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11/13/24, 7\:24 PM Guide | Nebulised medication

Nebulised medication

Table of contents

Nebulisers

Nebulisers quickly and easily administer high doses of medication required for patients with severe or life-threatening
respiratory conditions.
1,2
Nebulisers change the liquid medicine into a
can be used for all ages, as di
1
Examples of nebulised medication
Examples of common nebulised medication include\:
Saline\: used to thin respiratory secretions (e.g. in bronchiectasis)
Salbutamol\: used for exacerbations of asthma and COPD
Ipratropium bromide\: used for exacerbations of asthma and COPD
Antibiotics
Corticosteroids

Gather equipment

Gather the appropriate equipment\:
Non-sterile gloves
Apron
Equipment tray
Oxygen tubing
Oxygen face mask or mouthpiece with a nebuliser
Syringe (the smallest syringe that will accommodate the medication volume)
Drawing-up needle (also known as a blunt
when drawing up medications from ampoules
Sharps container
The medication to be administered
The patient’s prescription
Nebulisers can be oxygen-driven or air-driven. Oxygen-driven nebulisers are connected to an oxygen source (e.g. portable
oxygen cylinder or piped oxygen supply). Air-driven nebulisers use compressed air.
https\://app.geekymedics.com/osce-guides/clinical-procedures/nebulised-medication/ 1/511/13/24, 7\:24 PM Guide | Nebulised medication
Figure 1. A nebuliser chamber, adult and paediatric masks and oxygen tubing.

Introduction

Wash your hands and don PPE if appropriate.
Introduce yourself to the patient including your name and role.
Con
Brie
“ T o d a y I n e e d t o a d m i n i s t e r s o m e m e d i c a t i o n ;
t h i s w i l l b e u s i n g a n e b u l i s e r w h i c h w i l l t u r n t h e m e d i c a t i o n t o m i s t . Y o u w i l l n e e d t o b r e a t h e i n t h e m i s t b y w e a r i n g a f a c e m a s k
o r u s i n g t h e m o u t h p i e c e u n t i l a l l t h e m e d i c a t i o n i s a d m i n i s t e r e d . Y o u m a y e x p e r i e n c e a d r y m o u t h a n d e y e s . T h e r e i s a s m a l l
r i s k o f e y e a n d m o u t h i r r i t a t i o n .
”
Check the patient’s understanding of the medication being administered and explain the indication for the treatment.
Gain consent to proceed with administering nebulised medication.
Check if the patient has any allergies.
Position the patient so that they are sitting comfortably.

Final checks

Before proceeding, check the seven rights of medication administration.
1. Right person\: ask the patient to con
prescription. You should use at least two identi
2. Right drug\: check the labelled drug against the prescription and ensure the medication hasn’t expired.
3. Right dose\: check the drug dose against the prescription to ensure it is correct.
4. Right time\: con
if relevant.
5. Right route\: check that the planned route is appropriate for the medication you are administering.
https\://app.geekymedics.com/osce-guides/clinical-procedures/nebulised-medication/ 2/511/13/24, 7\:24 PM Guide | Nebulised medication
6. Right to refuse\: ensure that valid consent has been gained before medication administration.
7. Right documentation of the prescription and allergies\: ensure that the prescription is valid and check the patient isn’t
allergic to the medication you will administer.
Once all of the above has been con

Administering nebulised medication

1. Wash your hands and don PPE (if not already done).
2. Assemble the nebuliser device according to the manufacturer's instructions.
3. Pour the correct dose of medication into the nebuliser device. Keep the nebuliser upright to avoid spilling the contents.
If the volume of medication required di
into a syringe using a drawing-up needle.
Remove the drawing-up needle and immediately dispose of it into a sharps bin, then pour the medication into the nebuliser
device.
Some medications may require the addition of saline for dilution.
Figure 2. A nebuliser chamber
4. Position the patient upright (greater than 45 degrees) to ensure optimal lung expansion and medication distribution.
5. Attach the nebuliser onto the face mask or pipe system with a mouthpiece as appropriate.
6. Attach the oxygen tubing to the bottom of the nebuliser device. Attach the other end of the oxygen tubing to an oxygen
supply or compressed air.
7. Turn on the oxygen or compressed air to a
8. Secure the facemask over the patient’s mouth and nose or instruct them to seal their lips around the mouthpiece. This
ensures proper inhalation of the medication. If the patient is receiving oxygen via nasal cannulae, continue to deliver this with
the nebuliser.
https\://app.geekymedics.com/osce-guides/clinical-procedures/nebulised-medication/ 3/511/13/24, 7\:24 PM Guide | Nebulised medication
Figure 3. A nebuliser setup correctly
9. Instruct the patient to try and inhale slowly and deeply during administration to maximise the e
medication.
If an anticholinergic medication (e.g. ipratropium bromide) is being administered, the patient may
close their eyes to avoid irritation.
10. Run the nebuliser for around 10 minutes until the total dose of medication in the nebuliser chamber has been administered.
11. Continue to monitor the patient’s vital signs and monitor for any side e
It is important to monitor the patient when administering medications, particularly beta-adrenic bronchodilators, as cardiac
side e
Patients with COPD may be at risk of hypercapnic respiratory failure, especially when oxygen is administered.
12. Towards the end of treatment, inspect the nebuliser and tap the side of the chamber to release any droplets clinging to the
side to ensure the entire dose is administered.
13. Once the administration is complete, turn o
the patient.
If administration included steroids, ask the patient if they would like to rinse their mouth to remove residual medication and
help prevent oral candidiasis (thrush) related to steroid use.
14. Re-assess the patient’s vital signs and conduct a respiratory examination to determine if the administration of nebulised
medication has had the desired e
15. Dispose of your equipment into an appropriate clinical waste bin.

To complete the procedure…

Explain to the patient that the procedure is now complete.
Thank the patient for their time.
Dispose of PPE appropriately and wash your hands.
Document the details of the procedure and the dose of medication administered.

References

https\://app.geekymedics.com/osce-guides/clinical-procedures/nebulised-medication/ 4/511/13/24, 7\:24 PM Guide | Nebulised medication
Source\: geekymedics.com
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