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Research ArticleOriginal Research

Metered-Dose Inhaler With Spacer Instead of Nebulizer During the Outbreak of Severe Acute Respiratory Syndrome in Singapore

See Meng Khoo, Lian Kheng Tan, Nora Said and T K Lim
Respiratory Care July 2009, 54 (7) 855-860;
See Meng Khoo
Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.
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Lian Kheng Tan
Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.
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Nora Said
Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.
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T K Lim
Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.
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Abstract

BACKGROUND: The use of metered-dose inhaler (MDI) with spacer instead of nebulizer may be important during an outbreak of an airborne infection. However, there is a paucity of data on patients’ and nurses’ abilities and perspectives on MDI with spacer for the treatment of acute airway obstruction during such an outbreak.

METHODS: We evaluated 50 consecutive MDI-with-spacer treatments administered in the respiratory wards of the National University Hospital of Singapore, and interviewed the patients after each treatment during the outbreak of severe acute respiratory syndrome (SARS). We also conducted interviews with 50 nurses who had experience in administering bronchodilators via both nebulizer and MDI with spacer.

RESULTS: Forty-six patients (92%) were able to use MDI with spacer effectively. Sixteen percent of the patients preferred nebulizer over MDI with spacer. Fifty-eight percent of the patients thought MDI with spacer was easier to use than nebulizer, and 34% thought MDI was as easy to use as nebulizer. Sixteen percent of the patients thought that nebulizer was more effective than MDI with spacer in relieving their symptoms. Ninety-six percent of the nurses preferred nebulizer over MDI with spacer. Forty-two nurses (84%) thought that nebulizer was more effective for treating acute airflow obstruction in the hospital.

CONCLUSIONS: In the in-patient setting during an outbreak of an airborne infection, for treatment of acute airflow obstruction, MDI with spacer was acceptable and preferred by a high percentage of patients. However, a high percentage of nurses had misconceptions regarding the efficacy of and patients' ability to use MDI with spacer.

  • acute airway obstruction
  • bronchodilators
  • metered-dose inhaler and spacer
  • nebulizer
  • severe acute respiratory syndrome
  • outbreak
  • airborne infection

Footnotes

  • Correspondence: See Meng Khoo MBBS MMed, Division of Respiratory and Critical Care Medicine, National University Hospital, Lower Kent Ridge Road, Singapore 119074. E-mail: khoosm{at}nuh.com.sg.
  • Copyright © 2009 by Daedalus Enterprises Inc.
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Respiratory Care: 54 (7)
Respiratory Care
Vol. 54, Issue 7
1 Jul 2009
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Metered-Dose Inhaler With Spacer Instead of Nebulizer During the Outbreak of Severe Acute Respiratory Syndrome in Singapore
See Meng Khoo, Lian Kheng Tan, Nora Said, T K Lim
Respiratory Care Jul 2009, 54 (7) 855-860;

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Metered-Dose Inhaler With Spacer Instead of Nebulizer During the Outbreak of Severe Acute Respiratory Syndrome in Singapore
See Meng Khoo, Lian Kheng Tan, Nora Said, T K Lim
Respiratory Care Jul 2009, 54 (7) 855-860;
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Keywords

  • acute airway obstruction
  • bronchodilators
  • metered-dose inhaler and spacer
  • nebulizer
  • severe acute respiratory syndrome
  • outbreak
  • airborne infection

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