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.

Episoder(1145)

Podcast # 390: Haloperidol for Pain

Podcast # 390: Haloperidol for Pain

Author: Gretchen Hinson, MD Educational Pearls: Reasonable approach of haloperidol 10 mg IM (or 5 mg IV) for pain relief in opioid-dependent patients; can repeat once Chronic opioid use results in ...

10 Okt 20185min

Podcast #389: BRUE

Podcast #389: BRUE

Educational Pearls: BRUE (Brief Resolved Unexplained Event) replaces what was previously called ALTE BRUE describes an event in a child less than one year of age with one or more of the following...

8 Okt 20184min

Podcast #388: Antibiotics for Appendicitis

Podcast #388: Antibiotics for Appendicitis

Author: Aaron Lessen, MD Educational Pearls: 5-year follow up study on antibiotic treatment for uncomplicated appendicitis showed 39.1% recurrence rate requiring appendectomy by 5 years Nearly 6...

5 Okt 20182min

Podcast #387: Fluoroquinolones are Perfectly Safe?

Podcast #387: Fluoroquinolones are Perfectly Safe?

Author: Don Stader, MD Educational Pearls: Fluoroquinolones can cause connective tissue disruption leading not only to tendon rupture but also aortic dissection Retrospective study from Taiwan s...

3 Okt 20183min

Podcast #386: Respecting Transgender Patients

Podcast #386: Respecting Transgender Patients

Author: Kasey Champion, MD Educational Pearls: Transgender populations are frequent victims of discrimination in healthcare Ask transgender patients what their preferred pronoun is It is somet...

1 Okt 20183min

Podcast #385: Probiotics

Podcast #385: Probiotics

Author: John Winkler, MD Educational Pearls: Probiotics are bacteria that are ingested to promote gut health but recent research casts doubt on their effectiveness. Recent study suggests that most...

28 Sep 20182min

Podcast #384: Don't stab a PTA?

Podcast #384: Don't stab a PTA?

Author: Don Stader, MD Educational Pearls: Recent study suggests we may not need to drain uncomplicated peritonsillar abscesses Patients who received medical therapy alone had no difference in c...

26 Sep 20183min

Podcast #383: Prehospital Tubes

Podcast #383: Prehospital Tubes

Author: Sam Killian, MD Educational Pearls: Two high quality randomized control trials published in 2018 demonstrated no difference in mortality or neurologic outcomes when using a supraglottic ai...

24 Sep 20184min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
rss-nysgjerrige-norge
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie
smart-forklart
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
abels-tarn
tomprat-med-gunnar-tjomlid
aldring-og-helse-podden