NATIONAL NEWS - An innovative approach is set to make a huge impact on treating asthma in South Africa, made more critical during the coronavirus pandemic, according to the Red Cross War Memorial Children's Hospital.
In a statement on Monday 4 May, the hospital said asthma treatment usually comprises using an inhaler, but to get medication more effectively to the lungs in a crisis, the use of a spacer along with the inhaler, or a nebuliser, is required.
However, nebulisation, a popular therapy in emergency units, aerosolises patients' secretions, increasing the risk of spreading the coronavirus.
To address the problem, the team has tested and evaluated the efficacy of using plastic bottle spacers, which are immediately available, instead of expensive spacers. The programme aims at bridging the gap between expensive commercial spacers and the need in low income communities.
"Extraordinary times require extraordinary solutions," says Prof Michael Levin, head of Allergy at Red Cross and project leader. "This plastic bottle spacer not only allows the medication to work much more effectively, but also has the added benefit of minimising droplets in the air and ultimately reducing the risk to staff and patients becoming infected with the coronavirus."
The innovative bottle spacer with extrusion.
When one uses an asthma pump directly in the mouth most of the spray hits the back of the throat and does not go into the lungs. A spacer is a chamber filled with air, with the asthma pump fitting into the back. When you spray the pump first inside the chamber and then breathe this air into the lungs, the spray goes into the deepest part of the lungs where it is needed most.
"Since Prof Heather Zar first pioneered bottle spacers back in the late 90s using a manual burning technique, we have been using them at the Red Cross War Memorial Children's Hospital. But from just a few hundred units a year, we needed to produce tens of thousands, to facilitate the large-scale use of spacers in the public health service across the country," says Levin.
Prof Mike Levin is excited about the new bottle spacer.
Polyoak Packaging partnered with Habitat Industries to create a custom blow-mould base with an indentation in the shape of an asthma pump nozzle. "During production when the bottle is blown and the plastic is still soft, air is blasted into the bottle base, which creates the inhaler size extrusion. So, after that, the only small manual task is to slice off the end of the indentation leaving a perfect-fit attachment hole for the inhaler. Polyoak has even been able to include the Allergy Foundation website address on the base of the bottle," says Levin.
Dr Anita Parbhoo, medical manager at the hospital, says this is an example of an innovative project which aims to bring a low-cost, clinically effective solution to patients across the province, and potentially the country.
Says Dr Elma de Vries, senior family physician at Heideveld Community Day Centre, "It is amazing how fast behaviour change can happen in a crisis situation. Our nursing staff are impressed that the pump and spacer technique actually works well for patients presenting with tight chest and we hope that if we are able to give patients these bottle spacers to take home, there will be fewer emergency service visits just for nebulisation in future."
A young patient demonstrates how the spacer works.
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