Saline nebs?

Ended up admitted this weekend and discovered I'd been written up to have saline nebs prn as well as salbutamol ones. Although the care in general was great I wasn't that impressed I'd been written up for something without any explanation of why or what it was for (there was one dr who was rather tactless and bad at communication so suspect it was him as the rest were really good)! Apparently i'd been given one but not told it was saline not salb (not sure I actually believe this though as I've been given them once or twice before and they don't taste/feel the same IMO). Obviously it's not harmful but I llke to know what I""m getting and find salb generally helps but saline has not previously made much difference so a prn neb kinda needs to be the right one esp if they are counting how often you ask and using it to decide when you can escape!

As I said in general the care was great but the nurses also didn't seem to have been told why I had these on my chart. I did ask one and she said it was exactly the same as salb which I am afraid I don't quite buy as saline is not a beta-agonist! My understanding is that saline nebs are mainly used to loosen secretions and help cough them up. However, this isn't a problem I generally have and I did say I wasn't gunky + afaik they didn't think this was an issue (disch letter says dry cough)? I do tend to be cough variant during attacks though so wondered if it was related to that though as I said it's a dry asthma cough, no gunk - but have had A&E on about saline nebs for that before. not sure how it would help though? The doctor on that occasion was also on about how the cough was from the throat because it was dry (it's not but I did have a cold at the time so could understand the confusion) so perhaps related to that somehow?

Has anyone else been offered/had these in A&E or while in but not specifically told why/not known why or it's not been related to trying to cough stuff up? It's not that big a deal but I forgot to ask and now it's come up a few times I am curious.

6 Replies

  • I am cough variant and regularly get written up saline nebs when I am in hospital. For me I know it does help a little so I am always happy to use it.

    I think the theory behind it is that it helps moisten the airways, which may be more helpful for cough variant asthmatics than standard wheezers. they always recommend steam for coughs but I can never do it because the heat makes my cough much worse rather than better. I often think that saline nebs are doing the same thing as steam would, just without the heat.

  • Ahh thanks. Yes I get told about steam inhalation as well but it really doesn't work for me - humidity and steam make me really tight-chested, not good at all!

  • Well I've just spent the afternoon in A&E and was given saline nebs so thinking of your post, having a rather chatty nurse and generally rambling on from so much meds, I took the opportunity to ask about them. The nurse said that they can be given to loosen secretions (which is what I have had in the past) but today it was because my airways appeared dry and irritated from coughing which can then apparently contribute to more coughing. This is quite unusual for me as I usually get quite a lot of mucus during attacks but makes sense with the steam inhalation - I am so glad it doesn't set me asthma off as I have spent so many nights in a boiling hot bath to soothe a cough!

  • Thanks Kayla! :( re A&E, how are you doing now? Are you home? Hope they sorted you out a bit, how are things generally?

    That would make sense then but wish they'd said... They were v hot on fluids and being too dry, said it was common with asthma and made me have 2 bags of IV saline which I have never had before (was a diff hospital from usual as I was visiting an AUK friend...). Though I did one time have an A&E cons in my local nearly give me fluids along with magnesium, she decided not to in the end for some reason.

    It's very annoying lol, never had it before but of course it means you end up in the bathroom a lot but attached to a drip stand which is awkward. I had an argument about having a shower with the nurse (she thought I was too SOB for it but asked me if I thought I'd be ok, so I said yes then accidentally pulled cannula out and got blood everywhere oops!)

  • Hi Philomela,

    Did the usual quick turn around in A&E yesterday but unfortunately these are getting more frequent at the moment. I ended up in an assessment room with the chatty nurse as there were no cubicles available but it helped to pass the time between nebs! Generally, things were better for a brief period but keep getting colds at the moment. Hoping it settles before the hayfever season (I don't really react to trees in the same way as grass so have a few months)! Seem to have been on an awful lot of pred this winter.

    I don't think I would be able to have a shower with a drip - I can barely sit in bed with one! How are you doing (apart from the admission)?

  • Glad you had someone to talk to! My least favourite is where you end up stuck somewhere with no signal and no one to talk to...but luckily had Kindle etc and phone. Also the dr was in the cubicle about every 5 mins and I really don't know why - I don't have particularly bad attacks anyway and I don't think even by my standards this was a bad one - they were confused by me as ever though and I ended up in Sat night - Tues. grrr. With lots of nebs.

    I managed to have the shower in between bags of saline but then had to go to the loo a lot (and yes I'm bad with them in bed as well, pull things out by mistake!) They seem to have this annoying habit of putting in cannulas 'just in case we need it' as well grr.

    Hope things do settle for you soon! Have you had Xolair suggested, with the new criteria? You're so allergicy seems like it might be worth asking?

    grr re pred. know the feeling as been on it non stop since end of Sept and really starting to notice all the lovely side effects! Basically it's all a bit of a mess atm - my cons keeps saying I need to get off it as it's so bad for me, I keep trying, getting to about 15-20mg then ending up with an admission or A&E trip. He says well you didn't need to go did you and you don't really need this pred as not severe, I say well it might not kill me coming off but I'd quite like to be able to work etc (I'm not much use for anything when symptomatic on the lower doses right now). But then he suggests Xolair for me which I hadn't thought was an option?! Problem is I do have an allergy to SOMETHING but the tests keep coming up negative even for stuff like trees (and I am sure they are partly responsible given various reactions I've had). All vv confusing and frustrating but I do have an epic GP who is trying to help me sort it all out. :)

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