Controlling Severe Asthma

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How and When to Use a Nebulizer for Asthma

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Young woman using asthma nebulizer on couch
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If you have asthma, you need inhaled medicines to control the disease and treat asthma attacks. In many cases, metered-dose inhalers are the way people with asthma take these medicines. But sometimes, doctors prescribe nebulizers instead. An asthma nebulizer is a useful alternative for people who can't use an inhaler or who struggle to use them correctly. They are easier to use because you don't have to coordinate your breathing with the treatment. The important thing is to know when to use a nebulizer and the process to giving a nebulizer treatment.

When to Use a Nebulizer

If you aren’t getting the full benefit of an inhaler, your doctor may recommend using a nebulizer. A nebulizer is a machine that changes liquid medicine into a mist you can inhale. You simply breathe through the mouthpiece while the machine does the work. The mist delivers your asthma medicine into your lungs as you inhale and exhale.

You can use a nebulizer to take long-term control, or maintenance asthma medicines. Inhaled corticosteroids are the most common type of long-term control medicine. They are powerful anti-inflammatory medicines that you use on a regular basis. There are several choices in the corticosteroid class of drugs that you can use in a nebulizer. You can also use cromolyn sodium (Intal) in a nebulizer. Cromolyn prevents your body from releasing substances involved in inflammation. It is an alternative to inhaled corticosteroids. Typically, you use these medicines twice daily.

Nebulizers can also deliver quick-relief, or rescue, medicines for asthma attacks. Short-acting beta agonists are common rescue medicines. There are several of them that come as a nebulizer solution. Your will tell you when to use rescue medicines and how often to use them. Your asthma action plan will also outline the steps you need to take if your rescue medicine doesn't seem to be helping.

How to Use a Nebulizer

There is a procedure to follow each time you use a nebulizer. It involves setting up the three basic nebulizer components—the compressor, the air tubing, and the medicine cup and mouthpiece. The process generally consists of the following steps:

  1. Place the nebulizer on a stable surface. Some nebulizers are battery-powered, while others require an electrical outlet. But most are relatively small and portable, so you can move them to a suitable place for a treatment.

  2. Wash your hands with soap and warm water. Lather for about 20 seconds before rinsing them.

  3. Make sure the air tubing is connected to the compressor.

  4. Remove the medicine cup from the mouthpiece. Hold the cup upright and fill it with the amount of medicine your doctor has prescribed. Then, reattach the medicine cup to the mouthpiece component and keep it upright.

  5. Attach the other end of the air tubing to the bottom of the medicine cup.

  6. Turn on the compressor. You will see a mist coming out of the mouthpiece once the machine is powered. Some nebulizers have a finger valve you must cover to create the mist.

  7. Place the mouthpiece in your mouth and close your lips around it to make a seal. This will ensure that the medicine goes into your lungs instead of leaking out the sides of your mouth. Masks are available for babies and young children who may struggle to keep the seal. The mask covers the nose and mouth.

  8. Begin breathing through your mouth, taking normal, even breaths. You breathe in and out through the mouthpiece.

  9. Sit upright during the treatment and keep the medicine cup upright to ensure complete medicine delivery. Pediatric masks may allow children to lie down during the treatment. Your doctor may tell you to take deep breaths every so often or to briefly hold your breath during the treatment. The treatment should take about 10 to 15 minutes until the medicine cup is empty and the mist stops.

  10. Turn off the machine and remove the medicine cup and mouthpiece. Wash the medicine cup and mouthpiece in warm, soapy water. Rinse the components and let them air dry. They will be clean and ready to go for the next treatment.

Each nebulizer is a little different. Read the manufacturers instructions thoroughly. Your doctor or pharmacist can help you with proper nebulizer technique and cleaning. It’s a good idea to review the process with a healthcare provider. Also, ask about mixing nebulizer medicines. Some medicines must be nebulized alone, while others can go into the medicine cup together. With a little practice, using and caring for a nebulizer will become second nature.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 22
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