%0 Journal Article
%T Improving Metered Dose Inhaler Technique in the Emergency Department: A Prospective Study
%A Richards
%A John R
%A Luskin
%A Michael J
%A Krivoshto
%A Irina N
%A Derlet
%A Robert W
%J Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health
%D 2004
%I UC Irvine Health School of Medicine.
%X Objective: To determine if improvement in patients¡¯ metered dose inhaler (MDI) technique could be achieved in the emergency department (ED) with the use of a simple illustrated instruction sheet. Methods: Prospective evaluation of a convenience sample of patients with asthma or COPD. Patients were first subjectively and objectively evaluated on their usual MDI technique, then were given an illustrated instruction sheet to study for 5 minutes. There was no verbal coaching prior to the post-test. A post-test evaluation was then performed. Results were compared using paired Student t test. Results: A total of 115 patients were enrolled. Mean age was 34.9¡À13.1 years, and mean years using MDI was 5.7¡À3.8. Subjective improvement in technique was reported by 110 patients (96%) with a mean pre-test score of 7.4¡À1.5 and post-test score of 9.2¡À1.1 (p<0.0001, 10 point scale). Objective improvement was achieved in 113 patients (98%) with a mean pretest score of 3.9¡À1.3 and post-test score of 5.8¡À1.0 (p<0.0001, 7 point scale), corresponding to a 30% improvement in technique (95% CI: 22,39). Fortyfour patients (38%) reported never having been shown proper MDI technique by a health care professional, and 112 patients (97%) found the instruction sheet helpful. Conclusions: Rapid objective and subjective improvement of MDI technique from both patients¡¯ and physicians¡¯ perspective is possible in the ED with the use of an illustrated instruction sheet, and requires minimal effort from the treating emergency physician.
%U http://escholarship.org/uc/item/3m34577f