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1. NEBULIZATION
PRESENTED BY
JASMINE JOSEPH

3. DEFINITION
Process of dispersing a liquid (medication)
into microscopic particles and delivering into
lungs as patient inhales through the nebulizer.
• It is used to liquefy and remove retained
secretions from the respiratory tract.

4. PURPOSES
• • To relieve respiratory insufficiency due to
• Broncho spasm.
• • To correct the underlying respiratory disorders
• responsible for Broncho spasm.
• • To liquefy and remove retained thick
• secretions.
• • To reduce inflammatory and allergic
responses
• of the upper respiratory tract.

5. • To correct humidify deficit resulting
from
inspired air by passing the airway during
the
use of mechanical ventilation in critically
and
post surgical patents.
• When a person has a acute asthma
attack.
• When a person is in respiratory
distress.
• If a person is unable to use a inhaler.

6. • If a person has stridor.
• Respiratory congestions
• Pneumonia
• Atelectasis
• Asthma

7. BERNOULIIS PRINCIPLE:
• • By the mid 19th century the search was on
for a device that
would turn a solution into a spray. It was
believed that such
a device would break down the solution into
atoms, and in
this way the solution could be inhaled. This
breakdown was
thus referred to as atomization, pulverizing or
nebulizing,

8. • His concept was based on the fact that the faster water
flows
through a tube, the less the lateral pressure will be. A
decreased lateral pressure is also referred to as a negative
side stream pressure. If there is a hole in the side of the
tube, the negative pressure will force water into the
stream.
• This same concept was used in creating the first
nebulizers,
only using air. Air is forced through a tube, and a hole in
the tube is connected to a container with a solution in it
that contains the medication. The fluid is basically sucked
in due to the negative sidewall pressure, and turned into a
spray or
mist.

9. TYPES OF NEBULIZER
• • Inhaler or metered-dose nebulizer
• • Jet nebulizer
• • Ultrasonic nebulizer

10. FUNCTION
• • A nebulizer is a device that uses a small
compressor to convert liquid medication into
tiny droplets of mist that can be inhaled
directly into the lungs.
• • Since the medication goes straight to the
lungs, onset of the medication’s action often
takes place rapidly.

11. • This promotes quick symptom relief in the
case of illnesses such as asthma, where fast
relief is desirable.
• Also, it minimizes the risk of side effects of
the medication, preventing the medication
from being metabolized into a less effective
form by the body.

16. EQUIPMENTS:
• • Nebulizer and nebulizer connecting tube
• • Mouthpiece/mask
• • Respiratory medication to be
administered
• • Normal saline solution
• • Sterile water
• • Cotton balls

17. • Face mask
• Sputum mug with disinfectant
• Disposable tissues
• Kidney tray
• Medication card

18. SNO. PROCEDURE RATIONALE
1. Identify patient and check
physician’s instructions.
Ensures that the right procedure has
been done for the patent.
2. Monitor heart rate before and after the
treatment for patients using bronchodilator
drugs.
Drugs may cause tachycardia
palpitation, dizziness, nausea, or
nervousness
3. Explain the procedure to the
patient. This therapy depends on
the patient’s effort.
Proper explanation of the procedure
helps to ensure patient’s cooperation
and effectiveness of the treatment.
4. Place the patient in a comfortable
sitting or a semi fowlers position.
Diaphragmatic excursion and lung
compliance are greater in this position.
This ensures maximal distribution and
deposition of aerosolized particles tip the
base of lungs
5 Add the prescribed amount of
medications to the medicine chamber of the
tubing. Connect the tube to the compressor. A
fine mist from the device should be visible.
Aerosol particles enable deep
penetration into tracheobronchial
tree.

19. 6. Place the mask on patient’s face to cover his
mouth and nose and instruct him to inhale
deeply and slowly through mouth, hold breath
and then exhale several times.
This encourages optimal
dispersion of the medication.
7. Observe expansion of chest to ascertain that
patient is taking deep breaths.
This will ensure that the
medication is deposited below the
level in the oropharynx.
8. Instruct the patient to breath slowly and deeply
until all the medications is nebulized.
Medication will usually be
nebulized within 15 min.
9. On completion of the treatment
encourage the patient to cough after
several deep breaths
The medication may dilate airways
facilitating expectoration of
secretions.

20. 10. Observe the patient for any adverse
reaction to the treatments.
Patient may develop bronchospasms due to
inhalation of aerosol. The fluid may also
cause dried and retained secretions in
airways, leading to narrowing of the airway.
11. Document the medication used and the
description of the secretions
expectorated.
Proper documentation is a proof of
work done and observed.
12. Disassemble and clean nebulizer after
each use. Keep the equipment in
patient’s room. Tubing’s to be changed
in every 48hrs.
Proper cleaning, sterilization and
storage of equipment prevents
organisms from entering the lungs.
13 Wash hands.

21. PROCEDURE:
• 1.Position the patient appropriately, allowing
• optimal ventilation. (semi fowlers position)
• 2.Assess and record breath sounds,
respiratory
• status, pulse rate and other significant
• respiratory functions.
• 3.Teach patient the proper way of inhalation.

22. 4. Prepare equipments at hand
5. Check doctor’s orders for the
medication, prepare
thereafter
6. Place the medication in the nebulizer (can
add a
amount of saline solution if ordered)
7. Attach the nebulizer to the compressed gas
source
8. Attach the connecting tubes and mouthpiece
to the nebulizer

23. 9.Turn the machine on (notice the mist
produced by the nebulizer)
10. Offer the nebulizer to the patient,
offer assistance until he is able to
perform proper inhalation (if unable to
hold the nebulizer
[pediatric/geriatric/special cases],
replace the mouthpiece with mask.

24. AFTER CARE
• • Each time it is used, wash the nebulizer chamber in warm
water or clean with a spirit swab and then rinse thoroughly with
clean water. Do not use a brush to clean the nebulizer chamber
as it may damage it.
• • Reconnect the nebulizer chamber to the tubing and blow air
from it.
• • This will dry the nebulizer chamber and tubing. Disconnect
the nebulizer chamber from the tubing and allow it to dry
completely. Disconnect the tubing from the compressor
unit.

25. SIDE EFFECTS
• • Dry or irritated throat, temporary or occasional
cough
• • Sneezing, stuffy or itchy nose, watery eyes.
• • Burning or bleeding of your nose
• • Nausea, heartburn, stomach pain.
• • Urinating more or less than usual.
• • Dizziness, drowsiness, headache.
• • Unusual or unpleasant taste in your mouth.

26. CONTRAINDICATIONS:
• • In some cases, nebulization is restricted or
avoided due to possible untoward results or
rather decreased effectiveness such as:
• • Patients with unstable and increased blood
pressure
• • Individuals with cardiac irritability (may result
to dysrhythmias)
• • Persons with increased pulses
• • Unconscious patients (inhalation may be
done via mask but the therapeutic effect may
be significantly low)