A patient receiving mechanical ventilation is about to receive medication delivered via an MDI. Where should the therapist place the spacer, and when should the MDI be actuated?
A. Place the spacer anywhere along the inspiratory limb, and actuate the MDI at the end of inspiration.
B. Place the spacer in the inspiratory side of the ventilator circuit at the Y, and actuate the MDI at end-exhalation.
C. Place the spacer near the elbow connector, and actuate the MDI anytime during the ventilatory cycle.
D. Place the spacer along the inspiratory limb about 50 cm from the elbow connector, and actuate the MDI during inspiration.
?ANS: B
A. Incorrect response: See explanation B.
B. Correct response: When an MDI is used to deliver medication to a mechanically ventilated patient, the spacer should be attached to the Y in the inspiratory side of the circuit. The MDI can be actuated at end-exhalation so that the drug plume is inspired during the next inspiration. The MDI can also be actuated in synchrony with inspiration.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.
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