“Delivery of Medication via Nebulizers” by Craig Smallwood for OPENPediatrics

By Adem Lewis / in , , , , , , , , , , , , /

Delivery of Medication via Nebulizers,
by Craig Smallwood. Before we proceed, we’ll also want to ensure
that the patient is in the correct position. I’m going to put the head of the bed to approximately
30 to 45 degrees. An important performance note about jet nebulizers,
is that they should be oriented approximately vertically to work effectively. Tilting the device too far, perhaps 20 to
30 degrees on any angle in any direction, can cause the medication to move away from
the jet gas port inside the device and render the treatment ineffective. If you notice a treatment you are administering
is taking a long period of time, or there doesn’t appear to be an appropriate volume
of aerosol generated, you may want to check the nebulizer to ensure proper vertical orientation. Next, I’m going to connect the nebulizer to
our gas source using oxygen tubing. It should be noted that in order to adequately
power jet nebulizers, a specific gas flow is required for this device. The manufacturer in this case recommends nine
liters per minute. However, it doesn’t necessarily matter what
type of gas. It could be 100% O2, air, Heliox, etcetera. You’ll need to exercise good clinical judgment
to determine the appropriate gas for your treatment. Often, patients receive 100% oxygen if there
are no contraindications. Simply because this is the most readily available
compressed gas in most institutions. But importantly, make sure that the gas flow
is not running when you connect it. You should wait until the setup is complete
and the device is adequately affixed to the child before you start the gas flow. This will minimize the amount of wasted drug
and maximize the received dose. Next, I have our drug. I’ve removed the cap and I’m going to take
our medication, which is in a liquid suspension, and place it inside the device. We are going to replace the cap, attach the
interface, affix the oxygen tubing to the bottom portion of the nebulizer, and place
the mask on our patient. I’m going to turn the oxygen flow rate onto
nine liters per minute, as per recommendations by the manufacturer. This treatment should last anywhere from 10
to 20 minutes.

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