Abstract:OBJECTIVE: To evaluate studies comparing metered dose inhalers with holding chambers to nebulizers in the emergency department for the treatment of asthma exacerbation.
DATA SOURCE: Primary articles and systematic review provided by the Cochrane Airways Review Group of the Cochrane Library identified by MEDLINE search (1966–February 2004) and through secondary sources.
DATA SYNTHESIS: The Cochrane review included 21 randomized clinical trials conducted in hospital emergency depart… Show more
“…This included personal protective equipment, disinfectant wipes, and basic medical equipment, such as pulse oximeters, blood pressure cuffs, thermometers, oxygen tanks, and locked medication bins to store common medications such as fever reducers and albuterol metered-dose inhalers. Nebulizer treatments were not permitted due to the risk of COVID-19 transmission (Benge & Barwise, 2020), and a Cochrane review found that metered-dose inhalers with spacers are at least as effective as nebulized medications (Raissy & Kelly, 2004).…”
Background:In response to the surge of COVID-19 patients in March and April 2020, our emergency department in New York City implemented a novel triage screening process to identify low acuity patients who could be diverted from the emergency department to a surge space. Patients who were (1) ≤ 70 years old; (2) triaged as Emergency Severity Index category 4 or 5, and (3) not requiring use of a stretcher (4) displaying mild COVID-19 symptoms were diverted to one of two surge spaces [West Surge Space (WSS) or Ambulatory Clinic Surge Space (ACSS)], where a complete set of vital signs were taken and an exam by a medical provider was conducted.Methods: From March 12 to April 20, 2020, we analyzed the total volume of patients diverted to the surge space and their discharge disposition (i.e., admitted to hospital, transfer to main emergency department, left against medical advice, discharged from a surge space, or expired). A receiver operator curve (ROC) was calculated to predict discharge disposition based on triage diversion to either surge space.Results: There were 6,241 patients triaged during the study period, in which onequarter [n = 1,753 (26%)] were diverted to a surge space. The average number of patients per day was 141.8 (standard deviation [SD] 54.5) in the main emergency department and 39.8 (SD 29.9) in the surge spaces. Of the patients triaged and diverted to a surge space, a large proportion were successfully discharged from those areas without entering the main emergency department (84%, n = 866 in WSS and 94%, n = 745 in ACSS). Very few signed out against medical advice (3%, n = 26 in WSS and 2%, n = 12 in ACSS), transferred 14 Nover et al.
“…This included personal protective equipment, disinfectant wipes, and basic medical equipment, such as pulse oximeters, blood pressure cuffs, thermometers, oxygen tanks, and locked medication bins to store common medications such as fever reducers and albuterol metered-dose inhalers. Nebulizer treatments were not permitted due to the risk of COVID-19 transmission (Benge & Barwise, 2020), and a Cochrane review found that metered-dose inhalers with spacers are at least as effective as nebulized medications (Raissy & Kelly, 2004).…”
Background:In response to the surge of COVID-19 patients in March and April 2020, our emergency department in New York City implemented a novel triage screening process to identify low acuity patients who could be diverted from the emergency department to a surge space. Patients who were (1) ≤ 70 years old; (2) triaged as Emergency Severity Index category 4 or 5, and (3) not requiring use of a stretcher (4) displaying mild COVID-19 symptoms were diverted to one of two surge spaces [West Surge Space (WSS) or Ambulatory Clinic Surge Space (ACSS)], where a complete set of vital signs were taken and an exam by a medical provider was conducted.Methods: From March 12 to April 20, 2020, we analyzed the total volume of patients diverted to the surge space and their discharge disposition (i.e., admitted to hospital, transfer to main emergency department, left against medical advice, discharged from a surge space, or expired). A receiver operator curve (ROC) was calculated to predict discharge disposition based on triage diversion to either surge space.Results: There were 6,241 patients triaged during the study period, in which onequarter [n = 1,753 (26%)] were diverted to a surge space. The average number of patients per day was 141.8 (standard deviation [SD] 54.5) in the main emergency department and 39.8 (SD 29.9) in the surge spaces. Of the patients triaged and diverted to a surge space, a large proportion were successfully discharged from those areas without entering the main emergency department (84%, n = 866 in WSS and 94%, n = 745 in ACSS). Very few signed out against medical advice (3%, n = 26 in WSS and 2%, n = 12 in ACSS), transferred 14 Nover et al.
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