Nebulizers are medical devices used to administer medication in mist form directly to the lungs. This allows the medication to bypass the upper airways and reach the bronchi and alveoli more effectively. One of the most common medications given via nebulizer is a saline solution, which helps thin mucus secretions and make breathing easier.
What is a nebulizer?
A nebulizer is a small medical device that converts liquid medication into a mist. It consists of a cup or reservoir that holds the medication, a mouthpiece or face mask, and an air compressor that supplies pressurized air to aerosolize the liquid into tiny droplets that can be inhaled.
When inhaled through the mouthpiece, the medication particles penetrate deep into the lungs. This allows the medication to bypass the upper airways and quickly reach the smaller bronchi and alveoli where it can exert its effects.
Nebulizers are commonly used to administer bronchodilators like albuterol to treat asthma and COPD. They are also used to give steroids, antibiotics, and mucolytics like hypertonic saline.
How do nebulizers work?
Nebulizers work by using compressed air to convert medication solutions into an inhalable mist. The nebulizer cup is filled with the medication and fitted into the nebulizer chamber.
When the nebulizer is turned on, compressed air from the attached air compressor is forced through a small tube and directed at the surface of the medication. This creates turbulence that causes the medication solution to break up into small aerosol droplets.
The tiny mist droplets containing the medication move up the nebulizer cup and enter a baffle system. Larger droplets collide with the baffle and fall back into the cup while smaller particles make it through and become available for inhalation.
The patient inhales slowly through the mouthpiece, drawing the medication particles into the lungs. Typical nebulization takes 5-10 minutes to complete depending on the medication volume.
Why use saline solution in a nebulizer?
Saline solution is one of the most commonly prescribed medications given via nebulizer. It is an isotonic solution that has a similar salt composition as the human body. The main uses of saline solution in a nebulizer include:
- Thinning mucus secretions in the lungs
- Helping clear congestion from the airways
- Delivering moisture to the lungs
- Improving lung function
- Promoting bronchodilation
- Making it easier to cough up phlegm
Inhaled saline hydrates the airways and helps dissolve thick mucus, making it less viscous and easier to expel through coughing. This can help clear congestion and improve breathing difficulties in conditions like asthma, bronchitis, COPD, cystic fibrosis, and sinus infections.
How much saline solution should you use?
The amount of saline solution used in a nebulizer can vary based on a few factors:
1. Type of saline
There are a few different types of saline solutions used:
- Normal saline – 0.9% sodium chloride solution
- Hypertonic saline – 3% to 7% sodium chloride solution
- Bromic acid saline – contains sodium chloride and bromic acid
Normal saline is typically used for general hydration and thinning secretions. Hypertonic saline is more concentrated and prescribed for conditions like cystic fibrosis to help clear very thick mucus.
2. Age of patient
The dose given depends partially on the age and size of the patient:
- Infants – 3 to 5 ml
- Young children – 5 to 10 ml
- Older children & adults – 10 to 15 ml
Higher volumes may be used for adolescents and adults. Lower volumes are needed for infants and young children.
3. Administration schedule
How much saline is used per treatment depends on how often it is given:
- 2 to 4 times per day – Use smaller 5 to 10 ml doses
- 1 to 2 times per day – Can use larger 10 to 15 ml doses
With more frequent administration, the total daily dose is divided into smaller individual volumes. Less frequent use requires larger volumes for each treatment.
4. Condition being treated
Higher saline doses may be prescribed for certain lung conditions like:
- Cystic fibrosis – 10 to 15 ml of 7% hypertonic saline
- Chronic bronchitis – 10 to 15 ml of normal saline
- Pulmonary edema – 10 ml of normal saline
Always follow your doctor’s specific dosing instructions based on your lung condition.
How to administer saline solution with a nebulizer
Follow these steps to properly administer saline solution with your nebulizer:
- Wash your hands thoroughly to avoid contamination.
- Assemble the nebulizer according to the manufacturer’s instructions if using for the first time.
- Measure out the prescribed amount of saline solution and pour it into the nebulizer medicine cup.
- Connect one end of the tubing to the bottom of the medicine cup, and the other end to the air compressor.
- Turn on the compressor to begin nebulization.
- Sit in an upright, comfortable position and place the mouthpiece in your mouth, sealing your lips around it.
- Breathe slowly and deeply in through your mouth and out through your nose until the treatment is finished.
- Some saline solution will remain in the cup when finished. Tap the cup to collect any remaining medicine and inhale it.
- Clean and disinfect your nebulizer after each use as per the manufacturer’s instructions.
Try to keep the nebulizer upright during treatment to prevent spilling or leakage of the saline solution. Breathing calmly with periodic deep breaths will optimize delivery of the medication to your lungs.
How long does saline solution nebulizer treatment take?
On average, nebulizing saline takes about 5 to 10 minutes to complete. However, the nebulization time can vary based on:
- Volume of saline solution used – More saline means longer treatments
- Nebulizer flow rate – Faster nebulizers deliver the dose quicker
- Patient’s breathing pattern – Deep, slow breathing shortens duration
- Dead space in tubing – More dead space increases treatment time
Make sure to continue the treatment until all saline solution has been delivered, even if it goes past 10 minutes. Breathing normally and calmly will help reduce the overall treatment duration.
Are there side effects of saline solution nebulizer treatments?
Saline solution is generally very safe when inhaled via nebulizer. However, some potential side effects can include:
- Coughing – Common temporary effect as the lungs expel mucus
- Throat irritation
- Changes in heart rate or blood pressure
- Wheezing or chest tightness
- Altered taste sensations
- Nosebleeds (rare)
Coughing during or after nebulized saline is expected as mucus is cleared. Notify your doctor if coughing persists after treatment. Seek medical care if you experience wheezing, chest tightness, or difficulty breathing.
Precautions when using saline in a nebulizer
Take these precautions when using saline solution in your nebulizer:
- Only use sterile saline solutions intended for inhalation.
- Do not exceed the prescribed dose.
- Do not mix other drugs in the nebulizer without medical approval.
- Always follow the manufacturer’s instructions for cleaning the nebulizer.
- Keep water and saline bottles sealed when not in use.
- Notify your doctor if treatments cause increased coughing or wheezing.
- Seek medical advice before using if pregnant or breastfeeding.
Carefully following nebulizer instructions and your doctor’s directions for saline solution use can help avoid potential risks and side effects.
Key points
- Saline solution helps thin mucus and clear congestion from the lungs when used in a nebulizer.
- Typical saline doses are 3 to 15 ml depending on age and condition.
- Use sterile normal saline or hypertonic saline solutions as prescribed by your doctor.
- Breathe slowly during the 5 to 10 minute nebulizer treatment.
- Adverse effects are mild but can include coughing and throat irritation.
- Always follow safe nebulizer practices to avoid infections or complications.
Inhaled saline is an effective and low-risk therapy for improving lung health. When used properly under medical guidance, nebulized saline can help relieve congestion and improve breathing in both children and adults.
