HealthDay News — Treating adults with wheezing or dyspnea with a breath-actuated nebulizer (BAN) or a hand-held nebulizer (HHN) yielded similar clinical outcomes in the ED setting, but treatment times were longer with BAN, according to researchers.

“The data [suggest] that the higher cost and the longer treatment time do not justify the use of the BAN in this setting,” Dominic Parone, BSN, RN, from Cooper University Hospital in Camden, N.J., and colleagues reported in the Journal of Emergency Nursing.

They randomly assigned 54 patients who presented to the ED with dyspnea and wheezing, and who had an Emergency Severity Index of 3 or 4, to treatment with either BAN or HHN.

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One to three nebulizer treatments ([1] ipratropium bromide and albuterol sulfate; [2] ipratropium bromide and albuterol sulfate; [3] albuterol sulfate) were administered, consistent with guidelines.

There were no significant difference between HHN and BAN with respect to the number of treatments needed, respiratory rate, peak flow measurements and Modified Borg scores.

In the BAN treatment group there was a difference of 7 points in pulse rate between the pre- and post-second treatment (51 patients; P=0.01). Among BAN group participants who completed all three treatments (18 patients), total treatment time was on average of 10 minutes longer than those in the HHN group.

Additional studies with larger sample sizes are needed to further determine differences in patient outcomes between the two devices, the researchers wrote.


  1. Parone D et al. J Emerg Nurs. 2014; doi:10.1016/j.jen.2012.10.006.