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92440 Asthma Nursing Assignment

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Asthma Nursing Assignment (92440)

   

Added on  2020-05-28

92440 Asthma Nursing Assignment

   

Asthma Nursing Assignment (92440)

   Added on 2020-05-28

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Modes of salbutamol delivery 1THE MORE EFFECTIVE MODE OF DELIVERY BETWEEN SPACER AND NEBULIZERNameCourseUniversity
92440 Asthma Nursing Assignment_1
Modes of salbutamol delivery 2Scenario 2:Spacer versus nebulizerIntroductionThe asthma burden among children in Australia and the rest world is big considering lackof a definitive cure for the condition (Xu, 2013). Management of symptoms and acute exacerbations of the condition are therefore essential in improving the health of these patients. The drug of choice for the management of exacerbations of asthma is salbutamol, a beta-agonist bronchodilator, delivered by use of metered dose inhalers with spacers or, Nebulizers. A debate has been heating up on what method of salbutamol administration is more effective in relieving asthma symptoms. To fulfill the need for evidence-based clinical practices, the PICO model will be utilized to assess which method is the preferred one. The ‘P’ stands for population; ‘I’ for the intervention, ‘C’ for comparison and lastly ‘O’ for the outcome. In this case, the population is represented by the drug Salbutamol; the nebulizer is the intervention, the spacer is the comparison while the outcome is the management of Asthma. Several databases were browsed for reliable articles, and reviews comparing the two devices. The Medline database, PubMed, and the Cochrane library were the top databases where the search was conducted and results filtered according to the years of publication, age limits of the participants and countries in whichthe studies were conducted. The articles were then reviewed. Spacer versus nebulizerThe first article in line is ‘policy change implementation: spacers to replace Nebulizers for management asthma management in children’ from the Europe PMC in cooperation with TheNational Library of Medicine (NLM). It’s an article of a study that was done in an emergency
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Modes of salbutamol delivery 3department of a pediatric ward at a certain University medical center (Breuer, 2015). Participantswere a group of children admitted for management of asthma as the diagnosis. Both the nursing and medical staff were trained on how to use inhalers with spacers attached, and their use monitored closely by a supervising medical practitioner when nebulizers were replaced by spacers at a given date. The bronchodilator, salbutamol was administered through a spacer with puff numbers determined by disease extent or severity. 2 years down the line, an analysis was done from the approximately 93% of patients who used the metered dose inhaler attached to a spacer. Analysis of the results after two years since the start of spacer use revealed the same efficacy as the nebulizer and a surprising 63% reduction in cost. The study concluded that treatment of asthma using spacer devices was just as effective Nebulizers. Given the cost advantage of spacer devices, the researchers recommended that nebulizers be replaced by Metered Dose Inhalers plus spacer devices in the management of symptoms resulting from acuteasthma in collaboration with the hospital staff, patients, and hospital authority.From the Cochrane database, where many systematic reviews were discovered, the articlespacers versus nebulizers for beta-agonist (such as salbutamol) treatment of acute asthma’ was reviewed (Cates, Welsh & Rowe, 2013) 39 different trials involving 1897 children between the two methods of delivery of salbutamol. Thirty-three out of the thirty-nine trials were carried out at the emergency department which validates the application of the results in emergency wings. Six studies were done on 207 children with acute asthma. The first finding from the studies was that there was no disparity in the hospital admission frequencies, at least not a significant one, between those settings in which the nebulizer was used and those in which the spacer device wasused (Cates 2013). It was found that in fact, children’s duration of time spent in the emergency room was drastically reduced when metered dose inhaler with a spacer attached was used
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