Winter is coming, respiratory diseases have entered a high incidence period, many children have cough symptoms, many parents naturally think of nebulization inhalation**, so, for the well-known nebulization, how much do you know? Today, I'm going to give you some popular science.
First of all, what is nebulized inhalation?
Nebulized inhalation is one of the most important methods of modern respiratory diseases, which is to disperse the drug solution or suspension into inhalable particles - aerosols through different nebulization devices, which are inhaled into the respiratory tract with the respiratory airflow and deposited in the target organs to achieve the purpose of improving the disease and improving symptoms. Atomization methods are clinically divided into jet atomization, filter atomization, and ultrasonic atomization.
Among the aerosols for inhalation of the airways, drug particles with a diameter of 1 5 m are the most suitable and are distributed in large and small airways. The vast majority of particles of 5 m are trapped in the oropharynx and eventually enter the body through the digestive tract through swallowing. And 0Although 5 m particles can reach the lower respiratory tract, 90% of the drug particles can be excreted with exhalation during tidal breathing. The morphology of inhaled drug particles also affects the distribution of drugs in the airways, such as when nebulizing inhaled budesonide suspension, the output drug particles are irregularly shaped, have a wide contact area, and are more likely to be distributed in the lower respiratory tract.
So, what are the advantages of nebulized inhalation?
First of all, nebulized inhalation is local administration, and systemic adverse reactions are smaller than systemic administration. It acts directly on the respiratory tract, with fast onset and good curative effect; The child can breathe normally, which is bitter and does not require the patient's cooperation; Suitable for any age; The compression nebulizer pump is not heated, has no damage to the drug, and will not damage the efficacy of the inhaled drug.
Different devices have different effects, and this time we will mainly introduce jet atomizers.
What should I pay attention to when nebulizing inhalation?
Before atomization: Do not apply oily creams on the face to reduce the adsorption of the drug on the face and cause allergies. Try not to eat half an hour before nebulization to avoid vomiting and suffocation caused by aerosol stimulation during nebulization inhalation. First of all, remove oral and nasal secretions (if there is nasal discharge, nasal irrigation should be carried out before nebulization**), food debris, etc., so as not to hinder the depth of the fog droplets. For the atomizer that is used for the first time, due to the residual odor in the lumen during the production process, it is easy to induce wheezing attacks or discomfort, and it should be blown with air for 3 to 5 minutes before use.
During nebulization: it is best to choose a sitting position or elevate the head and 30° to the chest, which is conducive to the deposition of inhaled drugs into the terminal bronchi and alveoli to facilitate the sedimentation of the drug in the terminal bronchi; During atomization, the atomization cup has been kept upright to avoid the overflow of the liquid; It is best to nebulize in a quiet state to avoid crying, and older children can use their mouths to inhale slowly and deeply through their mouths to make the drug particles reach the deep part of the lungs with deep breathing, and then exhale slowly through the nose to increase the time of the drug in the airways and lungs and increase the efficacy. Infants and young children can use the mask type, the nebulizer can be 6 7cm away from the child at the beginning of nebulization, and then gradually close to the mouth and nose, so that the child can gradually adapt to the temperature of the nebulizer, reduce the stimulation of the airway by cold air, and reduce the discomfort of the child, but must be tightly linked to the face, can not leave, leave 1cm, the drug effect will be reduced by 50%, calm breathing, and the effect of nebulized inhalation in sleep is better than when crying; **In the process, check the fogging situation of the atomization device: if the fog droplets are suitable, the cause of the fog droplets should be found if the droplets are small, large or not foggy; Pay attention to the child's complexion and breathing to prevent suffocation; Do not spray aerosol into eyes. The air compression pump should be placed on a stable and solid platform, not on soft objects such as carpet or woolen fabrics, and should ensure that each vent is not blocked (when the home is atomized, it must not be covered with a quilt or other objects because of the loud sound of the compression pump, so as not to cause accidents due to the inability to dissipate heat).
After nebulization: let the child rinse his mouth after the nebulization is completed, so as to reduce the deposition of the drug in the oral cavity and pharynx and prevent Candida infection, if the younger child will not rinse the mouth, wipe the mouth with a cold boiled water cotton ball, and let the child drink water or ** after 10 minutes; Instruct the child's family to pat the back, which is conducive to the discharge of sputum, and at the same time observe the child's complexion and breathing changes, and treat symptoms such as shortness of breath and dyspnea in time; Pay attention to observe whether there are adverse drug reactions; In wet and cold weather, children should avoid going out immediately after inhalation** to avoid cold.
Are you doing home vaping right?
Many family members of patients who come to the hospital report that the effect of nebulization at home is not as good as in the hospital, this is because the nebulizer has a variety of varieties and the size of the particles is also varied. Or the way and method of nebulization are not the same reasons, so it is recommended not to use medicine atomization inhalation at home without authorization, the symptoms are different, the nebulization liquid used is also different, and you must follow the instructions of pediatric respiratory doctors, which is a bit of abuse at present. Nebulizers and masks need to be replaced in a timely manner when they are used frequently; When the dirt cannot be removed after the nebulizer is cleaned, it is advisable to replace it with a new part. If the air induction pipe is found to be filled with water, the conduit will be blown dry with compressed air when the atomizer is not connected. For children who need long-term nebulization, it is recommended to replace the nebulizer regularly to ensure the effective output, and it is recommended to replace it every 15 days (including the air connection catheter), and the specific frequency of nebulizer replacement should follow the instructions for use (including the air induction tube). The atomizer purchased by parents should be wiped with 75% ethanol after each use, and the fuselage shell can be wiped with a damp dry cloth, do not let the liquid enter the inside of the fuselage, once the liquid enters, please dry it thoroughly before powering on. It is necessary to check the pressure of the compression pump and the air filter core regularly, the filter core should be replaced once in about 1 year, and when it is found that there is a foreign matter blocking the air filter, it should be replaced in time.
Department of Pediatrics, Xingtai People's Hospital.