Nebulizer inhalation therapy is a treatment method that applies a nebulizer device to disperse drugs into tiny droplets in the form of aerosol spray, so that they are suspended in the gas and inhaled by the respiratory tract through the nose or mouth, the advantages of which are that the drug can act directly on the lesion, the amount of drug required, fast onset of action, the drug does not go through the liver and kidney circulation and other advantages widely used in pediatrics respiratory.
At present, in our clinic, more and more parents will nebulize their children at home for convenience and to avoid cross-infection, but we found that there are many problems in home nebulization, which affect the therapeutic effect. Therefore, some of the problems that need attention in home nebulization are organized for your reference!
I. Which diseases are suitable for nebulizer treatment.
Bronchial asthma, bronchitis, capillary bronchitis, pneumonia, allergic cough, allergic rhinitis, pharyngeal and laryngitis during acute attacks must be treated by nebulization inhalation; various other respiratory infectious diseases with difficult sputum excretion, allergic diseases, diseases requiring airway humidification can be treated by nebulization inhalation.
Second, the choice of nebulizer.
There are two main types of nebulizers sold in the market, one is ultrasonic nebulizer and the other is high-pressure pump nebulizer inhaler. Ultrasonic nebulization is mainly used for the treatment of upper airway diseases, the diameter of the fog particles is 3.7-10.5μm, easy to deposit in the upper respiratory tract and atmospheric tract; inhalation time is longer (10-30 minutes) and other shortcomings are not recommended to buy. It is recommended that parents choose high-pressure pump nebulizer inhaler, the diameter of the fog particles <5μm, easy to deposit in the lesion of the bronchi or alveoli to play a role, the advantage is that the aerosol can reach the lower airway, upper and lower airway diseases can be treated, inhalation time is short (10-15 minutes), good drug efficacy and other advantages. Many parents think that "any machine that can emit fog can be used to treat a cough". In fact, there are strict requirements for nebulization to treat tracheal and pulmonary diseases in children. One is that the pressure must be stable, and the second is that the particles emitted must be uniform in size, with a particle diameter of <5 μm, so that the drug can be deposited in the diseased bronchi or alveoli. The unqualified machine used for nebulization is also the reason why many children with the same drug nebulization effect is not good III. Commonly used drugs for nebulization treatment.
At present, the drugs routinely used in our pediatric asthma center are
1. Budesonide suspension (0.5-1mg/time, 2-4 times a day).
2. Ipratropium bromide suspension (250ug/dose, 2-4 times daily).
3. Salbutamol sulfate solution (0.5ml/2.5mg for children, 2-4 times a day) or terbutaline sulfate nebulizer (1ml/2.5mg, 2-4 times a day).
The above is the conventional dose of nebulizer treatment, but the doctor will adjust the treatment according to the condition of the child.
IV. Choice of nebulization device.
1.For children over 7 years old, it is recommended to use mouthpiece inhalation, and first train the child to breathe in through the mouth and out through the nose.
2, children under 7 years old use the mask inhalation, the mask covers the child’s mouth and nose.
V. Precautions when nebulizing.
1.Select the child to inhale when he/she is not crying and quiet.
2, do not apply oily cream before nebulization inhalation, the newly opened nebulization mask first connect and then open the switch to blow 1-2 minutes after adding medicine.
3, nebulized inhalation to keep the nebulized jet cup upright, the upper body of the child to keep upright, increase the chance of gravity deposition of inhaled drugs to improve the therapeutic effect and prevent drugs from splashing into the eyes.
4, nebulizer inhalation process pay attention to observe the child’s face and breathing, if there is purple lips, breathing speed up or slow down should be stopped immediately, do not force nebulizer treatment.
5.After nebulizer inhalation, clean the face, mouth and pharynx, gargle for older children, wipe the mouth with saline cotton balls for younger children, and let the child drink water or eat milk after 10 minutes.
6. After nebulized inhalation, tap the child’s back with the palm of the empty hand from bottom to top and from outside to inside to promote sputum discharge.
Six, the maintenance and maintenance of nebulized inhalation equipment.
1, compressed air nebulizer should be used on a clean table, not on carpets, beds, sofas and other dusty places, do not cover the machine 2, nebulizing jet cup and nebulizing mask after use with 40 ℃ warm water to wash and dry for use (also available to add detergent cleaning or 500mg / L chlorine disinfectant soaked for half an hour, remember that the detergent or chlorine disinfectant must be rinsed clean to dry for use). Remember not to boil, air ducts are not recommended for cleaning.
3, the atomization jet cup is recommended to use 15-20 days to replace.