Saline nebulisers for the management of secretions

Introduction

This information leaflet is for parents and carers under the respiratory complex chest service.

Children with neurological disabilities may have difficulty coughing and clearing oral secretions when unwell. This is because some medications, such as hyoscine patches and glycopyrronium, can change the consistency of oral secretions.

The secretions may become thick and sticky, making them difficult to cough out or swallow. This can cause them to build up in your child’s mouth and throat, causing coughing and gagging.

A saline nebuliser can help to thin down the secretions so that they are easier to cough up, swallow, or be suctioned out.

How does it work?

A nebuliser is a device that turns a liquid, such as saline (slightly salty water), into a fine mist, which your child can breath in through a face mask. Your child will be prescribed saline ampoules (small plastic vial) to use with the nebuliser.

The number of times your child will be recommended to use the nebuliser will from one to three times daily depending on the strength of the saline and your child’s requirements.

Benefits

Using a saline nebuliser often helps to thin down thick, sticky secretions so that they are easier to cough up and swallow or spit out.

Using the machine

You will be given:

• A nebuliser machine with instructions,
• Tubing, chamber and mask (single patient use – with a face mask)
• Prescribed Sodium chloride 0.9% ampoules (saline) and / or a prescription for 3% saline if it is deemed appropriate for your child.

To use the machine:

1. Connect one end of the plastic tubing to the port on the machine, and the other end to the port on the bottom of the chamber. Connect the top of the chamber to the plastic mask.
2. Unscrew the chamber into two halves, empty 5ml of saline (which may be more than one ampoule, they can come in 2.5 mls and 5 mls) into the bottom half of the chamber, around the central pillar, and screw the top half of the chamber back on.
3. Plug the power cable in to the side of the machine and connect to a wall socket. Turn the machine on using the button on the side. You should be able to see a fine mist coming through the mask.
4. Place the mask on your child’s face. They should feel moist air coming through the mask. They should breathe in and out normally until the saline has all gone from the chamber, or until you feel it is time to stop (usually around 10 minutes).
5. When this process is complete, remove the mask, then open the chamber and pour any remaining saline down the sink. There will always be a small residual amount.

Cleaning and maintenance

After each use, it is recommended that the saline chamber should be taken apart into its component pieces, washed in warm soapy water, rinsed with clean cold water, and allowed to air dry.

Sterilise the chamber weekly if it is used regularly.

Do not immerse the tubing in water.

The mask, tubing, and chamber should be replaced every 12 months, or sooner if needed.

The nebuliser machines are serviced annually. Please get in touch with the respiratory clinical nurse specialist or bring the nebuliser to your child’s next clinic visit.

Contacts / further information

The complex chest service: 01223 348067