Nebulizers Of Asthma

A nebulizer is a machine of asthma that uses an air compressor to mix liquid medicine with air and form a mist that is inhaled through a mouthpiece
or face mask. (Technically, the "machine" part is the air compressor, and the "nebulizer" is the tubing with medicine cup. "Nebulizer" is used here in its broader, more common meaning as the whole device.) When children are first diagnosed with asthma, many times they are treated using a nebulizer. After this initial experience, parents may think that a nebulizer is the most preferred way to administer medi-cine. Nebulizers are just one way to give asthma medicines. Other devices may be more effective and less cumbersome. While many parents and even some health care professionals think that the nebulizer is the best way to give asthma medicine, research has not shown that to be true. Many children, especially infants and tod-dlers, don't seem to improve on a nebulizer because their caretakers have not been taught the proper technique for giving a nebulizer treat-ment. Proper technique is just as important when medicine is given by nebulizer as it is when given by an MDI/spacer or a DPI.
Sometimes parents observe incorrect techniques for nebulizer treatments administered by the "blow-by method," which is holding the tube, with mist coming out of it, in the child's face. This technique is often used when a child won't cooperate by wearing a mask or is too young to use a mouthpiece. The main problem with the blow-by method is that very little medicine gets down deep into the lungs where it is needed, and most of the medicine is wasted. When a mouthpiece or face mask is used with a nebulizer, it's important to be sure that your child takes slow, deep breaths and holds each breath for five to ten seconds before inhaling the next breath. If a child is allowed to breathe normally during the nebulizer treatment, the medicine won't get into the airways effectively. Another problem with using a nebulizer for an infant or toddler is that, while you may get him to wear the face mask, he is also crying and taking fast, shallow breaths rather than the proper deep, slower breaths. (See chapter 12 for more about infants and toddlers.)
Even when the proper technique is used, nebulizer treatments take about ten minutes or longer. Another drawback is that a nebulizer is not easily portable. This is an important issue because families are constantly on the go, and children may need to take medicine at day.
controller medicines. If a child uses Advair, for example, she would also have to be able to take quick-relief medicine by MDI with a spacer or nebulizer (discussed later in this chapter). The Diskus comes with a dose counter. Another controller medicine, budesonide, is an inhaled cortico-steroid that comes in two forms: Turbuhaler is a dry powder, and Respules are a liquid solution for a nebulizer. If a child is on the Pulmi-cort Turbuhaler, she'll need to take her quick-relief medicine (albuterol) by MDI/spacer or nebulizer. The Turbuhaler has an indicator to let you know when it's running empty. A third DPI device is the Aerolizer that contains formoterol (Foradil), which is similar to salmeterol. Both formoterol and salmeterol are long-term controller medicines, but they are not anti-inflammatory medi-cines. If formoterol or salmeterol is prescribed for your child, she will also need both an anti-inflammatory medicine and a quick-relief medi-cine. The Aerolizer is loaded with a one-dose capsule for each use so it's easy to check that the whole dose has been taken. When you discard the capsule after taking the dose, you can see whether or not the capsule is empty.
It's important to understand that there may be variations in how different DPIs are used. For example, the Pulmicort device is twisted one way, then the other. With Advair, the device is opened and then a lever is pulled. For both of these, a child must breathe in quickly and deeply once the tablet is crushed, and the medicine is deposited into his lungs. Advair has a slightly sweet taste, and Pulmicort does not. Often par-ents of children taking Pulmicort worry that their children aren't getting the medicine because they cannot taste anything. Your physician or .nurse practitioner can assess whether your child is capable of inhaling deeply enough to draw the powder into her lungs. These devices are very easy to use, and they have counters that tell how many doses are left.