I. Allergic reaction
(A) Clinical manifestations
1, respiratory symptoms patients appear wheezing, or the original wheezing symptoms aggravated.
2, systemic symptoms of allergic erythema, may be accompanied by chills, less often anaphylaxis.
(B) Preventive measures
1.Before performing nebulization inhalation, ask the patient if he/she has any history of drug allergy.
2. Observe the patient’s reaction during nebulization.
(C) Treatment measures
1.Terminate the nebulizer inhalation immediately when the patient has clinical symptoms.
2.Establish intravenous access and apply anti-allergic drugs, such as dexamethasone, etc.
3. Closely observe the vital signs and changes in condition, and actively treat anti-shock if there is shock.
Infection
(A) Clinical manifestations
1.Pulmonary infections varying degrees of high fever, inflammatory changes in the lungs and sputum with positive bacterial culture.
2, oral infections are mostly fungal infections, yellow or white spots may appear on the tongue or the inner wall of the mouth, patients feel painful and refuse to eat.
(II) Preventive measures
1.After the nebulization treatment, clean the nebulization tank, oral spout and channel, then disinfect with 500PPM oxygenated disinfectant solution, then wash and dry for use.
2.Use disposable mouthpiece; when oxygen nebulization treatment, nebulizer for exclusive use and wash after use.
(C) treatment measures
1.Pulmonary infections can be treated with antibacterial drugs.
2, oral fungal infections need to pay attention to oral hygiene, local treatment: such as gargling with 2%-4% sodium bicarbonate solution.
III. Respiratory distress
(A) Clinical manifestations
1, chest tightness, breathing difficulties, can not lie down.
2. Cyanosis of mouth, lips and face.
3. The patient has a painful face, irritable, sweating, etc.
(B) Preventive measures
1.Choose the appropriate nebulizer and instruct the patient to choose the appropriate position to the patient.
2.Continuous oxygen inhalation during nebulization.
3.Control the time of nebulization inhalation and clear the sputum in time to avoid blocking the airway.
(iii) Treatment measures
1.Once respiratory distress occurs, assist the patient to take a semi-sitting or sitting position to facilitate breathing and suspend nebulized inhalation.
2.Pat the back and encourage the patient to cough and excrete sputum to keep the respiratory tract unobstructed.
3.Negative pressure aspiration if necessary.
4. Closely observe the change of condition.
Hypoxia and carbon dioxide retention
(I) Clinical manifestations
1. The patient complains of chest tightness and shortness of breath.
2.Shallow and rapid breathing, cyanosis of skin and mucous membrane, accelerated heart rate and increased blood pressure.
3.Blood gas analysis shows reduced partial pressure of oxygen and high partial pressure of carbon dioxide.
(B) Preventive measures
1.Assess the patient’s condition before nebulizer inhalation treatment.
2.Appropriate warming during oxygen nebulization inhalation to avoid respiratory spasm caused by low gas inhalation.
3, nebulization at the same time to give oxygen.
4, infants and children nebulization when the volume of mist should be small, about 1/3 ~ 1/2 of the adult, and the mask inhalation is better.
(C) Treatment measures
1.In case of hypoxia and carbon dioxide retention, stop nebulization inhalation immediately, increase oxygen flow, and ask the patient to breathe deeply.
2. Closely observe the changes in the patient’s condition and actively treat the symptoms.
V. Respiratory arrest
(A) Clinical manifestations
Sudden onset of respiratory distress, skin and mucous membrane cyanosis, or respiratory and cardiac arrest in severe cases.
(B) Preventive measures
1.Before using antibacterial drugs or biological dose of nebulizer inhalation, ask the patient’s allergy history in detail, and observe closely during nebulizer inhalation to prevent bronchospasm caused by allergy.
2, the first time nebulization or the elderly and frail people first with resistance, to adapt to then gradually increase the amount of fog.
3.Warm up the machine for 3 minutes before ultrasonic nebulization, and wrap the nebulizer with a hot towel outside the oxygen nebulizer inhalation to avoid stimulating the airway with low temperature gas.
(C) Treatment measures
(a) Apnea should be immediately given breathing airbag pressure oxygen, cardiopulmonary resuscitation for cardiac arrest.
VI. Retrograde
(A) clinical manifestations
Retrograde is a paroxysmal spasm of one or both diaphragms, accompanied by a sudden closure of the vocal cords during inspiration, emitting a short special sound.
(B) Preventive measures
The volume of mist can be adjusted downward appropriately during nebulized inhalation.
(C) Treatment measures
1.Talk to the patient about topics that are not related to treatment and cause emotional excitement to distract the patient’s attention and terminate the eruption.
2.Quickly drink cold water or stimulate the pharynx to try to stop the erratic reflux.
3.If the above treatment is ineffective, you can use chlorpromazine or metoclopramide (gastric reassurance) and other drugs to treat.
VII. Asthma attack and exacerbation
(I) Clinical manifestations
During nebulized inhalation or some time after nebulized inhalation is stopped, the patient develops wheezing or aggravation of wheezing, cyanosis of mouth, lips and face, and croup in both lungs on auscultation.
(II) Preventive measures
1.The volume of nebulizer inhalation should not be too large and the duration should not be too long for patients with persistent asthma.
2.Appropriate warming of the nebulizing solution during nebulization.
(C) Treatment measures
1.Stop nebulizer inhalation immediately when asthma occurs, take a semi-sitting position and give oxygen inhalation.
2.Keep the airway open and clear airway secretions in time.
3.Closely observe the change of condition and use the bronchospasm relief drugs.
4.If the condition cannot be relieved by the above treatment and the hypoxia is serious, tracheal intubation and assisted ventilation should be given.