when to use a nebulizer

[marbles]

DC got a nebulizer this past year with albuterol for wheezing. At the time, it was a cold or something but the dr. wanted to clear his lungs. Now he's had a cold again and is wheezing now. I'm not sure when is an appropriate time to use the albuterol. He sounds like he did then, but that dr was also a little on the precautious side. So he is coughing some, a wet productive sounding cough, but not much. His breathing is short, shallow and fast but not worrisome at this time. It doesn't sound whistle-y, but sort of like it's through a straw. The alberuterol makes him really jittery and he doesn't like it, so I don't want to use it if I don't have to but I'm thinking maybe I should? We won't have a car to have him seen until Tuesday, and like I said right now I'm not worried that he's not getting oxygen, I'm just keeping an eye on him. He sounds slightly out of breath just standing here. I'm doing what steam I can but our house is drafty it can be hard to get lots of steam.

[AmyDoll]

I do it when the resp count gets above 60.

[LadybugSam]

:popcorn because i never know when to use it.

Have you ever done a saline solution in the nebulizer? it really helps our Toby out a lot, there have been studies showing that it can help as much as albuterol but without the side affects :)

[mamacat]

I was going to also reccomend trying saline first and considering a guifenesen basde expectorant

[marbles]

:popcorn because i never know when to use it.

Have you ever done a saline solution in the nebulizer? it really helps our Toby out a lot, there have been studies showing that it can help as much as albuterol but without the side affects :)

No I haven't tried that. Thank you for suggesting it, I will definitely try that if his breathing doesn't get better. I think he's hovering right at 60, but it can be hard to count.

[TestifyToLove]

Saline solutions can cause bronchospasms. They are great for clearing out gunk but terrible for asthma issues and should not be used without albuterol first.

You should use a nebulizer when a child is struggling to breath and either too young to use an inhaler with a spacer, or the inhaler with the spacer is not providing sufficient relief. Specifically, you are looking for wheezing and retractions, not how may breaths per minute but moreso the quality of those breaths. If you look around the collarbone and see the skin sucking in, that is retractions. If you use a stethoscope (or with significant asthma attacks you can actually just put your ear to the child's chest) and they sound like a train whistle, that is wheezing. Also, if their lips have a blood tinge to them, or they are vomiting with any struggles to breath, these all warrant using a nebulizer.

I understand that the medication can make a child jittery, but there is nothing worse than the struggle to breath. If you are wondering whether it's time to use a nebulizer, then chances are the answer is yes.

[KarenBoo]

You can buy the name brand medication for the nebulizer called Xopenex. (It is still albuterol, just in a slightly different form.) It does not cause the jitters. However, I recently tried to buy some for Kitten, and the generic albuterol was going to cost $15. The Xopenex was $500!!:jawdrop But I have bought the Xopenex before, and it was not nearly that expensive or I never would have bought it. I'm going to call around before I fill this recent prescription.

A restricted airway does not necessarily make a wheezing sound, so you can't always go by that. I think that it is helpful to know the proper respiration rate for your kiddo. If it is too high, then it is an indication for potentially needing the medication. (especially if the RR is high, and there is coughing or you *think* there might be wheezing and struggling to breathe.) I don't wait until I see retractions to give the albuterol. I think that is waiting too long.

There is also a posture called "tripod." That's when they sit with their hands on the floor or chair in front of them (just in front of the crotch area), arms locked straight to push their chest up. They are leaning on those arms. If they have to get into this posture, it helps them to breathe. They need the albuterol.

Sometimes all the sign you have is coughing too much.

I recommend that you buy a pulse oximeter on Amazon. I think I might have seen one at Costco too. This gives me great relief when Kitten is really struggling. But a PO is by no means a way to know when to give the albuterol. I give it to Kitten all the time when her PO is perfectly fine. But it is comforting to have all the same.

You also might want to buy a stethoscope. I bought one, but I am so acutely aware of Kitten's symptoms, that I know what's going on in her body without using it.

I think it's also hard because she will still sound wheezy, even directly after taking a nebulizer treatment. She is old enough to verbalize and tell me that the nebulizer made her feel "looser," even though she still sounds terrible to me.

It's not always easy to know when to use it. You might have to use a little bit of trial and error. The medication is not dangerous if you don't use it too often. And if you don't know, and he can't communicate it to you, you could always have him use 1/2 a dose and see if it is helpful. If it is, then of course, he needed it.

We tried saline in the nebulizer, and it definitely made Kitten worse. But breathing in the steam from boiling salt water works very well for her. But you can't really do that safely with a 2yo.

[PrincessAnika]

speaking only in regards to the jittery feeling, we have discovered that eating a small handful of potato chips helps - something with the salt.
If you are wondering if you need to use the neb you probably do.
it might be helpful to ask his Dr for an asthma action plan and find some sort of peak flow meter if he is old enough to use one (can't see sig on my phone) - not that he necessarily has asthma but that it can be more concrete of "oh your number is only 200 we need to do neb" or "oh 400 that's ok we probably don't need neb" (just throwing out numbers, everyone is different for specifics ;))
hope he feels better soon!

Sent from my VS840 4G using Tapatalk

[mamacat]

Have never had saline cause broncho spasms :scratch and the side effects that most concern me are the long term kind of using albuterol.For starters contains bromides

[KarenBoo]

Have never had saline cause broncho spasms :scratch and the side effects that most concern me are the long term kind of using albuterol.For starters contains bromides

I would much prefer to use the saline, and I might try it again someday. I wonder if the difference is that when I tried it, Kitten was pretty acute. I wonder if we tried it earlier on in the onset of the whole mess if it would be more helpful??

When we lived in Orlando, we visited a place called the Salt Room. It's like a man-made European salt cave. They also nebulize salt into the room during your 45 minute visit. Anyway, this also triggered Kitten's asthma, but once she recovered, we started back at a slower rate and built up. Then we went 3x per week. I wonder if we should try that with the saline.

What kind of saline do you use? I have an Rx for hypertonic saline, but I think that might be too concentrated. Is there something we could try otc?

[marbles]

Thank you all for the help! He doesn't have asthma but he had breathing troubles as an infant and I think that can mean he gets more breathing troubles than most later on. Anyways, we all have the same thing but he's the only one wheezing. I completely understand that being jittery isn't so bad, and I don't hesitate to step in if he seems like he's struggling, but he wasn't showing any other signs that he was struggling to get enough air. He was still up and playing. The albuterol means he doesn't sleep, so I was trying to balance sleep and easy breathing.
I was able to get him breathing easier last night. This will all be very helpful in the future, thank you!

[KarenBoo]

I completely understand that being jittery isn't so bad, and I don't hesitate to step in if he seems like he's struggling, but he wasn't showing any other signs that he was struggling to get enough air. He was still up and playing.

Just fyi, he can absolutely be struggling to breathe and still be "up and playing." Kitten will still get up and run around (if I would let her) when she actually quite sick with the asthma. (extremely low peak flow)

I remember when she was about 2 and she was having big retractions, and I took her to the doctor. Kitten "bunny hopped" from the lobby to the exam room, and once Kitten was in the exam room and the nurse saw how bad the retractions were, she told me she didn't believe my child was sick at first and sort of apologized for thinking that. (She had given me "the look" when I told her how sick Kitten was and she watched her bunny hop away. :-/)