NEBULIZATIO

Presented by -
Mrs. Khushnasib
Associate Professor
 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

physician’s instructions. has
been done for the patent.
2. Monitor heart rate before and after Drugs may cause tachycardia
the treatment for patients palpitation, dizziness, nausea,
using bronchodilator drugs. or nervousness

3. Explain the procedure to Proper explanation of the

the procedure
patient. This therapy depends helps to ensure patient’s
on the patient’s effort. cooperation and effectiveness of the
treatment.
4. Place the pt in a Diaphragmatic excursion and lung
comfortable compliance are greater in this position.
sitting or a semi fowlers position. This ensures maximal distribution and
deposition of aerosolized particles tp
the base of lungs.
5. Add the prescribed amount of Aerosol particles enable
medications to the medicine chamber of deep
the tubing. Connect the tube to the penetration into tracheobronchial
compressor. tree.
A fine mist from the device should be
visible.

6. Place the mask on patient’s face to cover This encourages

his mouth and nose and instruct him to optimal
inhale deeply and slowly through mouth, dispersion of the medication.
hold breath and then exhale several
times.

7. Observe expansion of chest to ascertain This will ensure that

that patient is taking deep breaths. the
medication is deposited below the
level in the oropharynx.
8. Instruct the pt to breath slowly Medication will usually
and 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 facilitating expectoration
after several deep breaths. of secretions.
10. Observe the pt for any adverse reaction Patient may
to the treatments. develop
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
each use. Keep the equipment in pt’s and
room. Tubing’s to be changed in every storage of equipments
48hrs. prevents organisms from entering
the lungs.
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)
Thank you