The visit of Dr David Whyatt from the Division of General Practice UWA and joint leader of the Respiratory Health Network, Professor Peter Kendall, was part of a project funded by WA Health.

This phase of the project focussed on encouraging emergency department (ED) staff to use metered dose inhalers (MDIs) with spacers to administer salbutamol (Ventolin) and to instruct patients on their use.

“A lot of patients have problems using the equipment properly,” Dr Whyatt said.

“If we can enhance people’s ability to use the equipment we hope to reduce patients’ re-presentation to emergency departments, he said.

Asthma is a common condition among patients presenting themselves to hospital EDs.

Approximately 8 per cent return to the ED within 28 days and 14 per cent return within three months.

Also, the strap-on nebuliser mask, commonly used in EDs has proven inefficient at distributing the required dose of medication.

“When a liquid drug is administered through a nebuliser, a large proportion of the medication vaporizes - it’s a highly inefficient device,” Professor Kendall said.

“Also, when an MDI is used without a spacer it is not very efficient either,” he said.

“It is a metal canister under pressure and the spray hits the back of the throat too fast.

“Put it through a spacer and the drug rains out through a valve for one or two seconds.”

Research shows an MDI without a spacer disperses less than 10 per cent of medication into the lung, but with a spacer fitted 45 per cent is absorbed.

The WA Asthma Clinical Governance Project showed patients presenting to an ED were 70 per cent less likely to return if they received education in the use of MDIs and spacers.