Your maths are correct but you haven't added improved delivery by spacer
devices into your equation. Spacers delivery a much better particle size to
the airways that matter and so they work better than nebulisers.
Next time you see a patient getting a neb watch how much mist is lost in to
A lot of our more serious adolescent asthmatics prefer to multidose with a
spacer than receive time-consuming nebuliser. A spacer & MDI will fit easily
into a bag and mean that the adolescent can have more independence.
Specialist Registrar in Paediatrics
Royal Hospital for Sick Children
----- Original Message -----
From: Guy Haskell <[log in to unmask]>
To: Multiple recipients of list PED-EM-L <[log in to unmask]>
Sent: Thursday, September 09, 1999 3:07 AM
> One puff of Ventolin from an inhaler = 90mcg. 8 puffs,then would = .72 mg.
> The normal starting pedi dose is 2.5 mg. Therefore, it would take 27
> then, to be the equivalent of one nebulizer dose. Pretty pandemoneous
> puffing, I'd say.
> Anecdotal evidence in the face of the studies: my wife claims there is no
> way in hades a puffer can equal a nebulizer for effectiveness. Or, in her
> own words, how many of these research docs have asthma themselves and are
> relegated to paltry puffing, and trying to hold your breath in the midst
> asthmatic asphyxiation, when nefarious nebulization would be far more
> But hey, that's just anecdotal. And we need fact-based decision making, by
> Cheers, and heavy breathing.
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