Nebulizer Help!

[looking8186]

I was wondering if anyone had any experience just using saline or sterile water in a neb? I have two little foster kiddos (3.5 and 4.5) who are on an albuterol nebulizer for asthma but don't seem to need the meds at this point. They are very attached to the routine of using the neb but I don't want to over do the medication (obviously if they were showing ANY signs of asthma I would give them the albuterol). Their foster mom had them using the neb EVERY night with meds even when they're not sick/needing it because it "helps them sleep better" . I just don't feel comfortable administering medication to small children when they don't really NEED it.

Any suggestions ladies? Could I do a saline/sterile water neb for a placebo effect or...?

***************FOR THE RECORD*************

*** I am simply looking for info to call the dr with. I am not attempting to change anything on my own and their script is NOT for everyday use which is why I am investigating this further. ***

[monkeymama07]

You can get the individual Tubes of saline water for the neb just like you get of abuterol

We use it to help with bloody noses from dry air etc...

[looking8186]

Awesome mama! Thanks for the info... Do you happen to know if there's any risk in doing it? I know saline can sort of "unjunk" things and get mucous flowing but other than that...?

[luvsviola]

I wouldn't do it without calling the pulminologist first and asking.

[looking8186]

Unfortunately they do not have a pulminologist. Im only doing respite otherwise I would be taking care of this meds situation for good and getting them in to see one. I will be calling their pedi to check ASAP but figured I'd ask on here first so i could call and know what to specifically ask for/about. I honestly believe this is one of those "asthma" cases where these girls have had a label slapped on them with no one properly managing their care. Their foster mom does her best but there's definitely a language barrier and a lack of understanding about the true effect of these meds on their little bodies.

[monkeymama07]

Originally Posted by luvsviola I wouldn't do it without calling the pulminologist first and asking.

ours is a script. I don't think the saline does anything other then losen mucous and moisten though.

Really if you don't KNOW about the long term history you should give the treatments they get.

I know some kids seem healthy and stay healthy with the treatments which makes you think they are overkill but without can get sick and have a hell of a time getting better.

I would give the treatments until the doctor okays you not.

[looking8186]

Just for the record I have no intention of changing anything! The thing is that they are NOT supposed to be getting these treatments. The social worker informed me of that fact and the script is not for daily use it's only as needed when showing symptoms of an attack. That is my concern. I was looking for info that I could call the dr to ask about and inform the foster mom of. All too often kids in foster care are over medicated unnecessarily with no one who steps in to say "hey what's up with this?!? Let's take a look at what this child really NEEDS".

I appreciate the help and am not looking to change anything just honestly searching for some info to ensure that these kids are being taken care of properly.

[luvsviola]

Hmmm...I wonder if the foster mom doesn't understand the difference between albuterol and pulmicort/budesonide? Are they supposed to be getting pulmicort daily? That is a daily med.

[looking8186]

I'm honestly not sure... I only have them for 10 days but I'm trying to do my best to get these meds sorted out before they go back. The foster mother is Spanish speaking only so I think there's a bit of a language barrier... I also think that at least in the community I'm working in (a very very culturally diverse city) many people (foster parents and social workers included) have very little understanding of what meds should be used for what and how to administer them/monitor the need for them etc. This girls were dropped off to me with no medical cards, no instructions on using the neb (luckily I knew) etc etc.... There is veryyyyy little support for foster parents and the typical caseworkers with caseloads so large that a "little thing like asthma meds" just doesn't matter.

[TS8213]

I'm a Respiratory Therapist at a local hospital (and have been for the last 10 yrs). We NEVER give saline in the nebulizer. Saline could actually cause bronchospasms in the airways.

I didn't see Pulmicort/Budesonide mentioned by the OP (unless I missed it?) but that medication is a steroid/maintenance med that should be used, typically, 2x/day to maintain the airways and prevent any inflammation. Think of it as taking a blood pressure medication daily to keep your BP in check. We do the same thing for the airways in children who have RAD (reactive airway disease).

Albuterol is typically a "rescue" medication. It's used when the child has break through symptoms, like wheezing, to help relieve symptoms.

My DD has RAD and she uses her inhaler (used to be a neb when she was smaller) as needed. In the winter her RAD is triggered by the cold weather. It causes her to cough incessantly, to the point where she vomits. Using her maintenance meds helps, but sometimes we routinely use the Albuterol inhaler as well. In the spring, her RAD is triggered by seasonal allergies.