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A short review of the literature was conducted to compare the length of emergency department (ED) stay and hospital admission rates in patients with exacerbations of asthma or chronic obstructive pulmonary disease (COPD) treated with salbutamol via a metered dose inhaler with a spacer (MDIS) versus nebulisation. Database searches were conducted using Cochrane, EMBASE, MEDLINE and Google Scholar. Six papers met our inclusion criteria and underwent analysis. Our results suggest that delivery of salbutamol via MDIS may reduce hospital admissions and ED length of stay in this patient cohort.