Jacki is a 32-year-old mum who has had asthma as long as she can remember.
“I was hospitalised with asthma regularly from when I was diagnosed at around 3 or 4 years old until I was maybe 9 or 10. I was in hospital at least once a year, sometimes up to four times a year,” Jacki recalls.
It was during those hospital stays that she first experienced nebulisers. A nebuliser is a machine that turns liquid medication into a mist. This mist is then inhaled into the lungs through a mask.
“In hospital, they’d wake me up overnight to give me the nebulisers. I’d be on prednisolone during that time as well which was disgusting,” said Jacki
“I distinctly remember the smell and the noise of the nebuliser and I remember always getting a runny nose when I used it and that was annoying. But besides that I knew how to fit it to my face properly and pour the stuff in to start it myself. If I was going to stay at Nana and Papa’s I would always have to bring the nebuliser with me, just in case.”
If you’re a parent with asthma in your 30s or 40s you might remember a similar story. It used to be much more common for people with asthma to be prescribed a nebuliser to use at home.
But times have changed.
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We now know that for most children and adults, a puffer and spacer is quicker, cheaper and just as effective as a nebuliser. Even if you’re in the middle of an asthma attack. Using a spacer can actually be BETTER than a nebuliser for school aged children. Even though children under 4 will need a mask attached to their spacer, this is still considered just as effective as the use of a nebuliser.
Of course, there may be some exceptions, such as when a person simply can’t use a puffer and spacer or when an asthma attack is life threatening and oxygen is required in addition to the reliever medicine. In such cases, it is critical that the person is in the care of emergency services.
Jacki’s son Alfie is only 8 months old and luckily has shown no sign of breathing difficulties yet, but her nieces (ages 4 and 2) have, although are too young for an official asthma diagnosis. She can imagine the shift away from nebulisers may come as a shock to parents and carers of children with asthma.
“I would have been surprised if my nieces were taken to hospital with asthma and not offered a nebuliser,” she said.
“I would have just assumed that if anyone was taken to hospital for asthma they would be given a nebuliser since that’s what I always had”.
This comes as a surprise to many people, as a nebuliser might feel more active and reassuring.
In a hospital or doctor’s setting nebulisers may still be used, however, they do risk spreading infection through the air. In almost all emergency situations today which are managed in hospital or health service, you will most likely be asked to use a puffer and spacer in the first instance, unless your asthma attack is severe or life threatening.
If you do still have a nebuliser at home, it’s worth remembering that most need parts replacing and/or servicing quite frequently to keep them working well and safely. If you still have a 20+ year old nebuliser sitting in the cupboard we would not recommend attempting to use it.
If you have more questions of nebulisers or anything else related to yours or your child’s asthma, call our Asthma Educators on 1800 ASTHMA (1800 278 462). Understanding asthma is the first step to managing it.
Some children and adults with more severe asthma or other breathing conditions may still be prescribed a nebuliser to use at home. This is a decision to be made by your treating doctor or specialist. For most people with asthma, having a nebuliser at home is not needed. Knowing how to use your puffer and spacer properly in an emergency is crucial. Watch the video here.
If you are using a nebuliser as a reliever with salbutamol nebules, this is the exact same medicine as is in a blue puffer. Salbutamol takes about 4 minutes to relax your airway muscles and relieve your symptoms. In an emergency, you will usually need to take more than your normal amount of reliever puffer. Check your Asthma Action Plan or follow the Asthma First Aid steps if you aren’t sure how much you can take. If things aren’t improving or they’re getting worse, call Triple Zero (000) for an ambulance.