METERED-DOSE INHALER TECHNIQUE OF PATIENTS IN AN URBAN ED - PREVALENCE OF INCORRECT TECHNIQUE AND ATTEMPT AT EDUCATION

The metered-dose inhaler (MDI) techniques of 125 asthma patients who p resented to a county hospital emergency department (ED) were evaluated , Correct technique was divided into 7 steps. Twenty one percent of th e patients performed all 7 steps correctly. Mean number of steps +/- S D performed correctly was 4.8 +/- 1.7. Verbal individualized instructi on was used to improve the technique of patients whose technique was l ess than perfect, The instruction required a mean +/- SD of 8.3 +/- 5. 8 minutes (range, 0 to 30) for all 7 steps to be done correctly at lea st once. All patients were able to perform all steps correctly after i nstruction, The amount of time required for teaching was proportional to the number of steps performed incorrectly. The Vitalograph Aerosol Inhalation Monitor was used to verify correct patient technique and as a teaching aid with variable success, Education in proper use of the MDI is important in the overall care of the asthma patient; however, i nstruction requires a definite time commitment and may not be feasible for all patients in a busy ED, For some patients, alternatives that r equire less lengthy instruction, such as the use of breath actuated de vices, spacers, and reservoirs, may be required. Copyright (C) 1996 by W.B. Saunders Company.