Correct usage of nebulization for respiratory diseases

Follow the doctor's advice to choose symptomatic drugs specifically for atomization. Clean your mouth before operation and do not apply oily creams. During atomization, stay in a sitting or semi-recumbent position and breathe normally without deliberately inhaling deeply. The duration should be controlled to 10-15 minutes each time. Immediately after the end, rinse your mouth and wipe away the residual liquid around the mouth and nose. Operations that do not conform to this logic will either be done in vain or may harm the body.

Not long ago, I met the mother of a 3-year-old baby in the outpatient clinic. She said that she had been nebulizing her baby at home for a week, but her cough was getting worse and worse. I took the medicine she bought and saw that it was all saline. When I asked her why she didn't use the budesonide prescribed by the doctor, she waved her hand and said, "I heard that nebulizing hormones are not good for babies. Saline is safe, and it can moisturize the throat and resolve phlegm." In fact, this is also the biggest misunderstanding that many people have about nebulization. They think that nebulization is a "universal throat soothing item" and can be used with anything. Some people even take oral cough medicine or intravenous ambroxol and directly mix it with nebulization. In the end, there are not a few people who have airway spasm and are sent to the emergency room.

There have always been two different clinical views on whether nebulization can be done at home. Relatively conservative doctors would recommend doing it in the hospital, and the reasons are very practical: First, it is difficult for ordinary people to judge which medicine is suitable for their own symptoms. For example, for the same cough, an acute attack of asthma requires the use of hormones + bronchodilators. Pharyngitis caused by bacterial infection may only require antibacterial aerosol medicine. If the medicine is wrong, no matter what you do, it will be useless. ； Second, if you do it at home, if the atomizer cup and pipeline are not properly disinfected, it is easy to introduce bacteria into the airway, which will aggravate the infection. However, there are also many doctors who support qualified patients to operate at home. After all, there are many people in the hospital, and patients with fragile respiratory tracts are prone to cross-infection. As long as you find a doctor in advance to prescribe the appropriate atomization medicine and disinfect it before the operation, it will be more worry-free.

You must be careful when dispensing the medicine, and do not add any other medicine into it. Take ambroxol as an example. Some hospitals in China do use ambroxol aerosol preparations, but European and American drug regulatory authorities have not approved ambroxol aerosol preparations. They have also specifically reminded that using ambroxol that is not specifically for atomization can easily induce airway spasm. Therefore, you must not use ambroxol for intravenous infusion or oral ambroxol. All drugs used must be clearly marked "for atomization inhalation only." This is non-negotiable.

I met an old man with chronic obstructive pulmonary disease before. He always liked to lie down and take deep breaths while taking nebulization, saying that this way the medicine could be inhaled deeper. As a result, he felt dizzy and nauseated after every use, and it took him half an hour to lie down before he recovered. In fact, there is no need to deliberately pursue "deep inhalation" when atomizing. Just keep breathing normally, and occasionally take two deep breaths. If you lie down and do it, the lifting of the diaphragm will affect the ventilation of the lungs. On the contrary, it is easy to inhale less medicine and make you feel dizzy due to excessive ventilation. If the child really can't sit still, it's fine to half-rely in the adult's arms, rather than lying flat on his back.

Many people shake their heads like a rattle when they hear that nebulized hormones are needed, especially parents, who are afraid of affecting their children's growth and becoming dependent. In fact, the commonly used inhaled budesonide in clinical practice is local administration. After the administration, most of the medicine acts locally on the airways, and less than 1% enters the blood circulation. As long as it is used according to the doctor's instructions and the course of treatment, there will be no side effects of oral and intravenous hormones. On the contrary, many parents refuse to use it for their children. Asthma attacks occur repeatedly, and the lack of oxygen really affects the growth and development. However, there are some points to note when using hormones: Do not apply oily cream before atomizing, otherwise the hormones will easily stick to your face. After use, you must wipe your face with warm water and rinse your mouth carefully, especially for children, otherwise the hormones remaining in the mouth will easily induce thrush. Don’t be lazy on this point.

As for the often asked question "Can atomization be used when the baby is crying?", there is actually no absolute standard answer. Some doctors feel that when a baby cries, he breathes quickly and most of the medicine gets stuck in the throat and cannot enter the lower airway, so the treatment is in vain. It is best to wait until the baby calms down or falls asleep before taking the medicine. However, some doctors think that if the baby is really unable to be coaxed and has a severe asthma attack, even if he cries, as long as he can put the mask on his face and get some medicine in, it is better than having to carry it heavier and heavier, so there is no need to be too dogmatic.

Finally, I would like to remind you that nebulization is essentially a method of drug delivery, not a health care project. Don’t do it blindly if you don’t have symptoms, and don’t think that “nebulization is less harmful than infusion” and ask for it regardless of the disease. If you suddenly experience shortness of breath, rash, or numbness in your mouth after vaping, stop immediately and see a doctor to adjust your medication as soon as possible. Don’t hold on.