Nebulisers

Hello, my names is Kathy Unwin, I’m one of the Nurse for the Special Needs School Nursing Team. The function of the respiratory system is to supply the body with oxygen and to remove carbon dioxide.

There are three main functions of the airway; to protect the lungs from any foreign matter that has been breathes in; to facilitate gaseous exchange, turn from the lungs; and control the humidity of the gases. In a deteriorating child, the breathing is usually the first thing to alter. This is the structure of the upper airway, and this is the structure of the lower airway. The respiratory assessments helps to assess the child's current status and identifies any changes. Some of which can be improved with intervention. Look for certain symptoms, including: decrease in oxygen saturations, increase in respiratory efforts and pulse, excessive secretions and respiratory noises. When carrying out respiratory assessments, it's important to use a look, listen and feel approach. Look at the breathing rate, efforts and use of muscles and nasal flaring, skin colour around the lips, fingers and toes. Has it changed at all? Or also clubbing at the fingers? Listen for respiratory noises is there any grunting or wheezing and feel for any chest or abdominal movements.

The nebulizer is an air compressor that delivers medication through a mouthpiece or mask as a fine mist, which is then inhaled into the lungs. They require an electrical supply to work and if prescribed oxygen, medication can be delivered along with the pressurized oxygen. Nebulizers are a commonly used by those with exacerbation of asthma, those with lung conditions. It's a form of humidification which loosens secretions. By using a nebulizer but can administer large doses of antibiotics and steroids, which are used to treat and control infections. The nebulizer will deliver medication directly into the lungs. It’s quick and easy and takes between 5 and 10 minutes to administer the medication. When using the nebulizer, there are three pieces of equipment needed to deliver the medication. They are the face mask, the mouthpiece and the tubing. The liquid is placed into the nebulizer chamber where it is turned to a fine mist which can then be inhaled into the lungs. The type of chamber depends on the method the delivery used. There are various different types of nebulizer and there are also different types of chambers. For delivery, the equipment needed includes the interface, the nebulizer chamber, tubing, prescribed medication, syringe and medication record sheets.

The medication should be prescribed by the GP and consultants and the administration of the medication should follow the 6 Rs: Right child, Right medication, Right dose, Right route, Right time and Right documentation. And ensure that appropriate PPE is worn at all times.

Nebulizer Administration. It is a good idea to ensure that everything's kept together on a tray and prepare the child to have the medication, ensure you have consent, make sure that they are sitting in a comfortable position, if using a mouthpiece, ensure that there is a seal formed between their teeth, lips and the mouthpiece. When the child is ready, turn the machine on. Encourage the child to take slow, deep breaths. As I said earlier, it should take between 5 and 10 minutes to administer the medication. Once it's finished, the machine will start to make a spitting noise, remove everything, and advise the child to take some deep breaths and to cough to clear out any secretions. Thank the child for their cooperation. Ensure that everything is recorded, dated and signed. Disconnect and cleaned all equipment as advised by the manufacturer.

Here are the references. Thank you for listening