Abstract
For many years nebulisers have been the standard method of delivering beta agonists in ventilated patients, but metered-dose inhalers are increasingly seen as an effective alternative. Metered-dose inhalers are cheaper and less likely to cause infection. Clinical studies have shown inhalers to be as effective as nebulisers, but their use demands careful attention to detail. Minor alterations in inhaler technique can alter the delivered dose six-fold, varying from 0 to 38% of the total dose. We surveyed the frequency of metered-dose inhaler use and assessed the adequacy of the techniques currently employed. Our survey showed that only a minority (25%) of units were using inhalers, but that of these, 84% were using a dose or technique that was unlikely to deliver a therapeutic dose.