Your question: I live in a nursing home and my nurse adds a bullet of saline to my Albuterol. Will I get the same benefits from the medicine? Thanks
My answer: To add an amp of saline will still allow you to get the same effect from the medicine. I see no benefit of doing so, unless you want the treatment to run twice as long.
8 comments:
Where I work, if giving a 2.5mg Albuterol treatment alone (no Atrovent) then you have to add 2.5ml NS to dilute the medicine and have the nebulizer run on 3ml of meds.
I've wondered the same thing myself.
Why is it done if it is of no consequence either way? Or is this another case of "it's always been done that way" with no scientific proof to back up the action?
Either way, I'm curious.
Not an RT but as a patient, the added saline helps me loosen thickened phlem to make it easier to bring up. If I just use rescue inhaler, it does not work the same way.
The other reason why you would add a couple cc's of saline is so the patient can get a little more of the meds. The reason is all news have a dead volume, which is the amount of liquid the neb must have to actually aerosol. Most are 1-2cc's so if you only use the 0.5cc of albuterol then you will not get that much, but by diluting it you should get a little more. Yet again you get very little of the total meds using a neb because most escapes to the air.
Our pharmacy sends us 2.5mg in 0.5mL, so I have to had NS to the 0.5mL to make it 3mL, so that the neb has enough fluid to run on. If they're getting A/A the fluid from the Atrovent will make up the fluid deficit.
The nebulizer doesn't nebulize it all. There is a fixed residual volume left over that doesn't nebulize. Diluting the treatment with saline means that less drug is left over in the non-nebulized residual volume.
Few want to sit through an elongated breathing treatment, and I include myself in this. But whatever works for you go for it.
I have seen caregivers adding 3ml of saline to a premixed vial of albuterol and saline with 3 ml saline already in the vial-That just dilutes the med by 1/2 again what it was intended to be and since much is going out in the vapor only 1/2 of the intended amount is absorbed if that! RN MN
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