OSCE inhaler and nebuliser protocol

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A detailed protocol on how to use an inhaler and nebuliser in an OSCE examination.

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OSCE inhaler and nebuliser protocol

  1. 1. C. Riedinger 1Inhaler and nebuliser notesInhalerAn inhaler or puffer is a medical device used fordelivering medication into the body via the lungs. Itis mainly used in the treatment of asthma andChronic Obstructive Pulmonary Disease (COPD).Zanamivir (Relenza), used to treat influenza, mustbe administered via inhaler. To reduce deposition inthe mouth and throat, and to reduce the need forprecise synchronization of the start of inhalationwith actuation of the device, MDIs are sometimesused with a complementary spacer or holdingchamber device.Blue = reliever, brown = preventer Picture credit: http://www.dietsinreview.com/diet_column/07/study-soy-reduces-risk-of-copd/ • ID self and patient, grain consent and co-operation • Perform hand hygiene bla bla • Check prescription vs name • Ask for allergies • Ask patient to sit up with lifted chin • Take wipe and clean inhaler if previously used • Remove cap from mouthpiece and shake inhaler • Explain to patient that if inhaler has not (ever) been used, you need to test- spray into the air to check if it is working. Spray away from patient’s face! • Number on some inhalers shows how many doses left • Explain to patient to keep breathing, place inhaler mouthpiece in their mouth and put their teeth around it (not biting it!) and seal their lips around the mouthpiece. The patient can now take a few practise-breaths in and out through the inhaler while you explain to them what to do. • Ask them to keep breathing through the mouthpiece and when they are ready press on the inhaler as they breathe in deeply to release the medicine. Instruct the patient to hold their breath for 10 seconds or as long as they can, then breathe out slowly. • The patient may have to take more than one puff, in which case shake the inhaler again and repeat procedure after 30 seconds. • Replace the cap on the inhaler mouthpiece. • Sign the drug chart to say that the required dose has been administered.
  2. 2. C. Riedinger 2Inhaler and nebuliser notesNebuliserIn medicine, a nebuliser is adevice used to administermedication in the form of a mistinhaled into the lungs. Nebulisersare commonly used for thetreatment of cystic fibrosis,asthma, COPD and otherrespiratory diseases.Nebulisers use oxygen,compressed air or ultrasonicpower to break up medicalsolutions and suspensions intosmall aerosol droplets that can bedirectly inhaled from themouthpiece of the device.They therefore quire a gas supply such as an air compressor or oxygen tank.“All patients with a chronic respiratory condition who require nebuliser therapyreceive their nebulisers through compressed air. If supplementary oxygen is neededduring this therapy, it can be administered via nasal specs. Only patients suffering anacute asthma attack should receive nebulisedPicture credit: http://csc.madonna.edu/~mbowles/Portfolio/HSP.html • ID self and patient, grain consent and co-operation • Perform hand hygiene bla bla • Check prescription vs name • Ask for allergies • Drop in capsule with medication into the nebuliser • Attach mask to nebuliser • Connect mask to machine • Switch on machine • Assist patient to put on the mask by placing the retaining straps over the ears and back of the head • Be aware that the solution may take up the 10 minutes to vaporise • Leave machine running • Ask patient to inhale medicine until the mist is gone • Sign drug chart • Some meds require pre/post peak flow measurements (more likely for asthma patient than COPD) • Post nebuliser, make sure that the mask is left clean and dry for future use • Leave clinical area tidy • Perform hand hygiene

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