P4 Nebulised medications in secondary care: rising to the challenge. (11th November 2022)

• Record Type: Journal Article
• Authors: Bettany, M; Pilsworth, S; Barber, D; Wat, D
• Is Part Of: Thorax. Volume 77(2022)Supplement 1
• Page Start: A82
• Page End: A82
• Publication Date: 2022-11-11
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-BTSabstracts.140
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction: Nebulised challenges for respiratory patients are typically completed with inpatients in secondary care. Since 2017 the local physiotherapy team has completed nebulised challenges on outpatients in 6 local health centres and a local hospital. 38 patients completed 3%, 6% or 7% Hypertonic Saline challenges, 17 patients completed challenges for Colomycin, Tobramycin, Meropenem or Gentamycin. Spirometry was completed pre, post and 15 minutes after completion. Auscultation was also completed pre and post, SpO2 was monitored and patients' symptomatic responses reviewed. All patients had COPD, Bronchiectasis, Asthma or a combination of these diseases. Aim: To retrospectively review the adverse effects on patients in order to review the safety of completing nebulised challenges in a primary care setting. Methods: Patient data was collected for audit including pre and post spirometry values, and symptomatic responses. Results: Of 61 patients referred, 55 completed challenges. In all but 3 cases pre-bronchodilator medications were recorded as having been administered. In 37 (67%) of the cases where the challenge was completed the appropriate nebulised antibiotic or Hypertonic Saline was subsequently prescribed. None of the patients who experienced drops in FEV1 over 15% or who experienced adverse effects required admission to secondary care. Conclusion: Nebulised challenges can be safely completed in primary care settings with patients who have chronic respiratory diseases.