Now we talked initially about spacers
and I wanna just to explain to you,
they cost a lot when they come
from your insurance company
but really they're just a small
chamber that attaches to the inhaler.
The medication from the metered dose
inhaler are sprayed into the spacer.
Then the patient can, it
kinda suspends it in there
so that the patient can slowly
inhale that into their lungs.
That prevents them from getting
it on the sides of their mouth.
This is really helpful with
pediatric patients but sometimes,
adult patients are worse
than pediatric patients.
So a spacer is just a
brilliant little attachment,
hooks on toward the mouth pieces instead of
them putting that right into their mouth,
the spacer would be
connected to the medicince
and then the patient will put
their mouth on the spacer.
And it significantly improves how much
medication actually gets down to the lungs.
So always consider using a spacer if this
become problematic for the patient.
Now a nebulizer helps turn
liquid medication into a mist
that the patient can breathe
deeply into their lungs.
So any parent of a kid with asthma
or has chronic respiratory issues,
they know what these are.
For little kids, they come in all kinds of fun
shapes, dragons and panda bears and princesses.
For the adults
it's usually just a box.
But a nebulizer, you just put some
medicine in the connection.
You can also use nebulizers in the
hospital connected to a mask.
But anyway, as the air goes by that, it turns
the medication into a mist that can be inhaled.
That's what a nebulizer is and
it's a pretty effective way
because you're giving medication
over a longer period of time.
and the patient can
just breathe normally.
We don't have to get them to hold
their breath for 10 seconds.
So inhalation, the MDIs - the metered
dose inhalers or dry micronized powder
is a really simple way to
use an inhaled medication.
It can be carried in your
pocket or in your purse.
Remember, spacers will help your patient get more
of that medication down to where we want it to go
and a lot less of it stuck on
their mouth or on their throat.
Nebulizers require a
machine and at home,
there will be either a really fun
shaped one for your pediatric patients
or a simple box for the adults.
In a hospital, we can actually hook
the nebulizer right to an oxygen mask
and give a breathing treatment
Oral medications and IV medications are signs
that your patients are having a hard time
managing their asthma attacks with
just inhaled medications.
So your patients are gonna
have more systemic effects
and it is a sign that your
patient is not doing as well.
As we're preparing
to send them home,
it will be fantastic if we can get them
back in just the inhaled medications.
There's only 1 subq which stands out in your
mind, it's the IgE antagonist we discussed.
Remember, it had that
really fun name.
And the last thing is,
the peak expiratory flow rate.
This is a small meter that can
be used in the community.
It should be correlated with some type of
written plan with their health care provider.
Let me tell you what this does.
A PEFR is a way of just measuring what
their normal expiratory flow rate is.
If they're heading into attack,
that would become lower and lower.
If your patient, we know what
normal baseline is for them,
then we know that we'd give
them the regular medications.
If they're starting to get
into a little bit of trouble,
when they measure this, their numbers will be a little
bit lower and the healthcare provider will decide,
"Hey, take more of this med or more
of that med or add this medication."
The very specific written out
instructions for the patient to follow.
If you're in the red zone, the health care provider,
I mean if you've really been compromised,
your PEFR is much lower than your
baseline which is considered green,
you're gonna be in big trouble.
So it's gonna essentially say,
"Take these medications
on the way to the ER."
That's what PEFR is.
Every asthma patient should have a
plan from their healthcare provider
on how to adjust their medications and to
recognize when they're getthing into trouble.
This gives us a quantifiable number to know
beyond how the patient's just feeling,
although that's important, we get some real
numbers and knowing how they're being affected.
Thank you for watching our video.