2. WHAT IS THE NEBULIZER.???
• Nebulizers are devices generate aerosols from solutions.
• Aerosol: A substance enclosed under pressure and released as a fine spry by means of
propellant gas.
• Sterile liquid is converted into an aerosol, whose droplets are small enough to navigate
the nasal passages and vocal cords, and reach the airways.
• Nebulizers used for delivering drugs.
3. WHAT IS THE NEBULIZER.???
• Some patients with severe reversible airways obstruction, require larger doses of a
bronchodilator.
• If asthma symptoms become severe, inspiratory airflow may become limited to such
an extent that the contents of a MDI (metered-dose inhalers) cannot be inhaled
adequately.
• With a nebulizer, a high-velocity jet of air or oxygen sucks liquid up a tube and the
liquid is broken into tiny particles which are inhaled and deposited in the lungs
4. DEFINITION
• A nebulizer is a device used to administer
medication in the form of a mist inhaled into
the lungs.
ELLEN HILLEGASS, ESSENTIAL OF CARDIOPULMONARY PHYSICAL THERAPY, 3RD EDITION.
5. • Work on venturi effect:
• The venturi effect is the reduction in fluid pressure that results when a fluid flows
through a constricted section (or choke) of a pipe
• Stream of gas is passed through a small hole it creates a lower pressure as it emerges
from that hole
6. • In Nebulizer
• Small tube, with one end immersed in bronchodilator
solution and other end near the area of low pressure
• Consequently the liquid is drawn up the tube and it is
then pushed on to a baffle, which splits the liquid into
particle
9. PNEUMATIC JET NEBULIZER
• GAS-POWERED JET NEBULIZERS HAVE BEEN IN CLINICAL USE FOR LONGER
THAN 100 YEARS.
• MOST MODERN JET NEBULIZERS ARE POWERED BY HIGH-PRESSURE AIR OR
OXYGEN (O2) PROVIDED BY A PORTABLE COMPRESSOR, COMPRESSED GAS
CYLINDER.
• SMALL VOLUME JET NEBULIZER
• IT CONTAINS 5 TO 20 ML OF MEDICINES.
• LARGE VOLUME JET NEBULIZER
• IT CONTAINS UP TO 200 ML OF MEDICINES.
11. PNEUMATIC JET NEBULIZER
• GAS STREAM OPENING OF A CAPILLARY TUBE IMMERSED IN SOLUTION
• PRODUCES LOW LATERAL PRESSURE AT THE OUTLET
• HIGH JET VELOCITY DRAWS THE LIQUID UP TO CAPILLARY TUBE AND INTO THE GAS
STREAM,
• SHEARED INTO FILAMENTS OF LIQUID THAT BREAK UP INTO DROPLETS.
• PRODUCES SPRAY AEROSOL WITH DROPLETS RANGING FROM 0.1 TO 500µm.
12. ULTRASONIC NEBULIZER
• USN USES A PIEZOELECTRIC CRYSTAL TO GENERATE AN AEROSOL
• CAPABLE TO CREATES AEROSOL OF (0.2 TO 1.0 ML/MINS)
• HIGHER AEROSOL DENSITIES THAN CONVENTIONAL JET NEBULIZERS.
• PIEZOELECTRIC CRYSTAL GENERATE AN AEROSOL
• CRYSTAL TRANSDUCER CONVERTS AN ELECTRICAL SIGNAL INTO HIGH-FREQUENCY (1.2-
TO 2.4-MHZ) ACOUSTIC VIBRATION
• THEY DISRUPT SURFACE AND CREATE OSCILLATION WAVES.
14. VIBRATING MESH NEBULIZER
• IN THIS TECHNOLOGY A MESH OR MEMBRANE WITH 1000-7000 LASER DRILLED HOLES
VIBRATION AT THE TOP OF THE LIQUID RESERVOIR, AND THEREBY PRESSURES OUT A
MIST OF VERY FINE DROPLETS THROUGH THE HOLES.
• THE HIGH NEBULIZATION CAPACITY (>0.25ML/MIN) DEVICE OFFERS SHORT
INHALATION TIME.
16. PROCEDURE
• 1. ASSESS THE PATIENT FOR NEED (CLINICAL SIGNS AND SYMPTOMS, BREATH SOUNDS,
PEAK FLOW, %FEV1).
• 2. SELECT MASK OR MOUTHPIECE DELIVERY (NOSE CLIPS MAY BE NEEDED WITH
MOUTHPIECE).
• 3. USE CONSERVING SYSTEM (THUMB PORT, BREATH ACTUATOR, OR RESERVOIR) IF
INDICATED.
• 4. PLACE DRUG IN THE NEBULIZER. IF USING A MULTIDOSE VIAL, ADD SALINE TO
APPROVED DOSE VOLUME (PER DRUG LABEL).
• 5. SET GAS FLOW TO NEBULIZER AT 6 TO 10 L/MIN (PER MANUFACTURER LABEL).
17. PROCEDURE
• 6. COACH PATIENT TO BREATHE SLOWLY THROUGH THE MOUTH AT NORMAL VT.
• 7. CONTINUE TREATMENT UNTIL NEBULIZER BEGINS TO SPUTTER.
• 8. RINSE THE NEBULIZER WITH STERILE WATER AND AIR DRY, OR DISCARD, BETWEEN
TREATMENTS.
• 9. MONITOR PATIENT FOR ADVERSE RESPONSE.
• 10. ASSESS OUTCOME (CHANGE IN PEAK FLOW, %FEV1).
18. METHOD OF APPLICATION
• THE BRONCHODILATORS SHOULD BE DILUTED WITH A SOLUTION OF
SODIUM CHLORIDE, (NS) ITSELF A MILD BRONCHODILATOR ,
• TO MAKE 4ML
• THIS AMOUNT DELIVERS THE MAXIMUM DRUG WITHOUT AN
UNNECESSARY LENGTH OF TIME FOR THE PATIENT AND THE RESIDUAL
LIQUID IS NOT PURELY DRUG
• FOR E.G.
• 1 ML SALBUTAMOL WITH 3ML SALINE OR
• 2 ML OR 2 ML IPRATROPIUM BROMIDE WITH 2 ML SALINE
• IF BOTH DRUGS ARE PRESCRIBED TOGETHER THEY CAN BE GIVEN TOGETHER
19. • SOME PT WILL REQUIRE INHALED ANTIBIOTIC OR ANTIFUNGALAGENTS.
• AS THESE DRUG ARE THICKER THAN BRONCHODILATOR IT IS IMPORTANT TO HAVE A
POWERFUL COMPRESSOR TO DRIVE NEBULIZER.
• NEBULIZER MUST HAVE A MOUTHPIECE AND A ONE WAY VALVE ATTACHED TO A
PIECE OF WIDE BORE TUBING WHICH MUST BE PLACED LEADING OUT OF THE WINDOW
20. • IF ANTIBIOTIC OR ANTIFUNGAL
DRUGS ARE ALLOWED TO CIRCULATE
IN THE ROOM NOT ONLY WILL THE
ORGANISM BECOME RESISTANT TO
THEM, DRUGS SUCH AS
CERBENICILLIN ALSO DAMAGE THE
SURFACE OF FURNITURE
