The prescription for a nebulized bronchodilator must be accurate to ensure optimum relief from airway obstruction. Khoo and Lim identify 5 criteria for proper prescription. The authors are from the National University Hospital in Singapore.
Criteria for an accurate prescription:
(1) standard dose of bronchodilator
(2) unambiguous instruction on frequency of administration
(3) appropriate type and flow rate of driving gas
(4) appropriate type and volume of diluent solution
(5) correct final volume
where:
• The bronchodilator used by the authors was a mixture of salbutamol and ipratropium.
• Frequency of administration was considered ambiguous if more than one frequency was given.
• The driving gas was oxygen for asthma and compressed air for COPD. The flow rate was >= 8 L/min.
• The diluent solution used was isotonic saline.
• The final volume was >= 4 mL.
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