Nebulizer

#nebulizer

1. NEBULIZER PATEL.YASH.GIRISHBHAI (KAPC)

2. Nebulizer is the device may be used for inhalation of drugs. It is also used for moistening airways with saline or sterile water.

3. PRINCIPLE OF NEBULIZAR A nebulizer converts solutions into aerosol particles which are suspended in stream of gas. Nebulizer is defined as the process of reduction of bulk liquids into fine spray in which large particles are removed by introduction of suitable type of baffle

4. The aim of nebulizer therapy is to deliver a therapeutic dose of prescribed drug as an aerosol in the f rom of repairable particles (particles <5 micrometer in diameter) in acceptable period of time, approximately 5 to 10 minutes.

5. INDICATIONS Patient with thick tenacious secretions. Patients who need to clear secretions but are mouth breather, find expectoration difficult. Patients whose humidifying system has been bypassed by tracheal tube. Babies with respiratory problem whose small airways easily block with secretions Useful in chronic obstructive and restrictive diseases. Patients with bronchospasm.

6. DRIVNG GAS Most jet nebulizer operates efficiently with a flow rate of 6-8 lit/min. For patients in hospital it is convenient to use piped oxygen supply. In hypoxic patients without carbon dioxide retention, oxygen should be used.

7. Delivery Devices Face mask Mouth piece

8. DELIVERY DEVICES CONTINUE INTUBATED PATIENTS Endotracheal tube Tracheostomy tube

9. Jet Nebulizer Ultrasonic Nebulizer

10. TYPES OF NEBULIZER JET NEBULIZER With jet nebulizer, a driving gas(electric air compressor or compressor air or oxygen) is forced through a narrow orifice The negative pressure created around orifice draws solution up the feed tube from the liquid reservoir and the jet of gas fragments the liquid into droplets.

11. ULTRASONIC NEBULIZER An aerosol can be created by the high frequency sound waves (1-2 MHZ) An electric current applied to piezoelectric crystal causes ultrasonic vibrations The sound waves will travel through a liquid to the surface they produce an aerosol The particle size is influenced by the frequency of oscillation of the crystal.

12. ADVANTAGES OF US NEBULIZER OVER JET NEBULIZER It can produce higher output than jet nebulizers. They operate quietly. Suitable for home use. Very useful for delivering high humidity to patients with tenacious sputum to aid expectoration.

13. DISADVANTAGES It is expensive Few models require the patient to breathe in actively to open a valve of nebulizer so patient with very poor respiratory reserve and children may find this additional effort difficult.

14. NEBLIZER PERFORMANCE performance of nebulizer is measured with it’s respirable output. Respirable output: it is mass of respirable particles (<5 micrometer) produced particles minute. Respirable fraction: percentage of respirable particles in aerosol. It must be atleast 50%

15. DRUGES DELIVERED Wide variety of drugs can be administered Bronchodilators Corticosteroids Antibiotics Antifungal Mucolytic

16. DRUG IS DILUTED WITH SALINE TO MAKE IT AROUNS 4 ML For example 1ml salbutamol + 3ml saline 2ml ipratropium bromide + 2ml saline 1ml salbutamol + 2ml ipratropium bromide + 2ml saline

17. STEPS Have the patient in side-laying or sitting in a chair Select mask or mouthpiece according to patient preference. Masks may cause eye irritation, and mouthpieces are not suitable for breathless patients, but drug delivery is similar. Ensure that there is a minimum 4ml fill,and see the flow rate at 6-81/min

18. Ask the patient to breathe through the mouth. Nose breathing filters the drug and reduces lung deposition by a quarter. ADVICE THE PATIENT TO Breath – hold at end-inspiration at intervals. Tap the device when the liquid is beginning to fizz, in order to avoid drug wastages.

19. PROBLEMS WITH NEBULIZERS mask / mouthpiece Use of antibiotic requires filters Actylecysteine is inactivated by oxygen. So, when it is used the driving gas should be the air