Podcast 616: MDIs for the Win

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Contrary to many assumptions, meter-dose inhalers (MDIs) are as effective as nebulizers in pediatric and adult patients</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Nebulizers are associated with higher rates of tremor, tachycardia; they cost more and are associated with longer ED stays</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">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.</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Snider MA, Wan JY, Jacobs J, Kink R, Gilmore B, Arnold SR.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/29716819/"><span style= "font-weight: 400;">A Randomized Trial Comparing Metered Dose Inhalers and Breath Actuated Nebulizers</span></a><span style= "font-weight: 400;">. J Emerg Med. 2018 Jul;55(1):7-14. doi: 10.1016/j.jemermed.2018.03.002. Epub 2018 Apr 30. PMID: 29716819.</span></span></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Brocklebank D, Ram F, Wright J, Barry P, Cates C, Davies L, Douglas G, Muers M, Smith D, White J.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/11701099/"><span style= "font-weight: 400;">Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature.</span></a> <span style= "font-weight: 400;">Health Technol Assess. 2001;5(26):1-149. doi: 10.3310/hta5260. PMID: 11701099.</span></span></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Dhuper S, Chandra A, Ahmed A, Bista S, Moghekar A, Verma R, Chong C, Shim C, Cohen H, Choksi S.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/19081697/"><span style= "font-weight: 400;">Effica