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Helen Chapman: 07387 124378                          Paediatric Continence Nurse Specialist

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Helen Chapman: 07387 124378                          Paediatric Continence Nurse Specialist

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Resources for bladder and bowel problems in children

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Child information library Here you can find advice about bladder and bowel issues in children, and general bladder and bowel health. The information library is designed for you, for your family, as well as for the healthcare professionals who support you. Assessments information Assessments Bladder and bowel problems are common in childhood and adolescence.

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With your help, we can keep offering free support to those who need us.

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4. Nebuliser Care Plan Hypertonic saline Sept 2025

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Welcome to the Flocare® Infinity online training page. Here you will find videos that show you how to set up and program the pump, as well as deal with common alarms.

In addition, our unique online pump simulator will offer you the opportunity to interactively program the pump.

Please watch through all the videos below then test your knowledge of the pump using the simulator.

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Welcome to the Flocare® Infinity online training page. Here you will find videos that show you how to set up and program the pump, as well as deal with common alarms. In addition, our unique online pump simulator will offer you the opportunity to interactively program the pump.

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The Do's and Dont's of Caring-Young people's Animation

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The Do's and Dont's of Caring-Young people's Animation

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CYSUR: Mid and West Wales Safeguarding Board

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The Do's and Don'ts of Caring - Young People's Animation

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QRCode for Student placement Evaluation form  (7)

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In order to produce small enough particles from solution in 5-10 minutes, gas flow rates of at least 6 L/minute are usually necessary. Ultrasonic nebulisers use a rapidly vibrating piezoelectric crystal to produce aerosol particles. Ultrasonic nebuliser machines are often smaller and quieter.

Nebulisers are highly inefficient and many deliver only 10% of the prescribed drug dose to the lungs. Much of the drug is caught on the internal apparatus or wasted during exhalation. The efficiency of drug delivery depends on the type and volume of nebuliser chamber and the flow rate at which it is driven. Some chambers have reservoir and valve systems to increase efficiency of particle delivery during inspiration and reduce environmental losses during expiration. Breath-assisted open vent systems improve drug delivery but are dependent on the patient having an adequate expiratory flow.

Nebulisers are used for emergency and domiciliary treatment of many respiratory diseases. Indications for nebuliser use include the management of exacerbations and long-term treatment of chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, HIV/AIDS and symptomatic relief in palliative care. The British Guideline produced jointly by the British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) on the management of asthma identifies a limited use for nebulisers in this condition.

Patients using nebulisers must be advised on how to self-treat and when to seek medical help.

See also the separate Which Device in Asthma? article.

The BTS guideline also states that a nebuliser may be required where a young child cannot use a metered dose inhaler and spacer effectively. It does not give examples of when that might be the case.

COPD

Although patients with COPD are considered to have irreversible bronchoconstriction, most show some reversibility with high-dose bronchodilators. The nebulised aqueous vapour is also believed to alter viscosity of mucus and assist expectoration. Therefore, air-driven nebulisers are used frequently in the treatment of acute exacerbations and maintenance of COPD. However, there is no actual evidence of superiority of nebulisers over metered-dose inhalers for delivery of bronchodilator therapy in COPD.

Consider a nebuliser for people with distressing or disabling breathlessness despite maximum therapy with inhalers.

Assess the individual and/or carer's ability to use the nebuliser before prescribing and arrange appropriate support and maintenance of equipment.

Continue nebuliser treatment only if there is an improvement in symptoms, daily living activities, exercise capacity or lung function.

Nebulised therapy should not continue to be prescribed without assessing and confirming that one or more of the following occurs:

A reduction in symptoms.

An increase in the ability to undertake activities of daily living.

An increase in exercise capacity.

An improvement in lung function.

Nebulised therapy should not be prescribed without an assessment of the patient's and/or carer's ability to use it.

Patients should be offered a choice between a face mask and a mouthpiece to administer their nebulised therapy, unless the drug specifically requires a mouthpiece (for example, anticholinergic drugs).

Both nebulisers and handheld inhalers can be used to administer inhaled therapy during exacerbations of COPD.

If a patient is hypercapnoeic or acidotic the nebuliser should be driven by compressed air, not oxygen (to avoid worsening hypercapnoea). If oxygen therapy is needed it should be administered simultaneously by nasal cannulae. The driving gas for nebulised therapy should always be specified in the prescription.

Cystic fibrosis, bronchiectasis, AIDS-associated infections and terminal disease

Bronchodilator therapy not only improves airway obstruction but also increases mucociliary clearance of viscous secretions.

High-dose corticosteroids are used to minimise airway inflammation in the treatment of bronchial hyperactivity and to reduce the rate of decline of respiratory function.

Inhalation of the enzyme dornase alfa reduces sputum viscosity and improves clinical outcomes of people with cystic fibrosis.

Regular nebulised antipseudomonal treatment also improves lung function and reduces the frequency of exacerbations of infection in people with cystic fibrosis.

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Many nebulised drugs are employed in palliative care but few indications are based on published evidence. However, regular nebulised normal saline helps to loosen tenacious secretions, may reduce breathlessness and is unlikely to do harm.

Cleaning

Nebulisers should be cleaned daily in regular usage and after each use in intermittent use.

The mask, mouthpiece and chamber should be disconnected, disassembled and washed in a warm detergent and water solution. The components should be left to dry overnight.

Before reuse, the nebuliser should be run for a few seconds before adding medications.

Maintenance

Disposable components such as the mouthpiece, mask, tubing and nebuliser chamber should be changed every three to four months.

Compressors require annual servicing by manufacturer or local service provider.

Breakdown

Patients must have a written plan describing whom to contact in the case of emergency, such as a respiratory or practice nurse.

If nebuliser times are slow, the equipment should be cleaned and treatment tried again. If it remains slow, a spare nebuliser should be used.

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A nebuliser is a device that converts liquid into aerosol droplets suitable for inhalation in order to deliver medication solutions directly to the lungs.

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Delivery of Medication via Nebulizers by C. Smallwood | OPENPediatrics

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Easily create surveys and polls to collect customer feedback, measure employee satisfaction, and organize team events.

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Children's Community Service Contact details

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Children's Community Service Contact details