Table 1.

Practical strategies for aerosol drug delivery to mild-patients with COVID-19.

1. Avoid unnecessary aerosol drug delivery to patients with COVID-19.

2. Use prescribed inhaled corticosteroids to prevent the worsening of asthma and the serious consequences of asthma attacks.

3. Use pMDIs or DPIs for aerosol drug delivery instead of nebulizers, if your patient is awake and can perform specific breathing patterns.

4. Consider using nebulizers with a mouthpiece or high flow nasal cannula, if the inhaler increases cough or if the patient has acute respiratory failure.

5. Attach filters to nebulizers before delivering aerosolized medications to patients. Use HEPA filters if possible.

6. Do not use a face mask with nebulizers.

7. Prefer using a mouthpiece with jet and mesh nebulizers.

8. Attach filters or one-way valves to the large bore tubing of the jet nebulizer to prevent fugitive emissions during aerosol therapy.

9. Add a filter to the other end of the mouthpiece to eliminate the release of aerosols to the environment, when a mesh nebulizer is used.

10. Administer aerosol therapy in negative pressure rooms.

11. Wear personal protective equipment, including an N95 respirator, goggles/face shield, double gloves, gown or apron if the gown is not fluid resistant.

12. Consider using telehealth to evaluate coronavirus infected patients staying at home and minimize their utilization of healthcare facilities.