NEBULIZERS

Truly Effective Breathing Technique for Using a Nebulizer

Nebulizers deliver medication effectively only when properly used. Noses are designed naturally to filter particles and will do so even when using a mask.  This makes it important for you to breathe through your mouth when using a nebulizer. In order to get the proper dosage, you need to take nice, slow normal breaths rather than deep breaths or holding your breath.  Deep breathing and breath holding does not necessarily apply the proper drug dosage to your lungs. 

Steps to Properly Medicate:

1. Measure the correct amount of solution(s) into the cup. This may be separate amounts of medicine and saline, or a pre-mixed solution that contains both.
2. Connect the mask or mouthpiece to the nebulizer cup. Use a mouthpiece when possible because it will deliver more medicine than a mask will.
3. Put the mouthpiece in your mouth and seal your lips around it; Or, place the mask on your face and secure the elastic band around until it fits snuggly.
4. Turn on the compressor.
5. Take slow breaths in and out through the mouth.
6. If using a closed system, remove the mouthpiece from your mouth before breathing out. If using a t-shaped mouthpiece with an open end you can inhale and exhale directly through the mouthpiece.
7. Continue this until the medicine is gone or for at least 10 minutes, or as directed by your Doctor. Some medicine may stay in the nebulizer cup along the sides. It is a good idea to tap the side toward the end to get all the medicine out of the cup.

Meter Dose Inhaler Use

Proper technique is critical when using an MDI. If your technique is wrong, too much of the medicine can end up in your mouth instead of your lungs.  This will, in turn, reduce the therapeutic capabilities of the medicine. Even with proper technique, as much as 80% of your dose may end up in your mouth and throat. For that reason, many doctors recommend that you rinse your mouth after using an MDI. This will reduce the bad taste and minimize unnecessary side effects. MDI spacers, sometimes called "holding chambers," are widely encouraged by asthma educators for people of all ages. Spacers work with your MDI to deliver medication more easily and effectively, and can reduce side effects.

When you use an MDI by itself, more of the medicine is left in your mouth and throat.  This wastes your dose and causes an unpleasant aftertaste. Spacers hold the "puff" of medicine between you and the MDI, so that you can inhale it slowly and more completely. As a result, more of the medicine gets into your airways. A comfortable mask can be added to the spacer for small children or others who have difficulty maintaining a good lip seal on the mouthpiece.

The best way to tell if you’re MDI has medicine left in it is to take it and put it in a bowl of water.  If it floats, it’s empty.  If it sinks, it may be full or partially full.

Optimal Technique for Use of MDI without Spacer

1. Warm the MDI to hand or body temperature.
2. Assemble apparatus (make sure there are no objects or coins in device that could be aspirated or obstruct out flow)
3. Shake canister vigorously and hold canister upright, placing inhaler 4 centimeters (approximately two fingers) away from mouth. Aim directly into the mouth. If you place it in your mouth, most of the medicine will just hit the back of your throat. It will then be absorbed into your blood stream rather then in your lungs where you need it the most.
4. After a normal exhalation, begin to inhale slowly while pressing down on the inhaler. Continue to breathe in until lungs are full.
5. Hold Breath for 10 seconds.
6. Wait 1 minute before taking another puff.

Optimal technique for use of MDI with spacer

1. Warm MDI to hand or body temperature.

2. Assemble apparatus (make sure there are no objects or coins in device that could be aspirated or obstruct out flow).

3. Shake canister vigorously.

4. Place inhaler into one end of aero-chamber spacer.

5. Place holding chamber in mouth or place into mask over nose and mouth.  

6. Remember that you must take the breath through your mouth.

7. Breathe normally and actuate inhaler at the beginning of your inhale.

8. Allow 30 – 60 seconds between puffs.