Nebuliser

[johnkent]

I use my nebuliser at least 4 times a day with saline or Salbutamol 2.5ml dose's which take approximately 5 minutes to administer, During a 3 day stay in hospital I couldn't help but notice how much slower it was to get the same dose of medication from their machine, upto 20 minutes. Is my machine too fast was the hospital's slow , should mine be calibrated or even could it be calibrated to change time taken to administer?

[teddyd]

I cant answer your question, but my nebuliser takes about 15 minutes to administer a dose. I am interested to hear what others say.

[Hidden]

It depends on the type of nebuliser and its efficiency. Some are stronger because they are designed to nebulise antibiotic which is thicker than saline and salbutamol. The nebulisers which the hospital used to give me took 10-20 mins to finish antibiotic or saline and salbutamol. Also, the nebulisers in hospital last June took as long. I bought myself a Pari ebase which takes about 3 mins to nebulise 2.5 salbutamol, 5 mins for 5ml saline and 10 mins for antibiotic. The faster the better because it means that the nebuliser is producing smaller particles and driving them into the lungs more efficiently. I hope that helped.

[Hidden]

There are different types of nebuliser, and different types will run at different speeds depending on the mechanism by which they work. The mechanism also dictates the particle size of medication provided, with faster nebulisers usually generating smaller particles, which means that the medication should penetrate deeper. Particle size aside, day to day, fast or slow makes little difference to treatment efficacy other than convenience and the time spent completing treatment. If only doing one or two nebs a day, 40 minutes might be acceptable. If you have a condition like ncfb (bronchiectasis) or cf, though, where you might well be doing 5 treatments or more a day, spending an hour and 40 minutes hooked up to a neb would likely lead to very few people being compliant with therapy. Speed becomes a valid and more important consideration the more nebs you need to do each day. That being said, if you were really struggling with your breathing, then a slower treatment time could potentially be beneficial in some cases, as you might get more or the dose.

Running through them quickly, at the slowest (and cheapest) end of the spectrum you’ll have the really old compression nebulisers like the World Traveller. These nebs are usually quite big boxes and tend to be pretty noisy. We used to refer to it as getting the hoover out when child had one of these as a newborn. It’s a close call in terms of speed between a really old compressor style and using mains oxygen on a ward, but you’re probably looking at up to 20 minutes to complete a salbutamol neb as standard. Next you have jet nozzle nebuliser devices like the pari turboboy, which is also based on a compressor, but goes a bit quicker due to other changes to the design of how it works. We used to get through a salbutamol neb with one of these in around 10 to 15 minutes. The fastest category is mesh nebulisers, which is a broad range with devices like the innospire go at one end and the Phillips iNeb at the other. They all use a mesh to turn the medication into a mist using high frequency vibrations, but medication particle size varies significantly, and they all cost more than jet nebulisers because of the technology involved and that they are that much quicker. In theory. Anyone that’s ever used or splurged on an eflow, which will cost you (or the nhs) about £700 outlay, will know that although mesh nebs are meant to be really fast, there are a lot of variables that can effect delivery speed. Eflows are usually the neb of choice in children with cf over the age of two if they’re nebulising more than once a day, and with brand new parts will get through a dose of salbutamol in under 5 minutes. After a week or two, the consumable parts start to slow down, though (should be good for 6 months), sometimes increasing treatment time to no better than a world traveller. The iNeb can get through a dose of some medications in 90 seconds, but probably around 3 or 4 minutes for salbutamol, however it has an outlay cost to match of around £3000. The NHS has a deal whereby this cost is waived as long as the patient is being prescribed a specific brand of antibiotic neb, meaning that iNebs on the nhs are only available to a relatively small number of patients, but from our own experience they are by far superior to anything else currently available. Top end mesh nebulisers like the eflow and the iNeb also require smaller volumes of medication to deliver the same dose as other types.

Ultimately, which type of neb is most appropriate for a patient usually comes down to the drugs going through it, followed by the cost of the device to the nhs. Someone nebulising normal saline or salbutamol would most likely be given a world traveller or other jet neb, but some meds (particularly some inhaled antibiotics) are only licensed in the UK for use with either the eflow and/or the iNeb due to needing to run at a particular particle size.

This was a very long winded way of saying your neb is almost certainly fine, John. The neb you used on the ward was probably old and/or cheap, and faster is generally better under most circumstances. However, if provided by the nhs, and depending on the type, your neb should potentially be given to the prescribing hospital to be serviced once a year, so I would double check about this with a member of your respiratory team.

[Damon1864 Volunteer]

My nebuliser takes about ten minutes. Have a good day and take care 😊 Bernadette and Jack 🐕 xxxxxx 🌻🌻

[Angel-Girl]

Once asked this when in the hospital was told the nebs they use cost £5 to £10 each and are as the price shows cheap. The neb I use the portable one was £80 and much quicker. In the end its just cost. There is no benefit having meds slower other than the 20 ~ 30 mins everyone on the ward is on nebs is when they give staff a break. Lara 😀

[johnkent]

Thank you all for your replies.I found a spare mask I had and med chamber the same as the one I was using in the hospital and fitted it to my compressor, the result was it took 20 minutes for a 2.5ml neb so it would seem it's not the compressor but the type of mask/chamber that makes all the difference