Use and Care of Nebulizer
A nebulizer is a device driven by a compressed air machine. It allows your patient to take asthma medicine in the form of a mist (wet aerosol). It consists of a cup, a mouthpiece attached to a T-shaped part or a mask, and thin plastic tubing to connect to the compressed air machine. It is used mostly by three types of patients:
- Young children under age 5.
- Patients who have problems using metered dose inhalers.
- Patients with severe asthma
A nebulizer helps make sure that patients get the required amount of medicine
How to Use a Nebulizer (Advice for the patient)
- Directions for using the compressed air machine may vary (check the machine's directions), but generally the tubing has to be put into the outlet of the machine at first.
- Measure the correct amount of normal saline solution using a clean dropper and put it into the cup. If medicine is premixed, ignore this step.
- Draw up the correct amount of medicine using a clean dropper or syringe and put it into the cup with the saline solution. If you know your number of drops, you can count them as a check.
- Attach the mouthpiece to the T-shaped part and then fasten this unit to the cup OR fasten the mask to the cup. For a child over the age of 2, try to use a mouthpiece unit because it will deliver more medicine than a mask.
- Put the mouthpiece in your mouth. Seal your lips tightly around it OR place the mask on your face.
- Turn on the air compressor machine. 7. Take slow, deep breaths in through the mouth.
- Continue until the medicine is gone from the cup and no more mist is produced (approximately for 10 minutes).
- Store the medicine as directed after each use.
Cleaning
Regular cleaning of the nebulizer is important because an unclean nebulizer may cause an infection. A good cleaning routine keeps the nebulizer from clogging up and helps it last longer.
Nebulizer should be cleaned once every day
- Remove the mask or the mouthpiece and T-shaped part from the cup. Remove the tubing and set it aside. The tubing should not be washed or rinsed.
- Wash the mask or the mouthpiece and T-shaped part - as well as the dropper or syringe - with a mild dishwashing soap and warm water.
- Rinse under a stream of water for 30 seconds. Use distilled (or sterile) water, if possible.
- Shake off excess water. Air dry on a clean cloth or paper towel.
- Put the mask or the mouthpiece and T-shaped part, cup, and tubing back together and connect the device to the compressed air machine. Run the machine for 10 to 20 seconds to flash out and dry the inside of the nebulizer.
- Disconnect the tubing from the compressed air machine. Store the nebulizer in a ziplock plastic bag.
- Place a cover over the compressed air machine.
Delivery devices for asthma medications in children
|
Mode of Administration |
<2 Years |
2-4 Years |
5-7 Years |
>8 Years |
|
Nebulizer |
Yes |
Yes |
Yes |
Yes |
|
MDI+Spacer with mask |
Yes |
Yes |
-- |
-- |
|
MDI+Spacer without mask |
|
-- |
Yes |
Yes |
|
MDI (alone) |
-- |
-- |
-- |
Yes |
Topics:
There are some common concerns about Asthma prevailing in the society. In majority of cases, these are misconceptions or baseless fears. For optimum control of asthma, these points should be dealt with proper care. Otherwise the management plan may go in vain. It the physicians responsibility to eradicate such worries, if present, from the patient’s mind. Some common concerns and suggested clinicians responses are listed below. Model answers to some frequently asked questions (FAQs) are also given. These will help the physician to deal with such situations more confidently.
A peak flow meter is a device that measures how well air moves out of a patient's lungs. During an asthma episode, the airways of the lungs begin to narrow slowly. The peak flow meter can be used to find out if there is narrowing in the airways, hours - even days - before the patient has any symptoms of asthma. By taking the medicine early (before symptoms), your patient may be able to stop the episode quickly and avoid a serious episode of asthma. So its role in preventing severe asthma attack is very important.
The peak flow meter can also be used to help you:
Name of Patient ........................................ Prepared by Dr. .........................................
This plan will help a patient control his asthma and know what to do if he has an asthma episode. Keeping a patient’s asthma under control will help to :
- Be active without having asthma symptoms. This includes being active in exercise and sports.
- Sleep through the night without having asthma symptoms.
- Prevent asthma episodes (attacks).
- Have the best possible peak flow number - lungs that work well.
Management of Asthma Attacks :
Hospital-Based Care
Initial Assessment:
History, Physical examination (auscultation, use of accessory muscles, heart rate, respiratory rate) and Investigations (PEF or FEV1, Oxygen saturation SaO2, arterial blood gas analysis and other tests)
Initial Treatment:
- Inhaled short-acting b2-agonist, usually by nebulization, one dose every 20 minutes for 1 hour
- Oxygen to achieve O2 saturation >90% (95% in children)
Why we investigate asthma patients?
- For classification and assessment of severity
- For diagnosis of concomitant illness
- For exclusion of other causes of cough, wheeze dyspnoea or chest tightness
What are the investigations for asthma?
We should do four basic investigations of all patients.
1. Blood for TC, DC, ESR,
Hb% and :
How to prevent asthma?
Development of asthma has two distinct bases: Hereditary and Environmental. For the prevention of the development of asthma we should manipulate these two factors. Regarding hereditary factors, we have yet nothing to do practically. Genetic engineering is a future probability. What we can do is to manipulate the environmental factors. Effort should be concentrated on primary prevention of asthma.
What is primary prevention?
Why management at home ?
Since asthma is a chronic disease, it can be and should be managed at home up to a certain level. If home management plan is applied intelligently and skillfully, most asthmatics can lead symptom free normal life, avoid hospitalization thereby cutting down the financial expenditure significantly. All patients of asthma, except those with acute exacerbation, should be treated at home.
What are the components of home management plan ?
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