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Children asthma

Children with acute exacerbation of asthma are frequently seen in out-patient settings and emergency rooms. They are administered bronchodilators like albuterol to cause relief of symptoms. Albuterol is administered either through metered dose inhalers-spacer or jet nebulizer. Metered dose-inhaler spacer is an efficient and useful method of delivering albuterol for bronchodilatation. It delivers the drug quickly and can cause effects in few seconds. Delivery of the drug can be optimized using suitable mask. On the other hand nebulization is also an effective tool to deliver the drug. It is however cumbersome and needs atleast 15 minutes for one dose administration. The most commonly used delivery systems for asthma are nebulizers, dry-powder inhalers and metered dose inhalers with or without spacers (Smith and Goldman, 2012). In children less than 5 years of age, it is not possible to generate adequate inspiratory inflow and hence, effective use of dry-powder inhaler devices is not possible. Whether to use metered dose inhalers or nebulizers in acute exacerbation of asthma in children is a much debated topic. The main advantage with nebulizer is that the drug can be delivered even without the cooperation of the child. However, during this mechanism, only less than 10 percent of the aerosolized drug reaches the lungs (Smith and Goldman, 2012). The remaining drug gets deposited in the nebulization system or on the face or is lost to the surrounding regions. On the other hand upto 40 percent of the drug can be deposited in the lungs with metered dose inhalers. In infants and young children, the main difficulty in using metered dose inhalers is lack of coordination in triggering and inhaling the drug (Smith and Goldman, 2012). To overcome these aspects, spacers and masks are used. Spacers are able to eliminate the need for coordination in metered dose inhalers. The spacers have a valve "with the particular advantage of allowing aerosol to move out of the chamber at inhalation but holding particles in the chamber during exhalation" (Smith and Goldman, 2012). In this research essay, whether nebulizer or metered dose inhaler with spacer is a suitable method for administering albuterol therapy in children will be discussed through review of suitable literature. The research is made through PICO format and the steps involved in arriving at the evidence will be discussed. PICO Format When clinical decisions are made based on appropriate scientific evidence, it is nown as evidence-based practice. According to McKibbon (1998), "Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e. the most appropriate information available, to make clinical decisions for individual patients. EBP values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics, situations, and preferences." The most critical exercise for evidence-based practice is literature review. This can be done by approapriate search strategy and by creating a ...Show more

Summary

RUNNING HEAD: Asthma in Children Title: Asthma in Children: Use of Nebulizer versus Metered dose Inhalers Using Spacers for delivering Albuterol in Acute Asthma in Children Name of the student: Under the guidance of: University: APA Format Word Count: Use of Nebulizer versus Metered dose Inhalers Using Spacers for delivering Albuterol in Acute Asthma in Children Introduction Asthma is a condition in which there is reversible obstruction of the airways secondary to hyperreactivity of the bronchi and chronic inflammation…
Author : halvorsonagusti
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