, MD Educational Pearls: Syncope is usually benign but can be caused by serious etiologies which include: PE, certain cardiac arrhythmias, AAA, intracranial bleed/stroke The Ca...

22 Heinä 20194min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
rss-astetta-parempi-elama-podcast
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
filocast-filosofian-perusteet
rss-ammamafia
rss-tiedetta-vai-tarinaa
rss-lapsuuden-rakentajat-podcast
rss-sosiopodi