Steam inhalation

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1. S Steam inhalation BY, MR. ABHIJIT BHOYAR M. SC. NURSING CHILD HEALTH

2. Steam inhalation is one of the most widely used home remedies to soothe & open the nasal passages and get relief from the symptoms of cold or sinus infections Meaning Inhalation means the inhaling of medicines or anaesthetics in the form of a gas or vapour .

3. To relieve inflammation of the mucous membrane in acute cold & in sinusitis. It produces symptomatic relief. To soften thick, tenacious mucous & relief coughing from many causes Purposes

4. To aid in the absorption of oxygen. To provide warm and moist air following the operation. Eg . Tracheostomy . To provide antiseptic effect on the upper respiratory tract. Purposes Tracheostomy .

5. Methods of steam inhalation JUG METHOD STEAM TENT ELECTRIC STEAMER

6. Always remember the danger involved of scalding the patient either with the steam or with the water coming out of the inhaler . (This is particularly important when the patient is very young, very old, acutely ill or in a state of confusion. In these cases, the spout of the inhaler must be placed in such a way that the patient can not touch it or put his face too near). GENERAL INSTRUCTIONS Avoid scalding

7. 2. When jug or kettle is used, fill it only 2/3 with boiling water to prevent scalding of the patient . ( If the inhaler is filled to the brim, there is possibility of drawing water into the mouth and scalding the patient. The water should remain just below the spout. If the spout is filled with the water, it will not act as an air inlet. The patient will not get warmed air.) GENERAL INSTRUCTIONS Fill it only 2/3 with boiling water

8. 3 . Always remember the danger of fire. ( If a stove is used with a kettle to generate steam continuously, as in the case of steam tent, the blankets used may fall on the stove and catch fire). 4. Have the water in the jug method at a moderate temperature . { The temperature is maintained between 120 to 160 F ( 54.4 to 76.7 C). If the water is cold, it will not generate steam. If the water is too hot, it may cause scalding of the patient}

9. 5. Keep the patient warm and prevent draught before, during and after the inhalation . (During the treatment, the blood vessels of the skin and mucus membranes are dilated and the patient is easily chilled when exposed to draught. This predisposes him to a more severe and prolonged attack of inflammation and congestion. Therefore the patient should not go into a cold atmosphere for several hours after the treatment. The windows and doors are closed and the fan is put off during the treatment to prevent draught. Ask the patient to empty the bladder to ensure that the patient will remain on the bed for several hours after inhalation).

10. 6. When volatile drugs are used. ( e.g ., menthol, warn the patient to keep his eyes closed to prevent the drug irritating the conjunctiva .) 7. Watch the patient closely throughout the procedure for any adverse effects. ( Provide a calling device near the patient to call the nurse in case of necessity). 8. When giving inhalation by jug method, keep the spout away from the patient. ( This is a precaution to prevent scalding of the patient, should the patient tilts the jug during inhalation.) If not closed the eyes , it may get conjunctivitis

11. 9. Place a sputum cup in the reach of the patient ( to spit the sputum that is coughed up during the inhalation.) 10. Explain the procedure to the patient before the preparation of the inhalation , ( so that no time is lost to start the inhalation once the inhaler with boiling water is taken to the bedside. If the time is lost for explanations the temperature of the water will be reduced.) Sputum cup

12. Preliminary Assessment NURSES RESPONSIBILITY IN THE ADMINISTRATION OF STEAM INHALATION. USING A NELSONS INHALER . 1 2 3

13. NURSES RESPONSIBILITY IN THE ADMINISTRATION OF STEAM INHALATION. 4 5 6

14. SR. NO. ARTICLES PURPOSES 1 Nelson’s inhaler with a mouth piece To use as a vaporizer 2 Bowl or basin To hold the inhaler 3 Flannel piece or a towel To wrap around the inhaler to prevent the heat loss 4 Face towel To wipe the face of the patient 5 Bath blanket or bath towel To put over the patients head’s and the jug to prevent the loss of steam 6 Tr. Benzoin /any other inhalant ordered Used as a respiratory antiseptic PREPARATION OF ARTICLES . Nelson’s inhaler

15. SR. NO. ARTICLES PURPOSES 7 Tea spoon or minim glass To measure the inhalant 8 Kettle with boiling water 9 Gauze piece To wrap around the mouth piece 10 Cotton swab To plug the spout 11 Kidney tray and paper bag To collect the waste PREPARATION OF ARTICLES . minim glass Gauze piece Cotton swab

16. Explain the procedure to the patient to win his confidence and co-operation. (Explain the sequence of the procedure and tell him how he can take the inhalation.) Make the patient to understand that he has to remain in the bed one to two hours more after the inhalation Preparation of the Patient and the Environment

17. 3. Ask the patient to go to the toilet and empty the bladder and bowels, if necessary . (For a bed ridden patient, offer bed pan or urinal, so that he will not be disturbed during the procedure. Emptying the bladder and bowels ensures that the patient will remain on the bed for several hours after the inhalation) 4. Place the patient in a Fowler's position with a cardiac table in front . If the movements are restricted, place him in a side lying position, or place him in any position which is comfortable to him ( e.g ., sitting with a pillow on the lap). Preparation of the Patient and the Environment

18. 5. Close the doors and windows and put off the fan to prevent draught . 6. Place the sputum cup in a convenient place within the easy reach of the patient. 7. Provide a face towel to the patient to wipe the sweating from the face during the inhalation. Preparation of the Patient and the Environment

19. Procedure PROCEDURE RATIONAL 1. Measure the capacity of the inhaler with cold water. Measure the capacity when it is filled half to two thirds full. To determine the amount of inhalant 2. Warm the inhaler by pouring a little hot water into the jug and emptying it To maintain the temperature of the water, constant for a longer period.

20. PROCEDURE RATIONAL 3. Pour the required amount of inhalant into the inhaler and fill the jug 2/3 with hot water. The water should remain just below the spout. If the inhaler is filled to the brim, there is possibility of drawing water into the mouth and cause scalds. If the spout is filled with water, it will not act as an air inlet. The patient will not get warm air 4. Place the mouth piece and close the jug tightly. See that the mouth piece is in the opposite direction to the spout This arrangement keeps the spout away from the patient when inhalation is taken in. 5. Cover the mouth piece with a gauze piece and plug the spout with a cotton ball. Covering the mouth piece with a gauze piece will prevent burns of the lips. Cotton ball in the spout will prevent escape of steam

21. PROCEDURE RATIONAL 6. Cover the jug with a flannel piece or a towel To insulate the jug and to prevent the heat loss. 7. Place the inhaler in the basin and take it to the bedside without losing time Placing the jug in the basin reduces the chances for burns

22. PROCEDURE RATIONAL 8. Place the apparatus conveniently in front of the patient with the spout opposite to the patient. Remove the cotton plug and discard it into the paper bag. Keeping the spout opposite to the patient reduces the chances of burns. Removing the cotton plug helps to keep up the patency of the spout for the air. 9. Instruct the patient to place the lips on the mouth piece and breath in the vapour . After removing the lips from the mouth piece, breath out the air. Alternately, he should breath in the steam through the nostrils. Directing the steam through the nostrils relieves the congestion of the mucus membranes of the nostrils.

23. PROCEDURE RATIONAL 10. Cover the patient's head and jug with a bath blanket or a bath towel. To help to collect the steam around the face of the patient, thereby the concentration of the steam will be increased

24. Continue the treatment for 15 to 20 minutes , or as long as the patient gets the vapours . Remove the inhaler from the patient after the stated time. Wipe off the perspiration from the face. After Care of Patient and the Articles

25. 3 . Remove the back rest and the cardiac table. Adjust the position of the patient in bed. Make him comfortable. Tidy up the bed. 4. Instruct him to remain in bed for 1 to 2 hours to prevent draught. After Care of Patient and the Articles

26. 5. Take the articles to the utility room. Empty the inhaler, clean it inside with spirit to remove Tr. benzoin . Then wash it with warm soapy water . Rinse with clean water . Remove the gauze covering the mouth piece and clean the mouth piece thoroughly. Boil it to prevent cross infection . All the other articles are cleaned with warm soapy water and then with clean water. Dry and replace them in their proper places . Wash hands. After Care of Patient and the Articles

27. 6 . Record the procedure on the nurse's record with date and time. Record the patient's response to the procedure. 7. Return to the patient to assess his comfort and to observe any untoward reactions in him. Offer hot drinks if needed. After Care of Patient and the Articles

28. THANK YOU