PT  - JOURNAL ARTICLE
AU  - I A Campbell
AU  - S B Colman
AU  - J H Mao
AU  - R J Prescott
AU  - C F Weston
TI  - An open, prospective comparison of beta 2 agonists given via nebuliser, Nebuhaler, or pressurised inhaler by ambulance crew as emergency treatment.
AID  - 10.1136/thx.50.1.79
DP  - 1995 Jan 01
TA  - Thorax
PG  - 79--80
VI  - 50
IP  - 1
4099  - http://thorax.bmj.com/content/50/1/79.short
4100  - http://thorax.bmj.com/content/50/1/79.full
SO  - Thorax1995 Jan 01; 50
AB  - BACKGROUND--The merits of the use of beta 2 agonists by ambulance crew and best methods of delivery have not been fully explored. METHODS--A prospective comparison has been made of treatments applied in three districts in South Wales (200 micrograms salbutamol by pressurised inhaler, 5 mg salbutamol via nebuliser, and 5 mg terbutaline via Nebuhaler) by emergency ambulance personnel to acutely wheezy patients en route to hospital. Pulse rate, respiratory rate, peak expiratory flow rate (PEFR), and breathlessness scored on a visual analogue scale were compared before and after treatment. Data were collected on diagnosis, artificial ventilation, cardiorespiratory arrest, and death. RESULTS--Thirty eight patients received salbutamol inhaler, 51 salbutamol via nebuliser, and 41 terbutaline via Nebuhaler. There were greater reductions in respiratory rate and breathlessness score and more improvement in PEFR in the group receiving nebulised salbutamol than in the other two groups. No patient was ventilated and of the five deaths none was caused by asthma. CONCLUSIONS--For wheezy, breathless patients treated en route to hospital by emergency ambulance personnel, 5 mg salbutamol given by an oxygen-driven nebuliser was more effective than either 5 mg terbutaline via a Nebuhaler or 200 micrograms salbutamol via a pressurised inhaler.