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Topics About 'Inhaler'.

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  1. Chronic Obstructive Pulmonary Disease (COPD) Many patients with chronic obstructive pulmonary disease (COPD) struggle to use their inhalers properly.1 Though COPD is the fourth-leading cause of death in the United States, proper treatment can help many patients manage their condition.1,2 Unfortunately, the challenges presented by inhalation devices can place an additional burden on an already vulnerable patient population.1 It is critical that healthcare professionals work with patients to train them on inhalation techniques upon initiating treatment. In follow-up appointments, physicians and nurses should reassess and refresh patients on proper technique; and, when necessary, it may be important for healthcare professionals to consider and advocate for alternative device options for appropriate patients.1 A meta-analysis published in Chronic Obstructive Pulmonary Diseases in 2019 was a strong reminder of that basic tenet of treating patients with COPD: a large fraction of patients may not be getting adequate treatment because they are making errors with their inhalers. Metered-dose inhalers (MDIs) are the most commonly prescribed handheld device for treating COPD patients, but MDIs require hand–breath coordination that can be a barrier to proper administration. Some delivery devices, such as nebulizers, may be preferred by some patients. COPD treatments and devices vary and should be individualized to a patient's needs and abilities. Matching the proper delivery device to the correct patient can make a significant difference for patients struggling with their MDIs.1 How many patients are making errors with their MDIs? Eight in 10 patients who used an MDI made at least 1 error in taking their medication, according to the meta-analysis, which aggregated data for 1360 individuals across 10 published studies. Furthermore, the study showed that 7 in 10 patients performed ≥20% of their devices’ steps incorrectly.1 Though these numbers might seem high, the authors point out that they are in line with previous studies of MDI usage.1 The problem has been well documented by others looking at adherence and device usage in COPD. In other select reports, researchers have shown that ~25% of patients never receive instructions on how to use their device, and 69% report that their healthcare providers have never watched them try to take their medication.1 What kinds of errors are patients making? Coordinating breath, generating an adequate inspiratory force, and engaging the device by hand can be challenging, especially for a patient population plagued by comorbidities that include dementia and arthritis in addition to their breathing difficulties.1 The authors of the meta-analysis highlighted the following mistakes: 2 in 3 patients had trouble exhaling fully away from the MDI before inhalation (ie, failure to empty their lungs)1 2 in 5 patients failed to hold their breath after inhaling. This type of error can negatively impact treatment because of poor medication deposition1 1 in 3 patients failed to inhale slowly and deeply1 1 in 3 patients failed to shake the MDI1 What can be done? Clearly, nurses treating patients with COPD have significant challenges to overcome. More patient education and assessing and reassessing their patients’ technique with MDIs are crucial steps.1 Nurses should advocate for treatment options that suit their patients’ abilities and preferences, which may include nebulized therapies.1 SUNOVION is a registered trademark of Sumitomo Dainippon Pharma Co., Ltd. Sunovion Pharmaceuticals Inc. is a U.S. subsidiary of Sumitomo Dainippon Pharma Co., Ltd. ©2020 Sunovion Pharmaceuticals Inc. All rights reserved. 4/20 RESP-US-00039-20
  2. nursex23

    Asthma, no inhaler, WWYD?

    It happens pretty often that students forget their inhalers (MS). Every time it's happened there was no distress, O2 sats were mid to high 90s, mild wheezing and every other time someone was able to bring the inhaler within a reasonable time. But yesterday I had a student who had some wheezing and chest tightness, O2 93-95% up to 98% with deep breathing. I called dad who said he will bring her inhaler. 30 mins go by, no dad no inhaler, no change in student. I called and he said 15-20 mins. 30 mins go by still no dad. I called for admin to bring me a Coke (it had worked for a previous student) and then I called dad with no answer. I had the secretaries calling him too with no luck for about an hour. She was stable to where I did not feel an ambulance was necessary but I wanted to call one anyway because she was going on 2 hours wheezing and chest tightness. Finally dad shows up. She takes her inhaler, we wait about 5 mins and O2 is up to 99%, clear lungs, no chest tightness. I was so frustrated because this whole thing took 2 hours where I was constantly assessing her for changes while other students are still coming in and out. Had I known it was going to be 2 hours I think I would have called for an ambulance just to get her help sooner. I'm also not going to give them Coke and send them to class because it's definatley not a replacement for their inhaler. What do you all think of this? Would you have called an ambulance?

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