Proper Nebulizer Technique

Proper Nebulizer Technique

Being Alive Newsletter, Being Alive/Los Angeles - May 1993
John Lewis

It is not just the breathing patterns that must be considered. After the dispersion studies, we did a second study which involved taking X-rays of the nebulizer. We found that a large amount of medication remained in the Y-piece after treatments called dead space medication. To make sure a maximum amount of mediation was dispersed during the treatments, we asked our volunteers to hit the nebulizer cup for three for four seconds every time they held their breath. Using that technique, we then repeated the X-ray and found a substantial decrease in the amount of dead space medication at the Y-piece. As a side effect most patients reported that much less medication dripped into their mouths during therapy.

This study suggests that the correct breathing technique causes much better deposition of AP and thus helps prevent PCP. Our results clearly show that AP is as effective as Bactrim or Dapsone in preventing new cases or breakthrough of PCP. We also noted that combination therapy, Bactrim and AP, had excellent results in preventing new or breakthrough episodes of PCP.

If there is a better way to provide therapy, even if it amounts to something as simple as the sequence of breathing patterns, then I feel it is in the best interest of patient care for doctors to provide that education.

(John Lewis is a registered respiratory therapist and director of respiratory care at Pacific Oaks Medical Group in Sherman Oaks.)
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