Wife uses one when admitted to hospital but I understand you can get home ones?
Few questions:-
1. Do you have to buy your own or will NHS provide?
2. What about what goes in the nebuliser? I presume you need a prescription for this?
3. Are the home ones as good as ones in hospital?
I had to buy my nebulisers, I have a Medix AC2000 and a Philips Micro Elite (which is a portable one).
In my case my Respiratory Consultant prescribed the nebules but I think a GP would also be able to do this.
I have found both of my nebulisers to be just as good as the hospital ones.
Has your wifes consultant reccomended you get one? in some cases they prefer people not to have one at home (in which case they would be unwilling to prescrible the nebules - so having one would be of no use anyway) Currently my consultant doesnt want me to have one as if i need nebs he feels i should be in hospital where other treatments (hydrocortisone, magnesium, aminophylinne, even i guess ventialation) are all possible if i deteriorate rapidly. Often they are given with very strict instructions about when to call 999, its easy for people to wait until they are very ill before getting help if they have a nebuliser!
I know of cases where the hospital have provided one on a loan (although this person wasn't going to live very long) but not sure if they let you have one longer term!
yes you would need a prescription for the nebules, i think GPs can prescribe them, but i believe this is usually only after a consultant has agreed what is being prescribed (probably just to save the consultants time more than anything else!)
I believe the home ones are as good as the ones in hospital - although they wont be driven by oxygen and i *believe* that some people can drop their o2 sats when they have salbutamol nebs without o2 (although please correct me if im wrong on that - i really cant remember where i read that info!)
It would also depend what nebules your wife was prescribed, for example, it was discussed at one point that i might get a home neb just with salbutamol (and saline if i had a cough) but that if i needed ipatropium, i'd have to come to hospital, so that would affect whether the nebs at home were as effective as in hospital!
Nebulisers at home are not often prescribed.
People often see the benefit in hospital / emergency environment but at home and without strict guidelines they can be dangerous as people can become over dependent on them and fail to seek help earlier.
It is better to be able to control asthma with preventers rather than rely on relievers all the time.
I gather from another post that your wife is pregnant. She is much better to be seen in hospital for her asthma as a lot of ventolin will have an effect on the baby's heart rate.
Hope this helps
Kate
I completely agree with Kate, re the pregnancy issue, and would be extremely surprised if they were willing for her to have a home neb in that situation, it could be too risky.
I had to purchase both my home nebulisers which I gather is normal, and the consultant prescribed the drugs which the GP issues.
I believe the home ones are as good as the ones in hospital - although they wont be driven by oxygen and i *believe* that some people can drop their o2 sats when they have salbutamol nebs without o2 (although please correct me if im wrong on that - i really cant remember where i read that info!)
Many people in hospital have their nebs without oxygen attached. A lot of folk I know on permanent oxygen still stop it for a few minutes to have their nebs in hospital. I've certainly had O2 attached when admitted acutely ill but when things stabilise the nebs have been used without normally.
Lynda :
Thanks all for the replies.
Unfortunately, relying on the alleged expertise of out local NHS hospital is not a good idea. They are completely clueless to say the least. If you don't take the initiative yourself they will do nothing.
To be honest, plan is to see a consultant privately shortly so might wait to see what they say.
Wife is a registered nurse also so has some experience...
Well, consultant said no to home neb as well...
I can see the point that it masks the symptoms and that some people may rely on it rather than go to hospital- not clever.
But my wife is a nurse, knows all about peak slow/ SATs etc (got her own SATs monitor). Also, I've got a bit thing about the hospital 'experience'. Sometimes I would argue its better to be at home rather than stuck on a trolley on a dirty hospital ward, getting a hospital-acquired infection.
Hi Paul, Im also a nurse of 15 years. And when Im having an asthma attack that makes not a jot of difference. It doesnt matter how competent you are, when you are the one that is ill, your functioning, insight, and reasoning can and do deteriorate. And that aside, things can very rapidly deteriorate. I have gone from having breathing difficulties on the sofa and insisting I dont need an ambulance, to almost being ventilated in ITU, in the space of less than an hour. That is not predictable, no matter what your skills, knowledge or qualifications. Your wife wont have IV steroids, nebulised steroids, or IV magnesium at home, nor the ability to do blood gases. All these things can be required quite suddenly.
I don't think its sensible for anyone to have home nebs unless it is part of an ongoing regular treatment plan for maintenance. Emergency home nebs are risky.
I have to agree with NurseFurby. Having professional skills does not mean you can leave it a bit longer so to speak and with asthma, trying to cope at home with a home neb is not the best option without a strict protocol.
A Pulse oxymeter does not tell you what your co2 levels are... sometimes these can rise and you can still have reasonable O2 sats... this is a very dangerous situation.
I now have strict guidelines for using my home neb which I have had since 1990.... at first I would use too many nebs before getting help... not good. It gave me a false sense of security.
To use a home neb to avoid an emergency admission is not a wise move.
I use mine regularly as I have severe (brittle) asthma and without it, I would be permanently in hospital.
They are prescribed by a consultant for home use if the patient is not responding to other regular meds via other delivery methods. They can be used for nebbed steroids sometimes.
They are also prescribed for people who have brittle type two deteriorations, very fast, and live a long distance from help. This is to bide time while help is getting to them. It doesn't replace help from a paramedic or A&E.
People often thing nebulisers are a wonder treatment because they work well (most of the time!) in an emergency situation.
The gold standard treatment aim for most people with asthma is prevention. There are many preventors available these days and it can take a bit of tweaking to get it right.
Though some of these may not be OK with pregnancy... hence the need to see a proper consultant, which I think you have highlighted that you are having issues with.
A nebuliser with ventolin used in an emergency situation is going to affect the babies heart rate as well as the mothers.
I understand your frustration in not getting the best care that your wife deserves but it is better to get her to hospital for help, then if she goes in a lot, hopefully they will take notice! Don't be afraid to kick up a fuss in A&E, remind them they are responsible for two lives, not one.
Kate
x
Thanks all - I can see your point....
To be honest, like I said, private consultant said no anyway. So we're going to listen to him - he was great and took the time to explain things.
Also, I agree with you about the SATs thing too. At the moment, good news is that 3 days after leaving hospital shes ever so slightly better so maybe the ABs are working. Fingers crossed.
Its just sometimes I despair of the treatment in hospital sometimes... And we did kick up a huge fuss last time.
Glad to hear that your wife seems to have turned the corner and hope she is on the road to recovery now.
All the best for the rest of her pregnancy and don't forget to let us know when baby arrives :0)
Take care x
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