Inhalation MDI

By Adem Lewis / in , , /

(upbeat rock music) – [Voiceover] Medication
administration via metered dose inhaler, or MDI. A paramedic may administer salbutamol to patients who present
with respiratory distress and with signs and symptoms of suspected bronchoconstriction,
secondary to COPD, asthma, or anaphylaxis. This medication can be
given in conjunction with epinephrine, depending on the presenting severity of
the bronchoconstriction. Equipment required for the
treatment procedure includes metered dose inhaler, the
inhalation mouthpiece, or boot, and an aerochamber. Additionally, this medication
can be administered using an inline, MDI adaptor with CPAP, or in conjunction with a bag valve mask. Once the patient has been fully assessed and determined to be
experiencing bronchoconstriction, consider the most appropriate
route of administration. Always validate that it is
the correct medication by reading the label name and
confirm that it is not expired. The first method shown is using the MDI and the accompanying mouthpiece, or boot. Medication droplets dispensed from the MDI using this method are large, and are harder to inhale deeply, as much will end up on the buccal lining, or at the back of the oropharynx. The medication is released by depressing the MDI into the boot. One spray is equivalent to 100 micrograms and is given once every four breaths. One dose is a total of six sprays, or 600 micrograms, for
patients less than 25 kilograms and eight sprays, or 800 micrograms, for patients that are greater
than or equal to 25 kilograms. The second method shown
uses an aerochamber to aerate the salbutamol medication
into smaller droplets. This creates a smaller,
more mist-like droplet that is more readily inhaled
deeper into the lungs. Similar to the first method, the delivery of this
medication is timed to the patient’s inhalation phase
in the respiratory cycle. Should the patient respond to coaching, have them force exhale prior to the administration of each spray. This medication may also be given via an oxygen-supported nebulizer. However, this method is
contraindicated in patients with respiratory infections, such as pneumonia, whereas the MDI method is not. In all cases, personal
protective equipment is to be worn while administering
aerosol medications. (upbeat rock music)

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