Holiday Nebulisers

Judging by the amount of calls we are taking recently many of you are turning your thoughts to holidays. Spring sunshine makes everyone more optimistic and determined to shake off those winter blues, be it a day in the country, a trip to the seaside or a much more adventurous ambition. 

There’s lots of information in the form of clickable links throughout this blog to help you find the nebuliser you are looking for  as well as helpful comments from our friends. You can view our range of holiday nebulisers here https://evergreen-nebulizers.co.uk/ 
Or if you are still unsure you can email HERE or call us on 01942 701210

Of course travelling can be a little more daunting for those of you with a chronic medical condition but with the correct advice from your health professional , an ample supply of medication , enough spares and accessories to see you through and a little guidance  from those in the know, whats to stop you popping on those sandals and getting away from it all for a while? 

Nebuliser Accessories

Have you changed yours recently? 

At least once a week we get a call from a nebuliser user or their carers panicking because their unit isn’t working. As with any machine this is quite possible and over time some just wear out, even under guarantee faults can develop. But the first priority should always be to check your spares and accessories and you can find our full range by clicking HERE or on the red clickable links in this page. 

So how often should you change them?

There is no definite rule and each manufacturer has different recommendations. The questions to ask yourself are:

How often do I nebulise? 

Common sense tells you that if you nebulise several times a day, all year round, you need to be particularly conscientious  Just how long you have been using that chamber? Time flies and somethings can get missed. 

Which medication am I using? 

Some medications are stickier or thicker than others which means extra care has to be taken to ensure all accessories are free from residual medication which may block the jet holes causing the unit to nebulise less efficiently or not at all.

Did you choose a nebuliser with reusable accessories or disposable ones?

So, as a rough guide but by no means a definitive answer

Durable Medication Chambers such as, 

Philips Respironics Reusable Sidestream, Ventstream Sidestream Plus Medication Chamber

Pari LC and the LC Sprint Medication Chamber 

Omron V.V.T. Medication Chamber.

Should be washed in warm soapy water after each use, rinsed and left to air dry.  If kept clean by weekly boiling they can last between 6 to 12 months depending on which unit you chose.  Always dismantle the chambers before boiling and take extra care not to damage the jet holes. 

Disposable Medication Chambers such as,

Clement Clarke Medix Lifecare

Philips Respironics Disposable Sidestream Chamber

Must be washed and rinsed after each use as above but NEVER BOILED and should be changed at least every 12 weeks. 

Don’t forget to replace the baffle when reassembling any of the medication chambers.

Masks and Mouthpieces also need to be washed and rinsed regularly but Drive lines and Air tubes are better kept dry. If you have a durable medication chamber its more likely you will have a durable drive line so check your manufactures instructions. Filters should always be checked regularly to ensure they are clean and dry, some should be changed as often as every 3 months. If filters become blocked your nebuliser won’t function efficiently. 

The Omron MicroAir and the Medix Microneb have a cleaning regime all of their own and more details can be found HERE.

For those of you who suffer from recurrent, frequent infections your heath professional may recommend a different regime and if advised to change your accessories more often it may be more economical to choose a nebuliser with those that are disposable. 

As always we are here to help so please feel free to contact us if you have any worries or concerns with regards choosing the most suitable unit or caring for it afterwards.

Nebulising Saline

Can you sing?

We can’t or at least not very well. 

Recent research however shows that after nebulising isotonic saline Sopranos can sing more effortlessly and as a matter of fact over the years we have had occasional calls from exotic visiting entertainers needing a nebuliser to assist their performance. 

This research no doubt has a more serious aspect and is part of a ‘dehydration challenge’ where dry air and sterile water were used for comparison and although the results were noticeable, the benefit was only short term which helps explain why some of you will be prescribed saline at regular intervals. 

So what is Isotonic saline? 

Its basically sterile salt water at a concentration of 0.9% and often referred to as normal saline. It has many medical uses, nebulisation being just one, but for those of you with a tracheostomy or laryngectomy it can be vital to prevent sticky secretions blocking your airway.

Sticky mucus secretions in lower airways can cause serious long term issues in many chest conditions . They are difficult to clear by coughing and can lead to frequent recurrent chest infections, lung damage and often exhaustion from over coughing and lack of sleep. 

Treatment is very individual and can range from being recommended a simple oscillating PEP device such as the Flutter or the Shaker, regular nebulisation with normal saline, to a complex therapeutic regime  which may include chest physic, mucolytics, inhaled bronchodilators, antibiotics or steroids. 

So what is Hypertonic saline ?

As part of your therapeutic regime many of you are prescribed hypertonic saline. This is a stronger concentration of sterile salt solution which can be anything from 3% to 7%. 

It has been used over the years to treat many chest conditions such as bronchiolitis,  bronchiectasis and cystic fibrosis, and it has helped to the reduce the number of recurrent chest infections and improve lung function for some of you over the short term. However the research is still very much ongoing and where some of you find it beneficial, for others it is not appropriate or you may find it unhelpful. Your health practitioner may suggest a short term trial. 

As to which nebuliser to chose? You may find the hypertonic saline more difficult to nebulise due to its higher concentration of salt, therefore long term a slightly more powerful unit may be more appropriate or one with a specialised chamber. You can view our full range by clicking HERE 
There will almost certainly be more residual salt so cleaning the accessories will need extra attention and you can click on the red links for more advice.

If wish to chat about which nebuliser may be more appropriate or you can recommend a particular unit for others, please give us a call on 01942 701210, email HERE or post below. 

Brittle Asthma

We are enormously grateful for this contribution from Wendy especially as she is particularly unwell at the moment. You can follow her progress at her blog address.

http://myjourneyeverystepoftheway.blogspot.com

Life with Brittle Asthma

If anyone had said at 23 years old, I would be battling lung disease and reliant on a cocktail of medications just to stay stable, I probably would have laughed at them. Maybe looking back, I could have done more with my life while I could, but as a university student who had just moved out and started on a new track, I was all about enjoying myself and partying like a rock star.

Although I have had asthma for most of my life, things really started to kick off and get worse when I was around 21 years old. I had been unwell with a cold at the time and was noticing that I was getting more breathless and wheezing more than I ever had. By the March, I was so poorly with pneumonia in both of my lungs and was told that I was lucky to be alive. This triggered a long string of hospital admissions, some requiring some lengthy stays, long term prednisolone and becoming a regular visitor to my GP surgery. 

I began treatment at the Heart of England NHS Trust, in their specialist Chest Clinics and Severe Brittle Asthma Unit. I was started on a home nebuliser. My nebuliser is such a lifesaver and has meant that I have been spending more time at home rather than in hospital. I have my Freeway which sits by my bed, and it is so reliable and has helped me in so many ways. I carry with me my Omron Micro-air which has become my best friend. I really am able to have an active and enjoyable quality of life.

One piece of advice I would offer to anyone else who is struggling and feels as though they need extra help, I would really say be persistent. Don’t let anyone beat you down or tell you not to try, or ignore the symptoms of worsening asthma, it nearly cost me my life by being so flippant about it. 

Thanks Wendy, hope you feel better soon. 
If you have a similar experience I'm sure Wendy would love to hear from any of you through her blog and for anyone wishing to find out more why not contact Asthma UK            

http://www.asthma.org.uk/

What is a Peak Flow Meter?

A peak flow meter is a small tube that you blow into. It measures the speed of the air coming out of your lungs, and ideally should be performed standing up and at regular intervals through the day

Initially you should be shown how to use it by your health practitioner and the meters are available on prescription. Once you have  removed the peak flow from the box and checked that the marker is showing zero on the ruler, hold the tube with your fingers either side of the ruler so they are not touching or stopping the marker from moving. Take as deep a breath as possible, seal your lips round the mouthpiece, then blow into the tube as hard and fast as you can. You should do this three times with a short rest in between and it is the best of these three readings that you should write in your peak flow diary.  

Why should you measure your peak flow? 

It can help to confirm your diagnosis. For instance, asthmatics usually find their peak flow readings lower in a morning and using a peak flow meter will help you to tell what is going on in your airways  rather than just guessing by the way you feel. By keeping a record of your readings your health practitioner can monitor your progress at your next appointment. Is your treatment having the effect it should.? Does your peak flow improve following your medication?

What are normal readings? 

Readings vary depending on your height, age, medical history, time of day and whether or not you are well at the time. In 2004 a new scale  was introduced, make sure if you purchase you own unit that it is compatible with this new scale. One gentleman returned two units believing them to be “faulty” but when he investigated further his clinic were using the old scale. New Mini Wrights have a yellow label with blue writing.

Your health practitioner will explain what should be an average for you and the appropriate action to take should your peak flow start to fall. 

Other tests which may be carried out in clinic? 

Spirometry, this is a more sensitive method of assessing lung function, along with your symptoms and medical history it will help your health practitioner with a correct diagnosis. Reactive disorders, such as Asthma, produce different readings than obstructive disorders such as COPD. You may be asked to record your FEV1 at home as well as your peak flow then the      Mini Wright Digital  can help. FEV1 is the volume of air that you can force out in the first second when breathing out

A Blood Gases test measures how much oxygen and carbon dioxide is being carried in your blood and an Exercise Test  reflects how exertion may affect your breathing.  

 Treatment Reversibility tests will check if your condition is improved with certain medications and there are tests to help determine if you need Oxygen or a Nebuliser at home. You can find more details of these and other tests here

http://www.lunguk.org/you-and-your-lungs/diagnosis-and-treatment/breathingtests 

If you have any concerns at all about your breathing please contact your G.P. or health practitioner,and for advice about any of tests or treatments you may be prescribed don’t forget our kindred spirits. 

Nebulisers for Birds?

Well, animals of all types do get respiratory disorders and diseases and quite frequently we receive emails and calls from Vets, Zoo’s, Animal Clinics as well as individuals. 
For some species there has to be a certain amount of D.I.Y when it comes to fashioning medication chambers and accessories in order that the poor animal receives an effective therapy and nebulisers with a higher pressure rather than a technologically designed mouthpiece work the best.  As for the medication and treatment regime, that’s completely in the hands of your vet or animal health practitioner as a nebuliser isn’t suitable for every animal and comes with many contra indications and complications, just as it does for people.

One successful story came from Jayne:

“The speed with which your nebulizer was delivered, saved a little bird from suffocation. Her lungs and air sacs and become so congested with infection a nebulizer was the only effective way for the medicine to reach in and clear her airway, as she was too weak to be transported to a vets surgery. It was a great service and, again, much appreciated.”

Jayne works for Abijoes  which is a non-profit organisation that is raising money to build a unique bird sanctuary that will enable disabled people to become active participants in bird rescue, rehabilitation and care. They are based in Cornwall and if you would like to learn more I’m sure they would be interested  to hear from you either via their website, by phone 01736 757656 or email

We couldn’t begin to advise on the hows and why’s of nebulising animals, its an area we only touch on when contacted by you or animal health practitioners, but we do know quite a great deal about the units themselves and you can view our range by clicking HERE

 Always contact your vet if you have any concerns at all about the heath of your animal, we will help where we can and we are always interested to hear of your experiences you can phone 01942 701210, email or post

MicroAir Cleaning Guidelines

A question we often get asked is, “How do I clean my MicroAir ?”

Omron are one of the manufactures who do try to help out and along with your original instruction manual they are building an online library of guidelines

And this link will take you to U22 MicroAir Instruction manual 

 http://www.omron-healthcare.com/data/catalog/3/119/1/NE-U22-E_05-11-2011%20EN%20web.pdf

Omron recommend that you nebulise clean water to remove medication left in the mesh holes after discarding any residual medication and that the following items should be cleaned after each use:

medication container, mesh cap, mask adaptor, mouthpiece and mask, these parts (NOT THE MAIN UNIT) should be washed in warm soapy water, rinsed to remove soap residue and left to air dry on a lint free cloth. 

NEVER TOUCH THE MESH directly with you fingers or any implement such as a cotton swab

To reduce the risk of infection the parts listed above should also be disinfected which can be done by several methods such as boiling or soaking using either alcohol, commercially available disinfectant such as some dental tablets, or a solution of white vinegar. Not each solution is suitable for all the items listed so please check your manual or the link above 

Always pay particular attention to the mesh cap as residual medication can reduce its performance. 

The main unit can be wiped clean using a moist, not wet, cloth and don’t forget the contacts or electrodes. 

Mr Lewis emailed us to say he was worried about his U22 as “The on off switch was faulty,  turning its self off within 2 seconds of being turned on.”

This can happen and just wiping the contacts isn’t always enough as occasionally when cleaning the medication bottle, your finger or thumb rubs on the two metal contacts on the bottom which then build up a film of grease off your skin. However it can be easily rectified by using something such as a ladies metal nail file to give those two metal contacts, and the contacts on the top of the battery box, a really good scratch to remove the residue.

It worked for Mr Lewis who emailed again to say “ I lightly cleaned the contacts concerned the neb is working fine now. Thank you very much you saved me a couple of weeks of hassle.”

The MicroAir is a reliable efficient nebuliser which gives you the freedom to live your life the way you want. It needs minimal but valuable maintenance and this post should be considered as just an introduction to that care. If your worried or confused at all please feel free to call 01942 701210 or email us HERE. If you have any useful tips you would like to share please feel free to post.