A Revolution in Our Mi(d)st

Until recently, respiratory care practitioners (RCPs) were obliged to use “tee-type” nebulizers for bronchodilator aerosol treatments, over an industry-average treatment duration of 15 min. McPeck demonstrated that nine tee-type nebulizers delivered merely 7% to 15% of the dose (“charge”) instilled into them (McPeck et al. Respir Care. 2004;49[11]:1393). Now, however, a new type of device— the “waste-reducing nebulizer”—is available. Monaghan’s Aeroeclipse II^™ is a breath-actuated nebulizer (“BAN”), while Westmed’s Circulaire II^™ and Healthline Medical’s Medicator^™ reduce waste by diverting medicated mist, which would otherwise be expelled into the bedside environment, into a “conserver” element and delivering it during the subsequent inspiration. McPeck empirically verified that BAN and conserver nebulizers deliver 33% and 34% of their charge, respectively, within a shorter treatment duration: 12 and 6 min, respectively. If a respiratory care department was to swap a BAN for a conventional nebulizer that exhibits an efficiency of 15%, productivity would be ( [33/15] × [15/12] = ) 275% of baseline for this task. If that department was currently employing a tee-type nebulizer, displaying a 7% efficiency, switching to the conserver type would result in an enormous productivity gain: ( [34/7] × [15/6] = ) 1,214%! On average, then, substitution of a waste-reducing nebulizer for a conventional nebulizer will elicit a whopping sevenfold increase in productivity, and patients will benefit by receiving more drug, and receiving it faster! Navigate to http://web.me.com/bobdemers/ DCS_Website/Waste-Reducing_Nebulizers.html to see detailed results of our performance evaluation of waste-reducing nebulizers.

Bob Demers, RRT, NetWork Vice-Chair
Dr. Peter M. Browne, FCCP
Manny Banderas, RRT, MBA
Methodist Hospital of Southern California
Arcadia, CA