The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

ADHERENCE OF PRESCRIBED MDI BRONCHODILATOR DOSES BY RESPIRATORY THERAPISTS ON MECHANICALLY VENTILATED PATIENTS.

Onesimus Henry, David Chang; University of South Alabama, Mobile, AL

Onesimus Henry, David Chang; University of South Alabama, Mobile, AL BACKGROUND: Metered-dose inhaler (MDI) is a drug-delivering aerosol device frequently used on mechanically ventilated patients. Among other factors, the doses of bronchodilator administered in a clinical setting may be determined by the physicianÂ’s order and the patientÂ’s changing condition. The purpose of this study was to determine the correlation of the prescribed doses and the doses administered by the therapists to mechanically ventilated patients. METHODS: University and hospital IRB approvals were obtained for this study. Mechanically ventilated patients receiving MDI bronchodilator treatments were included in this study. Respiratory therapists were selected in random order and they were blinded to the purpose of the study and collection of data. The data collected were the type of MDI medications prescribed, the number of puffs ordered by the physician and the actual number of puffs administered by the therapists. Descriptive analysis was done to interpret the data. RESULTS: Seventeen therapists were observed administering the MDI bronchodilator. Each of the therapist was observed three times for a total count of 51 treatments. Of all 51 treatments, the physician ordered albuterol sulfate and a prescribed dose range of 2 to 4 puffs. All therapists administered the MDI dosages within this range. The breakdown of the doses administered showed: 2 puffs (32), 3 puffs (8) and 4 puffs (11). Eleven therapists used 3 or 4 puffs of MDI bronchodilator for at least one of the three treatments observed. Six therapists administered 2 puffs consistently for all three treatments observed. CONCLUSIONS: The respiratory therapists in this study adhered to the range of prescribed MDI doses. However, the range of prescribed MDI bronchodilator doses (2 to 4 puffs) was lower than that recommended by several studies (3+ puffs). The therapist should assess the patient and administer the appropriate bronchodilator doses for maximum benefit to the patient. Sponsored Research - None