Category: Pediatrics
Posted: 10/31/2020 by Rose Chasm, MD
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The current COVID-19 pandemic and known aerosolized transmission has triggered many ED process changes, including the discouragement of utilizing nebulizers to administer inhaled bronchodilators such as albuterol for concern of spread. Historically, both patients and providers preferred the use of nebulizers as they are easier to use and the belief was that they were more effective than meterd dose inhalers. However, evidence based data has consistently shown that for both adult and pediatric patients that when MDI's are used WITH a spacer:
Albuterol: 2.5 mg nebulizer solution = 3-5 MDI puffs
Albuterol: 5 mg nebulizer solution = 5-10 MDI puffs
Ipratropium: 0.25 mg nebulizer solution = 2 MDI puffs
Ipratropium: 0.5 mg nebulizer solution = 4 MDI puffs