NEBULIZATION

Presented By:
Ms. Sinsu Rachel Alex
MSc. (N) Prev Yr
 DEFINITION
• Process of dispersing a liquid (medication)
into microscopic particles and delivering into
lungs as patient inhales through the nebulizer.

• It is used to liquefy and remove retained

secretions from the respiratory tract.
 Most aerosol medication have broncho
dilating effects and are administered by
respiratory therapy personnel.
 PURPOSES
• To relieve respiratory insufficiency due to
broncho spasm.
• To correct the underlying respiratory disorders
responsible for broncho spasm.
• To liquefy and remove retained thick
secretions.
• To reduce inflammatory and allergic responses
of the upper respiratory tract.
• To correct humidify deficit resulting from
inspired air by passing the airway during the
use of mechanical ventilation in critically and
post surgical patents.
• When a person has a acute asthma attack.
• When a person is in respiratory distress.
• If a person is unable to use a inhaler.
• If a person has stridor.
• Respiratory congestions
• Pneumonia
• Atelectasis
• Asthma
 HISTORY
• The first "powered" or pressurized inhaler was
invented in France by Sales-Girons in
1858. This device used pressure to atomize the
liquid medication. The pump handle is
operated like a bicycle pump. When the pump
is pulled up, it draws liquid from the reservoir,
and upon the force of the user's hand, the
liquid is pressurized through an atomizer, to be
sprayed out for inhalation near the user's
mouth.
• In 1864, the first steam-driven nebulizer was
invented in Germany. This inhaler, known as
"Siegle’s steam spray inhaler”.

• The first electrical nebulizer was invented in

the 1930s and called a Pneumostat.
 BERNOULIIS PRINCIPLE:

• By the mid 19th century the search was on for a device that
would turn a solution into a spray. It was believed that such
a device would break down the solution into atoms, and in
this way the solution could be inhaled. This breakdown was
thus referred to as atomization, pulverizing or nebulizing,
and the devices created were often referred to as atomizers,
pulverizers or nebulizers.

• Yet no such machine would have been invented if not for

the discovery of the Bernoulli Principle. Daniel Bernoulli
observed that when water hits a rock it creates a mist that
can be inhaled. He published a book in 1738 where he
described that a similar effect could be created by forcing
water through a narrow tube.
• His concept was based on the fact that the faster water flows
through a tube, the less the lateral pressure will be. A
decreased lateral pressure is also referred to as a negative side
stream pressure. If there is a hole in the side of the tube, the
negative pressure will force water into the stream.

• This same concept was used in creating the first nebulizers,

only using air. Air is forced through a tube, and a hole in the
tube is connected to a container with a solution in it that
contains the medication. The fluid is basically sucked in due
to the negative sidewall pressure, and turned into a spray or
mist.
 TYPES OF NEBULIZER:

• Inhaler or meterd-dose nebulizer

• Jet nebulizer
• Ultrasonic nebulizer
 FUNCTION:

• A nebulizer is a device that uses a small

compressor to convert liquid medication into
tiny droplets of mist that can be inhaled
directly into the lungs.
• Since the medication goes straight to the
lungs, onset of the medication’s action often
takes place rapidly.
• This promotes quick symptom relief in the
case of illnesses such as asthma, where fast
relief is desirable.

• Also, it minimizes the risk of side effects of

the medication, preventing the medication
from being metabolized into a less effective
form by the body.
 EQUIPMENTS:
• Nebulizer and nebulizer connecting tube
• Mouthpiece/mask

• Respiratory medication to be
administered
• Normal saline solution
• Sterile water
• Cotton balls
• Face mask
• Sputum mug with disinfectant
• Disposable tissues
• Kidney tray
• Medication card
SNO. PROCEDURE RATIONALE

1. Identify patient and check Ensures that the right procedure has
physician’s instructions. been done for the patent.
2. Monitor heart rate before and after Drugs may cause tachycardia
the treatment for patients using palpitation, dizziness, nausea, or
bronchodilator drugs. nervousness
3. Explain the procedure to the Proper explanation of the procedure
patient. This therapy depends on helps to ensure patient’s cooperation
the patient’s effort. and effectiveness of the treatment.
4. Place the pt in a comfortable Diaphragmatic excursion and lung
sitting or a semi fowlers position. compliance are greater in this position.
This ensures maximal distribution and
deposition of aerosolized particles tp the
base of lungs.
5. Add the prescribed amount of Aerosol particles enable deep
medications to the medicine chamber of penetration into tracheobronchial
the tubing. Connect the tube to the tree.
compressor.
A fine mist from the device should be
visible.
6. Place the mask on patient’s face to cover This encourages optimal
his mouth and nose and instruct him to dispersion of the medication.
inhale deeply and slowly through mouth,
hold breath and then exhale several
times.
7. Observe expansion of chest to ascertain This will ensure that the
that patient is taking deep breaths. medication is deposited below the
level in the oropharynx.
8. Instruct the pt to breath slowly and Medication will usually be
deeply until all the medications is nebulized within 15 mins.
nebulized.
9. On completion of the treatment The medication may dilate airways
encourage the patient to cough after facilitating expectoration of
several deep breaths. secretions.
10. Observe the pt for any adverse reaction Patient may develop
to the treatments. bronchospasms due to inhalation of
aerosol.
The fluid may also cause dried and
retained secretions in airways,
leading to narrowing of the airway.

11. Document the medication used and the Proper documentation is a proof of
description of the secretions work done and observed.
expectorated.
12. Disassemble and clean nebulizer after Proper cleaning, sterilization and
each use. Keep the equipment in pt’s storage of equipments prevents
room. Tubing’s to be changed in every organisms from entering the lungs.
48hrs.
13. Wash hands.
 PROCEDURE:

1.Position the patient appropriately, allowing

optimal ventilation. (semi fowlers position)
2.Assess and record breath sounds, respiratory
status, pulse rate and other significant
respiratory functions.
3.Teach patient the proper way of inhalation.
4. Prepare equipments at hand
5. Check doctor’s orders for the medication, prepare
thereafter
6. Place the medication in the nebulizer (can add a
amount of saline solution if ordered)
7. Attach the nebulizer to the compressed gas source

8. Attach the connecting tubes and mouthpiece to

the nebulizer
 Turn the machine on (notice the mist produced
by the nebulizer)
10. Offer the nebulizer to the patient, offer
assistance until he is able to perform proper
inhalation (if unable to hold the nebulizer
[pediatric/geriatric/special cases], replace the
mouthpiece with mask.
 AFTER CARE

• Each time it is used, wash the nebulizer

chamber in warm water or clean with a spirit
swab and then rinse thoroughly with clean
water. Do not use a brush to clean the
nebulizer chamber as it may damage it.

• Reconnect the nebulizer chamber to the

tubing and blow air from it.
• This will dry the nebulizer chamber and
tubing. Disconnect the nebulizer chamber
from the tubing and allow it to dry completely.
Disconnect the tubing from the compressor
unit.
 SIDE EFFECTS
• Dry or irritated throat, temporary or occasional
cough

• Sneezing, stuffy or itchy nose, watery eyes.

• Burning or bleeding of your nose

• Nausea, heartburn, stomach pain.

• Urinating more or less than usual.

• Dizziness, drowsiness, headache.

• Unusual or unpleasant taste in your mouth.

 CONTRAINDICATIONS:

• In some cases, nebulization is restricted or

avoided due to possible untoward results or rather
decreased effectiveness such as:
• Patients with unstable and increased blood
pressure
• Individuals with cardiac irritability (may result to
dysrhythmias)
• Persons with increased pulses
• Unconscious patients (inhalation may be done via
mask but the therapeutic effect may be
significantly low)