Introduce yourself, check the right patient, explain confidentiality.
Then ask the patient what they already know about a nebulizer.
Then tell the patient what you are going to do – SIGN POSTING – e.g.:
- I am going to explain to you a little bit about how to use a nebulizer, how to clean it, and how to use it safely. If you have any questions feel free to interrupt at any time.
A ‘nebulizer’ is actually the little chamber you put the drugs in. (you might want to explain a little bit about what drugs go in there, and when to use it – you may have to find out a little bit more about the patient before you do this!)This is then connected either to a :
- Compressor – this is the noisy little box that compresses air and pumps it through the nebulizer.
- Oxygen – an oxygen canister
Open up the nebulizer from the packet. check that it has 3 removable components, and show the patient how to take it apart. Then tell the patient their medicine will come in a pre-sized pack, and they just have to pour it into the chamber.
Then you check the nebulizer packet for the recommended flow rate of oxygen/air through the nebulizer. It is often 7. Tell the patient to connect the tube to the bottom of the nebulizer than turn the flow rate to the correct amount.
If it is connected properly you should see the nebulizer bubbling slightly, and a mist coming out of it. Show them how to connect the mask, and how to put the mask on. Say they should keep it on until all the drug is gone (chamber is empty, and no mist being produced by the nebulizer.
Keeping it clean
After each use they should take the nebulizer apart, and wash it in warm soapy water they can scrub it if they like, but do not put in a dishwasher, as the temperature is too hot and can damage the device. Just leave it to drip dry on a clean surface. Do the same with the mask. They should replace the nebulizer every month, and will be sent a new one. If they have in infection, they should replace the nebulizer every time.
In the hospital setting the nebulizer and mask are one time use only!
If the patient has an oxygen canister you need to tell them about the dangers of oxygen. Oxygen is very flammable. You have to make sure you have completely turned the oxygen canister off when you are not using it. If your leave it on, then the oxygen can saturate the (air, or) the carpet/furnature, and this means even a very small spark can then eset the furnature on fire and may even cause an explosion!
At the end; double check about patient ideas, concerns and expectations – you can just bluntly ask them outright!
- Murtagh’s General Practice. 6th Ed. (2015) John Murtagh, Jill Rosenblatt
- Oxford Handbook of General Practice. 3rd Ed. (2010) Simon, C., Everitt, H., van Drop, F.
- Beers, MH., Porter RS., Jones, TV., Kaplan JL., Berkwits, M. The Merck Manual of Diagnosis and Therapy
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