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Pressurised metered dose inhalers with spacers versus nebulisers for β-agonist delivery in acute asthma in children in the emergency department
  1. R Boyd,
  2. P Stuart
  1. Emergency Department, Lyell McEwin Health Services, Elizabeth Vale SA 5112, South Australia
  1. Correspondence to:
 Dr R Boyd
 Emergency Department, Lyell McEwin Health Services, Elizabeth Vale SA 5067, South Australia;


Objectives: Wet nebulisers are widely used for β-2 agonist delivery in Australasian emergency departments (ED). An increasing body of work suggests that pressurised metered dose inhalers with spacers (pMDI-S) are as effective. This study aims to investigate the effect on admission rates, total time in the ED, and total time in hospital after initiation of routine pMDI-S treatment for mild to moderate asthma in children presenting to the ED.

Methods: Children with a discharge diagnosis of asthma were identified over sequential 3 month time periods. In the first period, wet nebuliser treatment was routine and in the subsequent trial period pMDI-S treatment was instituted as routine. Admissions rates, total time in hospital, and total time in the ED were recorded for each group.

Results: Admission rates fell significantly from 31% to 20.6% after routine use of pMDI-S treatment. There was a non-significant trend to an increase in total ED and total hospital times.

Conclusion: Introduction of routine pMDI-S treatment in the paediatric ED results in a significant drop in admission rates but no significant change in total hospital times or total ED times.

  • ED, emergency department
  • pMDI-S, pressurised metered dose inhalers with spacers
  • asthma
  • metered dose inhaler
  • nebuliser
  • paediatric
  • spacer
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  • Competing interests: none declared

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