Administering a nebuliser

Question 1

How do you initiate the procedure?

Answer 1

1. introduce self, identify patient
2. explanation + rationale - “we’re going to be giving you some medication though something called a nebuliser, this basically turns your medication into a fine mist which you will inhale by breathing normally. We’re doing this to ____ (improve your asthma etc), does this sound okay?”
3. any known allergies to drugs?
4. wash hands

Question 2

How do you set up a nebuliser?

Answer 2

1. collect equipment - electric air compressor, tubing, nebulsier chamber (base, lid, diffuser), mouthpiece (or mask - not for the exam), medication
2. assemble and fill - open nebuliser chamber, check date/route etc on patients notes and put medication into the base and reclose, keep upright and connect tubing to bottom of neb base and to the compressor, hold neb upright and turn compressor on - mouthpiece should emit cool vapour
3. do not remove nasal cannulae (as would compromise existing oxygen therapy and lead to desaturation), ask patient to sit upright and hold the neb chamber upright, instruct patient to breath normally though their mouth into mouthpiece/mask, check patient welfare
4. some medications ie steroids and anticholinergics should be used with mouthpieces as can exacerbate other conditions (glaucoma)
5. to monitor the efficacy of the treatment, take a peak flow 20 mins after the neb has finished