hey pft people out there, if you are using the tidal breathing method, do you use the vial with the 1cc well with your (wright) nebulizer? our medical director will not allow us to use it unless there is research to show that the particle size is not affected by it???? this of course triples our methacholine cost! thanks, jamey
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Posted 1 year ago #
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Laurie Allan
MemberHi Jamey
We use the bevelled container that now comes with the Wright nebulizer and actually use 1.5 ml of provocholine in it. I unfortunately do not have the research to back this up. This was something John Prost had us switch to when he was our manager. Since we are using 1.5 ml in it, our cost is now half. We also buy in bulk and make up our own provocholine under the fume hood.
Laurie Allan
Say hi to everyone out there for us!!Posted 1 year ago # -
Hi Jamey,
we have been using 1cc for our methacholine for a long time now. We used to use 3cc when we were able to purchase the english-made wrights which had the larger glass vials.
As far as I know the use of 1cc has not been validated in the published literature despite the fact many labs use less than 1cc. Is anyone aware of such validation?
This is an interesting topic which raises several questions. What nebulizers are you using? We use the Canadian made wrights available only through Roxon Meditech. Most literature suggests that the english made wrights was far superior but is no longer in production leaving few options. I hope the upcoming ATS guideline update will be more specific with regards to particle size and output of various nebulizers.
Anyone using disposable nebulizers?
Tony
Posted 1 year ago # -
tony, we use the roxon made neb, and cal it every 6 mos
thanks for your comments
ps - where do you work?Posted 1 year ago # -
Hi Jamey,
Sault Area Hospital...and you?
I am in for a challenge with our new hosptial. Best practice guidelines for infection control mandates that any decontamination/sterilization only occur in centralized processing areas, any staff involved with equipment decontamination must be certified with the CSAO (including manager and director). This means that we will no longer be allowed to cold soak any equipment in our new area. The nebulizers are going to be processed by our SPD department, resulting in daily transport and increased risk of damage.
Our plan includes processing trays, same ones used by the OR, where the nebs are disassembled and enclosed into these trays. The nebs are to be soaked and rinsed in these trays, which are designed for soaking. The entire tray returns clean for re-assembly and use.
My challenge is that I will need to double my nebulizer inventory because SPD can't assure their turn-around time. There are several issues in infection control and we face more resistance to operations in the future. We are under a lot of pressure to use single-use devices, that is why I am curious to see if anyone has been able to validate their use.
All the best,
Tony
Posted 1 year ago # -
in halifax tony... i feel for you... personally i think all this use of disposable equipment is ridiculous and huge waste fo money! when i started my career we used cardboard mouth pieces and no filters! and, what bugs are traveling upstream of 8 or so LPM to get to the nebulizer??
Posted 1 year ago #
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