Nebulizer therapy sends medication deep into the lungs. Lung medications work best when they are inhaled as a fine mist. The two types of medicines used most often in nebulizers are bronchodilators to help relieve wheezing or coughing, and anti-inflammatory medicines to help prevent wheezing or asthma symptoms.
The most commonly used nebulizer shoots a stream of air through the liquid medicine to create a fine mist. Medicines come in many different forms. Talk to your pharmacist, home care nurse or respiratory therapist if you have questions or concerns. Find a quiet area in your home where treatments can be taken comfortably and without interruption. Wash hands carefully before using the nebulizer to stop the spread of germs.
Nebulizer treatments can be taken one of three ways based on a child's age and level of cooperation:
Mouthpiece treatments are good for children ages 8 years and older. The child places the mouthpiece between their teeth, using their lips to form a tight seal. Children as young as 6 years old can be coached to take mouthpiece treatments. This may not be effective in the middle of the night when the child is sleepy.
Mask treatments should be used for children less than 8 years old. An aerosol mask is placed on the nebulizer, and then secured over the nose and mouth of the child. The mist is breathed in through the child's mouth and nose. Placing a mask on a young child can be scary. One way to help children with this fear is to let them play with the mask before the treatment. If they become upset, try to calm them down. Most young children will stop crying shortly after the treatment starts.
Blow-by treatments are for very small infants or children who cannot tolerate a mask treatment. This method directs the mist at the patient's nose or mouth through a flex tube. It sends very little medication to the infant's lungs.
To use a nebulizer, place the child in an upright position. Turn on the nebulizer and keep it upright. Tell the older child to take deep breaths through the mouth. Depending on the amount of medication to be used, the treatment will usually last 10-15 minutes. When the nebulizer begins to sputter, shake or tap it once or twice. If it continues to sputter, the treatment is done.
If you use your nebulizer every day, clean it every other day.
Always keep an extra nebulizer on hand.
Prior to using, check nebulizer parts for cracks or caking of material inside.
If the treatment is longer than 10 or 15 minutes, check the mist output. The nebulizer may be clogged or a dirty filter can obstruct the airflow from the compressor.
If the treatment is shorter than normal, check to see if the medicine is leaking out of the nebulizer.
A nebulizer that is taken care of should last for 100 treatments.
Frequently Asked Questions
1. Are treatments more effective when the child is crying?
Treatments are better when the child is calm; however, crying may induce coughing that may help clear loose secretions.
2. Is it normal for children to cry, kick and scream when first beginning breathing treatments? Preschool age children often do not enjoy breathing treatments and need special time and attention during the treatment.
3. Is it unusual for a child to vomit after crying hard? Crying children usually swallow air and mucus. This can cause nausea and vomiting. Crying and coughing can stimulate the gag reflex and cause some vomiting. If this happens often, call your healthcare provider.
4. How do I know when to give treatments? Always talk about the treatment plan with your healthcare provider. Treatments are based on the type of medication and the symptoms of the child. Some medications are not given for fast relief of symptoms.
5. Can someone in the house smoke during the treatments?
Smoke is always very irritating to infants and children. Smoking around a sick infant is dangerous.
Linda Jacobs, BS, RRT-NPS, AE-C, is respiratory education coordinator at Cook Children's Health Care System, Forth Worth, TX.
The purpose of this patient education handout is to further explain or remind you about a medical condition. This handout is a general guide only. If you have specific questions, be sure to discuss them with your healthcare provider. This handout may be reproduced for distribution to patients.