The Queen Elizabeth Hospital (QEH) has denied that the Accident and Emergency Department (AED) has not been treating asthmatics in recent months, insisting that people experiencing serious asthma attacks are still being nebulized.
Director of Medical Services Dr Clyde Cave sought to make this clear, telling Barbados TODAY that, in the midst of the COVID-19 pandemic, and in accordance with current international guidelines, asthmatic patients presenting with mild to moderate attacks, are treated with bronchodilators via metered dose inhaler (MDI) and the use of a spacer. He said that protocol is as effective as a nebulizer when treating mild to moderate asthmatic attacks.
“It is not true to say that we were not treating asthmatics. Asthma is an important health problem in our country and the Accident and Emergency Department is the place to respond to emergencies. What we are saying is, if it is not an emergency and there are other places that can take care of these problems, that is where it should better be looked after. We were never not seeing asthmatics,” Dr Cave said.
He explained that liquid droplets produced during the nebulization process could potentially spread COVID-19 and other viruses to nearby patients and healthcare workers, and the aim was to limit the use of the nebulizer to reduce the chances of that spread.
“For a long time, there has been a medical change in the management of asthma where we knew medically that the use of inhalers and spacers could adequately manage asthma equally well to the nebulizer. But it was our cultural practice where the Barbadian public likes coming to the hospital to have the nebulizer.
“However, right now in the time of COVID, nebulization is an aerosol producing procedure and that would put other people in the vicinity, other visitors, relatives, patients and staff at risk. And that would be an unnecessary risk because there are alternative ways of effectively treating that asthmatic attack,” Dr Cave explained.
“Anything which is aerosol generating, like nebulization, like incubation of people for anesthesia, like, to some extent, coughing and sneezing, are some of the things that we want to reduce…. But that is not to say that we can never nebulize, because in severe asthmatics who are on a ventilator or who are hardly breathing, we are still going to have to nebulize. But our numbers compared to anywhere else in the world with treating asthma, we are doing way too much in the way of nebulization and for a long time we have been trying to make that change. It has just become acute because of COVID,” he added.
Patients are being reminded to take their personal inhalers and spacers when visiting the AED, and all asthmatics are strongly advised to continue the use of their prescribed maintenance medication as directed by their physician, as doing so could prevent an asthma attack. anestahenry@barbadostoday.bb
