Nebs v Inhalers?!?!

My daughter is 3 years old and a brittle asthmatic - in the last 4 weeks we've needed 4 courses of pred and antibiotics!

We've also had 4 hospital stays - on our second to last discharge the Dr suggested not to give my daughter 4 hourly nebs and swap over to inhalers instead as these are proven to be more effective.

I continued at home the pred and antibiotics for the required days and followed the 'weening program' suggested by the Dr.

2 days after we'd finished doing what we were told she wasn't going even an hour between the salbutamol, resps of 52, very wheezy and sats of 89!!

Now when I give her a neb I can visually see it relaxing her breathing, slowing down and not wheezing so much but I'm not seeing this with the 10 puffs of her inhaler - anyway we've just been admitted again :(

Does anyone have any advice on this matter?

I'm a single parent (with no support system) with another daughter who is 6 and perfectly well and just finding it all too much now, I don't sleep as through the night it's either 3-4 hourly salbutamol and 6 hourly atrovent..........every night without fail she wakes just before midnight needing something to help her breath, takes me ages to settle her and then within an hour or so she needs something else.

As well as all of this I now have my elder daughters school reporting me to education board, as we have to rush to A&E at all sorts of time and sometimes she's just too tired to go to school - I have no family locally so it's just me and no one at the school seems to want to help.

She takes seretide 125mg 2x twice daily, montelukast 4mg, omeprazole, atrovent, salbutamol neb/inhal as needed

Gosh that seemed to be a bit of a moan too - apologies x

4 Replies

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  • I have always found that nebs seem to help more than multi dosing with salbutamol when struggling, though we have only ever used nebs when in hospital, then move onto 4 hourly multi dosing when discharged untill things get better. I feel the nebs seem to get the medicine into their lungs better and more effectively than inhalers. Though have also heard that 10 puffs of ventolin is supposed to be equal to nebs..

    Sorry not much help!

    Hope ur daughter is feeling better soon x

  • Hi

    I am 33 years old and suffered with asthma all my life. I have a nebulizer at home and also several inhalers. I was told a couple of years ago a similar thing that to go onto using my ventolin inhaler with a spacer rather than the nebs.

    I was very surprised at how well the inhalers and spacer worked the first few times i needed them and it did help to a certain extent but if i am completely honest, if I am really bad the only option i feel i have is the nebuliser. It can regulate my breathing much quicker. There is no need to concentrate on how you are breathing in the medicine like there is with the inhalers, as long as the mask is on its working.

    There is a great value to the inhalers for carrying around but I would not choose them over a nebuliser.

    Things will get better for you and it is important for you to talk to your doctors as what is proving to work for most people may not be right for your daughter.

    Also I cant comment on having a daughter who is ill as I have been lucky my daughter is allergy/asthma free, but it sounds to me that if you do not get some help you will end up being ill and then no use to anybody. Have you a community nurse/social worker that you could talk to. Talk to your gp as they will be able to refer you.They may be able to offer guidance and just general support for you. Its not as if you are keeping your eldest daughter off school for the fun of it. There are genuine reasons and it sounds to me you just need someone on your side.

    I hope this offers some help.

  • Our GP insists that there is no need for nebulisers now as 10 puffs of inhaler have the same effect...he clearly doesn't have a 3 yr old child with chronic asthma! It is a lovely theory but in the heat of the moment when the child is upset and almost delirious, getting 10 puffs into him isn't as easy as it sounds. Even though he doesn't like nebulisers much, particularly the noisy hospital ones, even just holding it very close to, but not directly on his face, seems to provide more relief overall, or so we have found.

    Obviously in the middle of the night at home etc it makes more sense to do the ten puffs than to take him to hospital unless it is clearly necessary but I do think that from our experience with our son nebulisers have proved to be more effective and last longer too.

  • I have had a nebuliser at home for my daughter for 5.5 years (she's now 6.5). They've always worked better than 10 puffs when she's having a serious attack. She's one of very few in our clinic to have one at home and I'm reminded of this often by speicialist nurses who doubt it really works better. Luckily the consultant accepts my observations (plus she has tracheal stenosis so I get a bit more leverage with that additional complication).

    Maybe it's because young children can panic, or maybe some physiological differences mean people vary on which method suits them best.

    I will say though that even if a school is willing to keep a nebuliser on the premises, hospitals will rarely accept anyone monitors a child on one other than trained staff or experienced main carers.

    Best of luck.

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