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Welcome to our chat on the book, “The Five Dysfunctions of a Team,” hosted by the Section of Clinical Specialists and Scientists Educational Steering Committee! #SCSSChat
Don't forget! Our Section of Clinical Specialists and Scientists is hosting an X (Twitter) Chat about the five dysfunctions of a team next Tuesday (11/14) at 7:00 p.m. ET. Follow along during the chat using #SCSSChat.
Thanks for joining tonight’s #SCSSChat! If you have questions or suggestions for future chats, feel free to DM us.
On the front end, consider adding your alternative products as “non-formulary, stocked” options with the understanding that they will be removed from your shelves once the shortage resolves. #SCSSChat
Open communication with all involved stakeholders is as important after the usual products return as it is on the front end of a shortage. Consider evaluating your usage patterns to determine whether albuterol was being used optimally in the first place. #SCSSChat
Q9: How do you ensure a return to preferred products and uses after the albuterol shortage resolves? #SCSSChat
Ordering providers, pharmacy staff, and those administering treatment need education including the different products and doses, the importance of barcode scanning, and any extra equipment. #SCSSChat
Q8: How can you promote safe medication use if new agents are stocked during this shortage? #SCSSChat
Terbutaline is typically for patients refractory to or unable to use inhaled bronchodilators. It is in short supply but may be an option if available. Be aware that scheduled dosing is not well-defined and that PK, PD, and monitoring differ from inhaled beta 2 agonists. #SCSSChat
Q7: Have you considered using subcutaneous terbutaline in any population(s)? #SCSSChat
Metered dose inhalers can be administered to patients on mechanical ventilation via the inspiratory limb if synchronized with inspiration; however, additional equipment including a spacer and/or mouthpiece adapter should be used. https://t.co/PBRLGikXLP #SCSSChat
Q6: Would you consider using albuterol metered dose inhalers? #SCSSChat
Both formoterol and arformoterol are available as stand-alone nebulized products; however, there is limited evidence for their use in the critically ill. If you are able to do so, consider limiting to continuation of COPD or asthma maintenance therapy. #SCSSChat
Q5: Have you considered nebulized long-acting beta agonists in the event no short-acting products are available? #SCSSChat
While levalbuterol holds no advantage for most critically ill patients, it is a viable, albeit more expensive, option. Equivalent levalbuterol dosing is half the albuterol dose: levalbuterol 1.25 mg = albuterol 2.5 mg. https://t.co/ECbqNdjXuU, https://t.co/g2ZpMzuu4h #SCSSChat
Nebulizer reservoir volume may change the approach—administering consecutive treatments versus administering one treatment over twice the duration. Risk of human error increases with differing concentrations; ensure administration instructions are clear. #SCSSChat
In the event 2.5 mg/3 mL treatments are unavailable, one facility reports auto-substituting one 1.25 mg treatment for adult patients and for escalation to two consecutive treatments totaling 2.5 mg if the patient does not adequately respond to the lower dose. #SCSSChat
Q3: If albuterol 1.25 mg/3 mL is the only product available, are you administering one treatment or two treatments for a total of 2.5 mg? #SCSSChat
Welcome to our Twitter Chat on navigating nebulized albuterol shortages, hosted by the Section of Clinical Specialists and Scientists. #SCSSChat
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