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Asthma is one of the most common chronic diseases in children, according to the third national epidemiological survey in 2010, the prevalence of asthma in Chinese children is 3.02%.
Asthma has the characteristics of long course, repeated attacks, and difficulty in control.
Asthma control therapy should be started as early as possible, and the principles of long-term, continuous, standardized, and individualized treatment need to be adhered to.
Nebulized inhalation therapy has become a widely used technical means in children's respiratory diseases, especially in the maintenance period of bronchial asthma in children, nebulization inhalation therapy generally has no age limit, and is also the preferred treatment method for asthma in young children, without complex technical requirements.
Family nebulization has the characteristics of simple, practical, easy to operate and gradually favored by parents of children with asthma, while the child is treated in a familiar environment, and can also better cooperate with inhalation therapy to avoid crying due to fear, and compliance is significantly better than the nebulization treatment in the hospital.
Various guidelines at home and abroad also actively encourage families with conditions to choose long-term nebulization treatment for children with asthma at home, let's take a look at the relevant precautions that parents should know when home nebulization treatment.
1
Choose the appropriate atomization inhalation device
Choosing the right nebulization inhalation device and using it correctly is the key to successful treatment.
At present, there are many kinds of nebulization treatment instruments on the market, how do we choose a nebulization treatment instrument suitable for children with asthma?
First of all, we must understand the principle of nebulization treatment, nebulization treatment is the application of special aerosol generators to make drugs into aerosol particles, inhaled and settled in the lower airway or alveoli, to achieve the purpose of treatment.
The ideal household nebulizer should have the characteristics of small size, low noise, fast fogging efficiency, easy to carry and use, etc. The atomized particles output by the nebulizer must be 1 to 5 μm to ensure that the drug can reach the lower respiratory tract.
When choosing a atomization machine, parents must see the output atomization particle parameters and choose the appropriate atomization treatment instrument.
In the clinic, those who can meet the above requirements are mostly compression nebulizers, and ultrasonic nebulizers are generally not recommended due to the large density of fog droplets, few effective drug particles, and increased airway resistance.
2
Choice of atomization drugs
Before the atomization treatment, the treatment plan and course of the child should be fully understood according to the doctor's instructions, and there are more drugs for the treatment of nebulization in children clinically, including budesonide, terbutaline and ipratrope bromide, etc., and the choice of drugs should follow the doctor's opinion, including the variety, dosage and use method of the drug.
Asthma control requires long-term, continuous and standardized treatment, drug reduction or discontinuation has its own quite strict standards, must be fully judged by clinicians, do not give drugs to children without authorization, reduce drugs or stop drugs.
When the child's condition changes, he should immediately consult the doctor to adjust the medication, and do not use the drug without authorization according to subjective judgment.
3
The specific process and precautions of the atomization operation
Do not apply oily cream before the nebulization treatment to prevent the drug from depositing on the face.
Respiratory secretions need to be adequately removed prior to nebulization therapy, which facilitates the deposition of aerosols in the lower respiratory tract and lungs.
Infants generally adopt a sitting position, and infants can take a semi-sitting recumbent position to keep the cup upright.
Older children breathe through the mouth as much as possible until all medications disappear, while younger children who cannot cooperate with the bite type choose mask inhalation.
In the process of household nebulization inhalation, do not rush to cover the mouth and nose when the fog is just out, to prevent coughing caused by drug stimulation, and should slowly attach the atomization mask to the mouth and nose of the child.
The handheld nebulizer should be perpendicular to the ground, the mouth and nose should be covered when using the mask, and the distance from the mouth and nose should be less than 1cm, and the mouth should not be too deep into the throat when using the mouth, so as not to cause vomiting reflex.
If the child's crying is intense during atomization, it can be paused for a while, and inhalation is better than when crying, because most of the drugs do not enter the respiratory tract when the child cries badly, but is deposited in the oropharynx and face.
The total amount of nebulization solution is generally maintained at 3-4 ml during nebulization treatment, and the total amount of the solution can be output in 10-15 minutes.
During the atomization process, pay attention to the child's condition and fogging, and do not spray aerosol into the eyes.
After the atomization is completed, remove the mask or bite the mouth before turning off the power to ensure that the machine is not charged.
4
What to pay attention to after the end of the nebulization inhalation
For older children, they need to rinse their mouths, while younger children choose to drink water and wash their faces if they cannot rinse their mouths, prevent the deposition of drugs on the face and oropharynx, reduce pharyngeal discomfort and drug residues in the mouth, and reduce adverse reactions caused by drugs. For some small babies, you can also use a cotton swab dipped in normal saline to wipe the mouth for oral care.
After the end of the atomization treatment, the necessary cleaning and disinfection of the nebulization treatment pipes, atomization masks, and atomization machines are also required. After the sprayer is used, in order to prevent the drug crystals from clogging the nozzle, a small amount of water can be added to atomize for a few 10 seconds, and then rinse the sprayer.
Rinse all the sprayer accessories except the air duct together with clean water (or warm water), shake off the residual water, put the parts on a clean cloth or paper towel to dry, or dry with a cloth, after the sprayer is completely dry, assemble the sprayer and put it in a clean box for later.
A child is advised to use his own set of atomized masks to prevent cross-infection.
Atomizing masks and atomizing machines should also be disinfected regularly according to the instructions in the instructions. Atomization machines are generally disinfected once a week, using the disinfectant recommended by the manufacturer to disinfect the equipment, when the atomization machine is not in use, cover the machine with a clean cloth to keep the machine clean.
It is worth mentioning that for the use of nebulization drugs that have not been used up once, they can also be stored in a 4 ° C refrigerator, in order to avoid affecting the efficacy of the drug, it is recommended that the storage time is not more than 24 hours.
Write at the end
Home nebulized inhalation therapy is not only a change in the treatment place, but also a breakthrough in the concept of individualized treatment, self-management and treatment mode. When the family atomization, the child is familiar with the family environment, avoids crying, is easy to cooperate, increases the child's compliance, and the drug effect will be better. Of course, although home atomization is fast and convenient, but because there is no on-site guidance of the doctor there are also many potential dangers, parents should pay attention to observation, especially in children less than 1 year old, family atomization may even lead to hypoxia and suffocation, parents should be screened in time, found any adverse reactions can immediately stop nebulization treatment, if necessary, still need to go to the hospital for evaluation and treatment.
Bibliography:
Editorial Board of Chinese Journal of Pediatrics, Respiratory Group, Science Branch of Chinese Medical Association. Guidelines for the diagnosis and prevention of bronchial asthma in children (2016 edition) [J].Chinese Journal of Pediatrics,2016,54( 3): 167-181.
Feng Wei,Zhang Jing,Li Youzi. Health education in home nebulization treatment for children with asthma[J].Primary Medical Forum, 2017.21(13):1691-1692
Xu Youlan,Zhong Xueqiong. The application of rational selection nebulizer in pediatric inhalation therapy[J].Journal of Qiqihar Medical College,2007.28(12):1530-1531
[4] Respiratory Group of Shanghai Medical Association Branch, Pediatric Medical Consortium of Shanghai Children's Medical Center (Pudong). Inhalation method and quality control expert consensus of common inhalation devices for children's asthma[J].Chinese Journal of Practical Pediatrics, 2020.35(14):1041-1050
This article was first published: Pediatrics Channel of the Medical Professions
This article is written by Feng Wei
Editor-in-Charge: Wen