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Allied Health: Articles of Interest What do you know about static electricity and spacers? There are many responsibilities that the healthcare provider faces when treating their patient. One of the more difficult responsibilities can be to ensure adherence to treatment regimens and correct use of medications. Patients with chronic diseases, such as asthma and diabetes, also need to be educated on the proper use of their equipment. In the case of asthma inhalers, if the patient uses it incorrectly, it is estimated that only about 10% of the expelled medicine from an inhaler will reach the lungs, while 80% will remain at the back of the throat. Inhaler efficacy can be greatly improved by adding a spacer device, which will hold the medicine in a chamber long enough so the patient can fully inhale their medication. Recently, there has been an issue with spacers that has been brought forth in the research journals. Dose delivery can be affected, even if the patient is using the inhaler and spacer correctly. The majority of spacers manufactured today are made of plastic, which makes them light weight and easy to manipulate. However, this plastic is a non-conductive material and carries an electrostatic charge (ESC). This charge attracts the aerosol particles to the surface of the spacer and can significantly reduce the dose available for inhalation. The research that has been conducted addressing the issue of ESC uses different types of pre-treatment techniques to reduce the ESC. These techniques include wiping the spacer with an antistatic cloth, coating the inner walls of the spacer with an antistatic lining, washing the spacer with a detergent solution or “priming” the spacer so that the inner surfaces are coated with surfactant. These studies found that each of the techniques reduced retention of drug on the plastic surface and increased lung deposition. Spacers were introduced to ensure that the patient would get all of their inhaled medication. If the medication does not leave the spacer, we are defeating the purpose of using a spacer. One way to ensure that there is no ESC in a spacer is to purchase a metal spacer that does not conduct an ESC. If the patient has a plastic spacer, manufacturers list several ways that patients can reduce the ESC:
When patients are being educated on the proper use of a spacer, they also need to be instructed on the care and cleaning. By adding the information about ESC, patients will be able to increase their dose delivery. It is the responsibility of the healthcare provider to ensure that their patient has all of the information they need to properly use their equipment. References Dompeling, E., Oudesluys-Murphy, A.M., Janssens, H.M., Hop, W., Brinkman, J.G., Sukhai, R.N., de Jongste, J.C. Randomised Controlled Study of Clinical Efficacy of Spacer Therapy in Asthma with Regard to Electrostatic Charge. Archives of Disease in Childhood 2001; 84:178-182. Keenan, J., Baldesare-Burton, K., Adams, C. Facility Survey for Eliminating Electrostatic Charge with Meter Dose Inhaler Chamber Devices. Respiratory Care Journal 2004; 49: 1394. Pierart, F., Wildhaber, J.H., Vranchen, I., Devadason, S.G., Le Souef, P.N. Washing Plasic Spacers in Household Detergent Reduces Electrostatic Charge and Greatly Improves Delivery. European Respiratory Journal 1999; 13: 673-678. |
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