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November 3, 1975


JAMA. 1975;234(5):482. doi:10.1001/jama.1975.03260180021011

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In Reply.—  "The Indiscriminate Use of IPPB" (231:1141, 1975) contained no implications of "incompetency" but rather the subjective acceptance of a technique widely heralded for routine use in patients with obstructive lung disease. The indications and physiologic rationale for use in patients with respiratory failure in a hospital setting are properly appreciated. In simplistic terms, we stressed the absurd "habit" for employing a Mercedes Benz rather than going by small car, bicycle, or foot to get to the corner grocery store.The authors having spent a long, long time in the field of respiratory therapy urge a rational, physiologic questioning approach to the use of therapeutic aerosols and mechanical aids in this rapidly burgeoning paradigm of treatment. An editorial in the British Medical Journal (1:703, 1975) includes the remark: "nor is the `inhalation therapist' a distinct entity as in North America." This recent report points out that there might be