2. DEFINITION :
• Inhalation is the act of drawing in air, vapour or gas into the lungs. Drugs are
inhaled either for a local effect (e.g., steam inhalation to relieve congestion in the
respiratory tract) or for a general effect e.g., inhalation of oxygen and anaesthetics.
Inhalations are given either dry or moist.
3. ADVANTAGES :
• Less systemic toxicity
• More rapid onset of medication
• Delivery to target of action
• Higher concentrations available in the lung
6. INHALATION
• Inhalation is the process of entry of air into the thoracic cavity.
• Inhalation therapies are a group of respiratory treatments designed to help restore or
improve breathing function in patients with a variety of diseases
8. DRY INHALATION:
• It is the inhalation of gases, fumes from volatile drugs or burning drugs. Example of dry inhalation are:
1. Inhalation of general anaesthetics: ether, chloroform, nitrous oxide etc., are given by using a mask.
2. Oxygen and carbon dioxide inhalations: these are administered by using a mask, tent or catheter.
3. Inhalation of volatile drugs: amyl nitrate contained in an ampoule is broken and emptied into a
gauze piece or handkerchief and is held under the nose of the patient and the patient inhales the fumes.
This is used to relieve the pain in angina pectoris.
Volatile drugs such as menthol, aromatic spirits of ammonia, eucalyptus; etc., are administered in the
same way. When aromatic spirits are administered, care should be taken that the drug neither touch
the skin nor its fumes irritate the conjunctiva of the eyes. Therefore, it be held away from the nose and
eyes.
4. Inhalation of strammonium and belladonna: these are burned and the patient breathes the fumes.
5. Aerosol spray: an aerosol is a fine suspension of liquid or a powder that deliver medications topically
into the respiratory tract. Atomizers and nebulizers are used for spraying medication into the
respiratory passages.
16. MOIST/STEAM INHALATION:
• Breathing down and moist air produced by a vaporizer is called stream/moist
inhalation. The value of steam inhalation lies chiefly in the moisture and heat,
although the medicines used are also helpful as they are acting as respiratory
antiseptics.
• Examples are:
• 1. Steam inhalation
• 2. Nebulization
17. COMMON INDICATIONS :
• Inhalation therapy is a traditional treatment in
• chronic asthma and
• chronic bronchitis.
• Emphysema,
• Bronchiectasis
18. STEAM INHALATION PURPOSES:
1. To relieve the inflammation and congestion of the mucus membranes of the respiratory tract and
paranasal sinuses, thus to produce symptomatic relief in acute cold and sinusitis.
2. To soften thick, tenacious mucus and help its expulsion from the respiratory tract, thus to relieve
cough in bronchitis, and in post-operative cases etc.
3. To provide heat and moisture and to prevent the dryness of the mucus membranes of the lung and
upper respiratory passages following operations such as tracheostomy.
4. To aid in the absorption of oxygen.
5. To relieve spastic conditions of the larynx and bronchi.
6. To provide antiseptic action on the respiratory tract e.g. by using menthol, tr. Benzoin, eucalyptus etc.
20. JUG METHOD:
• In this method, a Nelson’s inhaler is used. The type of the inhalant
required and the boiling water is filled in the jug and the patient
breathes a vapor.
At Home: when Nelson’s inhaler is not available the patients can
be advised to improvise a jug. A tea kettle or a mug is filled with
boiling water and the inhalant. A ‘cone’ is made with a card board
paper and is fitted over the kettle or the mug. Through a small hole
made on the top of the cone the patient breathes in the stream.
21. STEAM TENT
• When a high concentration of stream is required, a steam tent may be used. There are
different ways of making a tent.
• A quick and easy method is to place a screen on either sides on the patient’s bed and
stretch blankets or sheets across them, fixing them with safety pains, and forming a
canopy.
• Wooden blankets are preferred to sheet because they absorb moisture and will not
drip over the patient.
• For a child, the blankets can be stretched across the top of the cot.
• The stream can then be directed into the tent from the spout of a kettle.
22.
23. ELECTRIC STEAM INHALER:
• Small electric vaporizers can be used to give steam
inhalation.
• It consists of a small jar with a heating element extending
into the jar.
• The jar is filled with water.
• On the top of the jar is a removable perforated cup to
which is attached a small metal spout.
• Cotton saturated with medication is placed inside the cup
and the metal spout is fitted over the cup.
• As the water boils, the medicated steam is directed
through the spout which is inhaled by the patient.
24. NEBULIZERS :
• Patient cooperation and coordination is not as critical
• It converts solution into aerosol particles, < 5μm.
• An acceptable time 5-10minutes.
• Two types:
• Jet nebulizers
• Ultrasonic nebulizers
• Commercially available nebulizers deliver 12% to 20% of the nebulized dose into the
bronchial tree.
25. JET NEBULIZERS:
• With a jet nebulizer driving gas is forced
through a narrow orifice.
• The negative pressure created around the orifice
and it allows the smaller particles for inhalation
and larger particles drop back into the reservoir
26. ULTRASONIC NEBULIZERS:
• An aerosol can also created by high frequency(1- 2MHz) sound waves.
• Piezo-electric crystal causes ultrasonic vibrations, it will travel through liquid to the surface
where they produce aerosol.
• Produce higher output than jet nebulizers
27.
28. PROCEDURE (STEAM INHALATION):
• Check the physician’s order .
• Warm the inhaler by pouring a little hot water into the inhaler and emptying it
after one minute.
• It reduces loss of heat from inhaler during procedure.
• Pour the required amount of inhalant into the inhaler and fill to a level below the
spout with boiling water.
• The water should remain just below the spout.
• If the inhaler is filled up to the level of spout there is possibility of drawing water
into the mouth when inhaling and can cause scalds.
• If the spout is filled with water it will not act as an air inlet.
29. Place sterile mouthpieces and close the inhaler tightly.
Cover the mouth piece with a gauze piece and plug the spout with a cotton ball.
Covering the mouthpiece with a gauze piece will prevent burns of the lips.
Cotton ball in the spout will prevent escape of steam.
Place a towel around the inhaler and position it in the bowl.
It insulates the inhaler and prevents heat loss.
Take it to the patient without losing time.
Switch off fan/AC and close windows and doors
30. Position the patient in high fowlers or sitting position.
Place the apparatus conveniently in front of the patient on cardiac table with spout
opposite to the patient.
Remove the cotton plug and discard it into the kidney tray
Keeping the spout opposite to the patient reduces the chances of burns.
Removing the cotton plug helps to open spout, so that it can act as an inlet for air.
31. • Instruct the patient to place lips on the mouthpiece and take deep breath.
• After removing the lips from the mouthpiece, breathe out air through nose.
• Directing the steam out through the nostril relieves the congestion of the mucous membranes of
the nostril.
• Continue the treatment for 15 to 20 minutes as long as patient gets the steam. Observe the
patient during procedure.
• Removes inhaler from the patient after the stated time, wipe off perspiration from the
patient’s face
• Give chest physiotherapy and encourage patient to bring out sputum by coughing.
• Instruct the patient to remain in the bed for 1 to 2 hours.
32. PROCEDURE (ELECTRIC INHALER)
• Explain the procedure to relieve anxiety and gain cooperation.
• Auscultate the patient lung fields to know the lung condition.
• Place him/ her in a sitting position for comfort.
• Put off the fan and cover the patient with a bed sheet or blanket to avoid chills or droughts to
help collect the steam around the face of the patient to prevent steam loss.
• Place the electric inhaler to the cardiac table.
• Switch on the electric inhaler.
• Instruct the patient to inhale by mouth and exhale through the nose for 15 to 20 minutes –
steam through nostrils relieves congestion of the mucous membranes.
33. • Keep the sputum cup with disinfectant ( 1% savlon) and face towel for spitting and
wiping the face.
• Remove the inhaler, keep the patient in a comfortable position and observe him/ her
frequently, keep him/ her well covered- to prevent chilling.
34. NEBULIZATION PROCEDURE
Articles:
Nebulizer and nebulizer connecting tube
Mouthpiece/mask
Respiratory medication to be administered
Normal saline solution
Sterile water
Cotton balls
Face mask
Sputum mug with disinfectant
Disposable tissues
Kidney tray
Medication card
35. STEPS :
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.
4. Prepare equipment 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
36. 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.
37. 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.
