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Aerosol Therapy and Nebulizers RET 2274 Respiratory Therapy Theory Lab I Module 6.1 Aerosol Therapy and Nebulizers Aerosols Particulate matter suspended in a gas Particulate matter can be either a liquid or a solid Examples: Liquid - Albuterol (liquid medication) Solid - Cromolyn sodium (powdered medication) Aerosol Therapy and Nebulizers Aerosols Liquids are aerosolized in clinical practice Bland aerosol therapy (cool or heated) Agents used Sterile water Saline (hypotonic, isotonic, hypertonic) Use to treat Airway edema Humidification of bypassed upper airway e.g. artificial airway Sputum induction and mobilization Aerosol Therapy and Nebulizers Aerosols Liquids are aerosolized in clinical practice Aerosolized medication Directly to the pulmonary system for treatment of a pathology Bronchospasm Mucosal edema Infection Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Nebulizer – a device that produces particulate matter that is delivered into a gas Large-Volume Nebulizer Large-Volume Ultrasonic Nebulizer Small-Volume Nebulizer Small-Volume Ultrasonic Nebulizer Bulb-Type Nebulizer Respigard II Small-volume Nebulizer Breath-Actuated Nebulizer Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Pneumatic Nebulizer 1. 2. 3. 4. 5. 6. High pressure nozzle Maximum shear force Capillary tube Baffle Area of vorticity Reservoir Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Large-Volume Nebulizer Pneumatically powered Variable air entrainment port Increase flow rate Alter FiO2 Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Large-Volume Nebulizer Single-patient use Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Large-Volume Nebulizer Heaters Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Large-Volume Ultrasonic Nebulizer 1. 2. 3. 4. 5. 6. 7. Radiofrequency generator Shielded cable Piezoelectric crystal transducer Water-filled couplant reservoir Solution chamber Chamber inlet Chamber outlet Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Small-Volume Nebulizer Pneumatically powered Medication administration Bronchodilators Antiinflammatory agents Antibiotics 10 ml medication reservoir Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Small-Volume Nebulizer Single-patient use Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Respirgard II Small-Volume Nebulizer Administration of Penamidine Tx for Pneumocystis carinii pneumonia (PCP) Two one-way valves Wye Expiratory filter Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Breath-Actuated Nebulizers Deliver aerosol only during inspiration Eliminates waste during exhalation Increases delivered dose AeroEclipse Aerosol Therapy and Nebulizers AeroEclipse Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Bulb-Type Handheld Nebulizer Medication administration Powered by squeezing the bulb Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Small-Volume Ultrasonic Nebulizer Medication administration Home use Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Small-Volume Ultrasonic Nebulizer Medication administration Mechanical ventilators Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Small-Volume Nebulizer (continuous nebulization) Intravenous drip system for Used to manage severe bronchospasm when traditional dosing strategies are ineffective Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Large-Volume Nebulizer (Continuous Nebulization) Medication administration Used to manage severe bronchospasm when traditional dosing strategies are ineffective 240 ml medication reservoir HOPE Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Small-Particle Aerosol Generator (SPAG) Special-purpose large-volume nebulizer Administration of Virazole (ribavirin) Tx for respiratory syncytial virus (RSV) Used with masks, hoods, tents, vent circuits Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Airway Appliances Used to deliver aerosol therapy A. B. C. D. A Aerosol mask Face tent T-Tube Tracheostomy mask B C D Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Metered Dose Inhalers (MDI) Medication administration Bronchodilators Steroids Aerosol Therapy and Nebulizers Aerosol Therapy Equipment MDI Accessory Devices Reduce oropharyngeal deposition Eliminate need for hand-breath coordination Aerosol Therapy and Nebulizers Aerosol Therapy Equipment Dry Powder Inhaler (DPI) Patient creates an aerosol by drawing air through a dose of finely milled drug powder Do not require the hand-breath coordination needed for MDIs, but do require high inspiratory flows