I know that nebulisers have been mentioned several times but the information I am after does not come up with anything in the search box.
My Respiratory Consultant has recently prescribed nebules to me because he said that I must have nebuliser at home.
I have already been advised by my GP as to which nebuliser is best for me
The information I am after is which company is the best to purchase my nebuliser from and do I need to purchase a servicing agreement from them.
Evergreens are a nebuliser specialist, sourcing and distributing a variety of nebulisers. I have found alot of the larger manufacturers are moving away from dealing with patients in the community and more interested in selling to larger concerns. For a variety of advice etc I swear by Evergreens. I have had problems with a neb I bought recently, and I can say that Evergreens service was second to none in sorting the problem ( I hasten to add the fault was no way caused by them, just down to bad luck in my account). Many others on here use Evergreens as a supplier and I am sure that someone will back me up at some point. Just google Evergreens Nebulisers and you get their contact details.
PS Gail has a background in nursing from Evergreens and I found this far better than dealing with some sales person from a major company just selling a product and not really knowing or understanding breathing problems.
I agree evergreen have a great customer service and I cannot fault them .
Thanks for your replies, I shall have a look at their website to see if they do the nebuliser that has been recommended to me by my GP
Information required: Nebulisers
Hi, sorry I'm not in a position to answer your question because I reside in Nairobi, Kenya.
My concern however, is why your GP prefers nebuliser therapy over pressurised metered dose inhalers for your use at home. Did he give you his reason for his preference? I'm of the opinion that inhalers are what you need. Please ask him what advantage nebulisation offers over inhalers. Inhalers are much cheaper and have good outcomes if your asthma is fairly controlled. I'm of the opinion that nebulisation should be done in a healthcare setting after 'oxygen saturations' have been determined.
Are you currently using your 'reliever' and 'preventer' inhalers?
Kindly let me know if you are using the above inhalers and what your GP says about my concerns.
Kind regards,
Collins Jaguga.
Collins Jaguga,
Not sure if you are aware. Most people are experienced asthmatics here, many severe and not under control despite taking all medication options available. Nebulisers are generally only given in the UK to people that otherwise would be in hospital frequently.
You can see user profiles (which may include medication) and previous posts if the name is in purple.
Asthmagirl, good luck with the nebuliser at home and sounds like your consultant and GP are looking after you. Do you have an action plan about how often you can use them and when you should get help?
Hi TJ,
Thanks for your reply. I do have a very strict asthma management plan and when to use the nebuliser and when to get medical help to me.
Nothing new to add except I brought a portable nebuliser from Evergreens 2 yrs ago and was really impressed with the service.
Information required: Nebulisers
Hi Asthma girl,
Good to know that you have a very strict asthma management care plan. Your healthcare team is doing a great job and that's commendable.
Dear TJ,
Thanks for your comments on nebuliser therapy.
1. It's great to know that many asthmatics in the UK are 'expert patients'. Kudos to your healthcare system.
2. I'm concerned that many asthmatics in the UK have 'severe' asthma and are 'not controlled' despite taking 'all medication options' available. What is the root cause of this and what is being done to address this issue?
3. Please forward to me papers of scientific studies that have been done to warrant routine use of nebuliser therapy. This evidence will be of great help to me. (<email removed by Peaksteve> - posting your email address is against the T&Cs of using this message board)
4. In addition, please forward to me the UK asthma care standard treatment guidelines.
Kind regards,
Collins Jaguga.
to collins j..... just to ask... as a memeber of asthma uk, why cant you look up the information you require yourself regarding guidelines and studies.or do you wish it served to you on a plate. Also i find your atitude to nebulisers and asthma old fashioned and offensive to be honest. I ask why without knowing or assessing the people that use nebulisers can you state that a mdi is all they need . many of us on one have it after consultant has decided that its what we require not a pharmacist.... If i used a mdi it would not be cost effective as i would be in hospital more frequent and be in for a longer duration, thus more expensive than using a nebuliser. i take my nebuliser 4-6 times per day and oh yes before you ask i do comply with medication and as a nurse i do know how to take all my medications by the correct methods...
Manufacturers and suppliers of nebulisers
Hi Asthma girl,
Below is a list of manufacturers & suppliers i've just come across in this Asthma UK website. Hope you find them helpful.
AFP Medical Ltd
71 Somers Road
Rugby, Warks CV22 7DG
Freephone 0800 328 2306
Cameron-Price
Charlotte Road
Stirchley, Birmingham B30 2BT
0121 459 2121; asthmarelief.co.uk
Clement Clarke International
Edinburgh Way
Harlow, Essex CM20 2TT.
01279 414969; clement-clarke.com
Omron Healthcare UK Ltd
Opal Drive
Milton Keynes MK15 0DG
08707 502771
Pari Medical Ltd
Enterprise House, Station Approach
West Byfleet, Surrey KT14 6NE
01932 341122
Profile Respiratory Systems Ltd
Heath Place, Bognor Regis
West Sussex PO22 9SL
0870 7703434
Schill Medical
2 Garnett Drive, Bricket Wood, St Albans,
Hertfordshire AL2 3QN
01923 676499
derekbt@schillmedical.com
Sunrise Medical Ltd
Sunrise Business Park
High Street, Wollaston
West Midlands DY8 4PS
01384 446688
Nebuliser therapy
Dear Gussypo,
It's not my nature to be furnished with information on a plate like you seem to have the impression. I will check up the information and keep you posted. In fact, a quick scan at the Asthma UK website gives me some information which i've inluded at the end of this message.
Secondly, you are totally mistaken that my attitude to nebulisers and asthma is old fashioned. Please, you need not feel offended. I'm an advocate of evidence based practice and that's what I'm seeking.
Thirdly, you are also mistaken that i'm of the opinion that pMDI's is all that patients need and never nebulisers. What I require is the rationale for use of nebulisers routinely at home.
Fourthly, I would like to challenge your practice of consultants having the final say when it comes to management of asthma patients. Can I propose that you adopt a multidisciplinary approach that encompasses consultants, pharmacists, nurses etc. In addition, please encourage your asthma team to be at liberty to ask a consultant about a decision they make if they (asthma team) have a concern.
Finally, I agree with you that pMDI's alone cannot be used in the management of asthma. My local standard treatment guidelines advises appropriately on a systemtic approach in managing asthma.
Regards,
Collins.
Please see below an excerpt from the Asthma UK website.
""Nebulisers are most commonly used to treat severe attacks of asthma at a doctor’s surgery or in an accident and emergency department. In fact, research has shown that in most cases, multiple doses of reliever medicine through a spacer are at least as good as a nebuliser at treating most asthma attacks in children and adults.
Most people with asthma will not need to use a nebuliser at home. Their inhaled medicine is best delivered by an inhaler or by an inhaler with a spacer. Inhalers and spacers are also more portable and cost-effective for use at home.
However, sometimes people who have severe asthma symptoms or other lung diseases find that normal reliever inhalers do not work for them. To help to open up the airways or deal with an attack that comes on very quickly, a doctor may prescribe nebulised reliever medicine to use at home. A very small number of people with asthma also need to use a nebuliser to take their regular preventer-type medicine. Nebulisers are medical equipment and to make sure they are used safely,
they need to be used under the supervision of your doctor, respiratory specialist nurse or hospital consultant.
Hey Collins,
Welcome to the Asthma UK boards!
I thought I would try and answer a couple of your questions. Firstly the reason that lots of people on these boards are on nebulisers, is that due to the nature of the discussion boards it attracts asthmatics at the more severe end of the spectrum. There are 5.4 million people in the UK that have been diagnosed with asthma in the UK and the majority of those are well controlled. However a small proportion of those are above the L5 BTS guidelines and most of them end up on here!
These are the 5 stages before nebulisers are started;
Step 1: mild intermittent asthma
Step 2: introduction of regular preventer therapy
Step 3: initial add-on therapy
Step 4: poor control on moderate dose of inhaled steroid + add-on therapy: addition of fourth drug
Step 5: continuous or frequent use of oral steroids
These guidelines can be found here: brit-thoracic.org.uk/Portal...
In the UK asthma is normally managed by your GP and Practice Nurse however when your asthma is not controlled at level three you are normally moved to a respiratory specialist consultant at the hospital and are treated under their care.
The general feelings within the NHS is that if your sick enough to need a nebuliser then your sick enough to be in hospital; however there are a small minority of people who are above L5 on the treatment scale and are still not controlled. It is these people who are still experiencing severe symptoms that are put on nebulisers at home in order to give them a better quality of life so there not spending the majority of their life in hospital.
As for why there are so many people with asthma in the UK.... well we appear to be developing more and more allergies... and more severe allergies as a country.
..... will have to write the rest another time! Sorry I'm going to be late for my lectures!
Anyways take care Collins and stick around!
Alice
I'm of the opinion that inhalers are what you need. Please ask him what advantage nebulisation offers over inhalers. Inhalers are much cheaper and have good outcomes if your asthma is fairly controlled. I'm of the opinion that nebulisation should be done in a healthcare setting after 'oxygen saturations' have been determined. ""..........
this statement is what has caused the problem..... as your are unable to physically assess how can you state that inhalers is all that she needs. this advice should only be given by a dr after a physical examination. and nebulisers only given in the healthcare setting is out dated practice .... as many people now have a home nebulsier. i appologise as i was wrong in saying you wanted things served on a plate but it shows how we can misjudge with preconcieved ideas. my home nebuliser was given following discussion with my gp and practice nurse and treatment changed by consultant.
I am fortunate thati trust my consultants decision as he is a professor of respiratory medicine and he makes decisions on care with the physio, pharmacist and nurse input ...but when i disagree i ask .
i dont want this thread to turn into an arguement, as it distracts the main question and need of others
Just a quick query on the breakdonw of the Steps 1 - 5
I consider myself to be Step 4 with -
Beclometasone as Clenil Modulite 250 microgram. Two puffs four times a day via Aerochamber
Salmeterol Xinaforte as Serevent 25 microgram. two puffs twice a day via Aerochamber
Montelukast as Singulair 10 microgram tablet. One tablet at night.
Quinine Sulphate 200 microgram. One tablet at night.
Proton Pump Inhibitor as Lansoprazale 30 microgram. One tablet at night
Salbutamol as Ventolin Evohaler 100 microgram
Uniphyllin 400mg one a day
As can be seen there are more than four medications for my Asthma.
Am I a 4 or 5? definetly not a Len Ganlly 7!
Collins Jaguga, It is unnecessary to duplicate by messaging me & writing the same on here.
You should not have your email on any post here as it is against the terms and conditions you agreed to when you registered (asthma.org.uk/applications/... and also the forum is available to view without registration to everyone.
Also to answer your lengthy replies in brief, as Gussypoo has said your initial posts give the impression you do want information on a plate as you asked me to forward ""UK asthma care standard treatment guidelines"" and 'papers of scientific studies that have been done to warrant routine use of nebuliser therapy. This evidence will be of great help to me"". Why are you asking for this? Erm, no as I do not have time to do your research and as ally18 has said the British Thoracic Society guidelines are easily available on the internet.
I did not state many asthmatics in the UK but users of this forum have severe asthma.
Consultants do not have 'the final say' and 'management of asthma patients"" is generally a multidisciplinary approach with GPs & nurses in particular.
Please let us return to the original purpose and question here of which companies to purchase nebulisers from and service agreements. Asthmagirl, I hope you have found this useful (I know I have if needed in the future) and have purchased a suitable nebuliser.
This is an intriguing one, but I think it boils down to this:
There are situations in which an MDI is inappropriate and a nebuliser is the best delivery option for medication. These situations are decided by the doctor in consultation with the patient, taking everything into account. It is thus impossible to make suggestions about treatment plans when you've never met the person you're talking about, and only have what they have elected to post on a message board to go on.
It's also worth pointing out that using the members of this message board as a sample of the population of the UK with asthma will always give a very skewed view, because it is more likely for the more severe asthmatics to seek help here than those who are less severe.
Asthma UK has an excellent report that may be of interest to you:
asthma.org.uk/document.rm?i...
Steve
hey asthmagirl...random que, but if you cons has said about you needing nebs at home could you not save your money and use a hospitall one?
x
Maddie has a 'pari boy' which is tough enough to manage the steroids through too. Its a hospital one, as the consultant prescribed it. We also have a back up one from the gp's surgery.
I did however contact evergreen about a portable device. They were brilliant and very informative.
I hope you manage to sort one soon. x
Asthmagirl
Hope you managed to get an appropriate nebuliser.
To the rest
Sorry guys, my sentiments elicited ill feelings. I was hoping to generate a constructive discussion on the topic but I realize I chose the wrong forum and used inappropriate phrases.
Happy holidays!
Collins.
Thanks for that Collins Jaguga
Hi asthmagirl, I to was recently told that it would be benifical to me to have a home neb, I phoned a couple of different suppliers but have to say I went with evergreen due to their excelent customer service and helpful advice, I had my nebuliser within 48 hours of ordering which considering was right at the start of the holidays I thought was excelent, however i do feel the need to say they are shut now till jan 11th I think it was, anyway hope this has been of some help x
Thanks for all your replies, I took your advice and ordered my nebulisers from Evergreen I found that they were excellent and if anybody needs to get a nebuliser then I would certainly recommend Evergreen to them
getting worse, and what next?
Nebulisers at home advice.
Incorrect information on Asthma.org
