Nebulizers
A nebulizer is actually a device that includes an air compressor and tubing with a medicine cup that helps mix liquid medicine in the air. This creates a mist that can be breathed through a mouthpiece or a mask.
Nebulizers often are used for young children — particularly with quick-relief medications or inhaled corticosteroids. For infants and toddlers, a mask should be used; for children over age five, a mouthpiece should be used.
Alert!
The nebulizer should never be used by applying the “blowout” method, which is circling the mist around the child's face rather than using a mouthpiece or mask. This is ineffective, especially when the child is crying, because he cannot properly breathe in the medicine.
A child should be reminded to breathe deeply and slowly — then hold that breath for five to ten seconds — when using the nebulizer. If the child breathes normally during the treatment, much of the medicine will not enter his airways.
If nebulizers are used correctly, they can do their job. But, the size and bulkiness of a unit hinders its portability. Smaller battery-powered nebulizers are available for traveling.
In terms of benefits of nebulizers over portable inhalers, researchers have not found any great differences between the two.
Using a Nebulizer
Using a nebulizer usually takes more time than the other devices. Once the device is set up, you will need to:
Place the medicine into the nebulizer cup, and attach the mouthpiece or the mask to the nebulizer.
Have the child wrap her lips around the mouthpiece. (A mask will require additional discussion with a health care provider.)
Once the nebulizer is on, the child should breathe in deeply and hold her breath for five to ten seconds.
The process should be continued until the cup is empty (about ten minutes).
Home Nebulizer Dangers
While home nebulizers may seem helpful in controlling asthma symptoms, researchers are concerned that if they are used improperly, they could lead to serious asthma complications and even death. This could occur, Michigan State University researchers reported, if the home nebulizers are not used according to the National Asthma Education and Prevention Program (NAEPP) guidelines.
Essential
The widespread prescription and use of home nebulizers in asthma may have the unintended consequence of contributing to an over-reliance on quick-relief medications and inadequate use of longer-acting preventive medicines. The result could be a delay in seeking medical care during an asthma flare-up and poor management of chronic asthma.
In the study, the researchers looked at all asthma deaths that occurred between 2002 and 2004 in people between the ages of two and thirty-four years old. During that time period, eighty-six people in the specified age group died as a result of their asthma, with thirty-eight of them children. Fifty-two people who died had a home nebulizer. They found that thirty of those people used their machines regularly — usually between once a week to six times a day. While about two-thirds of those who used their nebulizers regularly were prescribed either inhaled or oral steroids, only a third used them as directed.
Although thirty-eight of the people who died had peak flow meters, only eight used them daily, the researchers found. And, only nine out of the fifty-two people with nebulizers had written asthma action plans. Having the nebulizers for use at home may lead to a sense of complacency that they can handle any emergency, but sometimes an asthma flare-up may be more serious than anticipated — leading to serious or fatal results.
