Aerosol Therapy in the Emergency Department

Asthma and chronic obstructive pulmonary disease are prevalent conditions associated with sudden, symptomatic decline in respiratory function requiring urgent treatment. Management of acute airflow obstruction includes frequent, thorough assessments as well as timely administration of supplemental oxygen, corticosteroids and inhalational drug delivery of short acting bronchodilators. The benefits of inhaled administration of aerosolized short-acting bronchodilators include rapid symptom relief and improvements in lung function with fewer side effects. To optimize these benefits requires an understanding of the factors concerning aerosol delivery in the acute care setting that include patient age, severity of airway obstruction, aerosol generating device and the patient and device interface. Treatment strategies have been developed that include increased dosing of short-acting bronchodilators, combined administration of β-agonist and anticholinergic bronchodilators, continuous drug delivery and the use of helium to enhance lower respiratory tract drug deposition and improve patient outcomes.