Preventing out-of-hospital asthma deaths

Jext has the most powerful springs and longest needle, one spring to force the needle through clothing and skin, and another to inject syringe contents into muscle. 7 Other strategies for parents and bystanders, when faced with severe bronchospasm (and patient inability to use a metered dose inhaler; MDI), are 'mouth-to mouth' and cardiac massage. Ninety-nine percent of this volume is HFA134a gas (norflurane, chemically similar to halothane), which relaxes smooth muscle, and is an inhalational anaesthetic agent studied only in animals. 11 This latter effect is appreciated by 'huffers', who collect multiple puffs in plastic bottle reservoirs and then inhale and re-breathe. 12 Up to 12 puffs of a large MDI (192 mL of gas, 1200 [micro]g of salbutamol), into a valved holding chamber (VHC) inhaled in one breath is an effective alternative to salbutamol nebulisation, and is used in hospital practice in Australia.