A nebulizer is a machine that converts liquid medication into fine mist that is inhaled into the lung. It pushes compressed air through the liquid medication turning it into the mist form. This is then inhaled through either a facemask or a mouthpiece.

Usually it takes 5-10 minutes to nebulize and deliver the medication. For effective nebulization the drugs must be in a volume of 4mls. The deficient is volume is making up with o.9% normal saline.

It has three parts:

• The chamber
• Facemask or mouthpiece
• The tubing

Several types of medications and solution can be delivered through the nebulizer:

• Normal and hypertonic saline
• Bronchodilator
• Steroids
• Antibiotics
• Adrenaline

There are many types of nebulizer. The medical practitioner will use one that suits the patient needs. Most nebulizer is plug to a power outlet.

Oxygen is used to drive the nebulizer if the oxygen level is low in the patient or air driven. The flow used is 6-8l/min.

Who should use the nebulizer?

It is indicated in variety of situations including:

• When a child or young person has an acute asthma attack
• When a child or young person is in respiratory distress
• When a child or young person has stridor
• Before physiotherapy to loosen secretions
• The drug required is not available in an inhaler preparation
• Large doses of nebulized antibiotics are required to treat or control persistent infections

Medical practitioners in hospital settings prescribe this.

Children with asthma no longer require nebulizer at home to deliver the asthma medication particularly the reliever medication.  Reliever medication can be delivered using spacer device even when they have an exacerbation at home. Nebulizers are not recommended to be used at home to treat asthma attacks. Children are required to be assessed by the doctor in hospital setting or in the clinic.   

However there are situations when nebulizer is used in home setting prescribed by lung specialist. It can be used at home to deliver antibiotics to treat infection in children with cystic fibrosis and use before home physiotherapy.

Cleaning the nebulizer

The nebulizer is disconnected from the flow meter and tubing. The nebulizer chamber is taken apart and the three components separated. Residual solution is discarded.

The three components are washed with warm soapy water or mild detergent. Rinse all three apart and dried with paper towel. The tubing and chamber should be discarded if discoloured, stickiness or the chamber cracked. The pump must be serviced every 6-12 months. Filter must be checked and cleaned and replaced regularly

How to use the nebulizer?

Steps to use nebulizer

• Wash hands
• Place medication into the nebulizer
• Attach mouth piece
• Connect tubing
• Using the nebulizer
• Turn on oxygen/air compressor
• Continue to inhale medication
• Turn off the nebulizer and clean up

Source: http://www.healthline.com/health/asthma-nebulizer-machine

References

1. http://www.gosh.nhs.uk/health-professionals/clinical-guidelines/nebuliser-administration
2. European Respiratory Society Guidelines on the use of nebulizers 2001, Porter-Jones 2000; Nursing Times 2007