Inhalation

INHALATION

           Inhalation is the act of drawing in air, vapor or gas in to the lungs. Drugs are inhaled either for

§  a local effect (steam inhalation) or

§  for a general effect (inhalation of oxygen& anaesthetics).

Types of Inhalation

1.     Dry Inhalation.

2.     Moist inhalation

1.     Dry inhalation:

·        Dry inhalation is the method of inhaling gas & fumes from volatile drugs (evaporating rapidly) or burning drugs.

·        Inhalation of general anaesthetics: Ether, nitrous oxide, chloroform, etc. are given through a mask.

·        02 and C02 inhalation: Administered through a mask, tent, or a catheter.

·        Inhalation of volatile drugs: Amyl nitrate contained in an ampule is broken and emptied in to a gauze piece or hand kerchief and is held under the nose of patient, then the patient inhales the fumes. This is used to relieve pain in angina pectoris (eg..menthol, aromatic spirit, ammonia, eucalyptus ol

ALERT:

In case of aromatic spirit, care should be given that, it neither touches the skin nor its fumes irritate the eyes. Always keep away from nose and eyes.

·        Aerosol spray: An aerosol is a fine suspension of liquid or a powder that deliver medication tropically in to the respiratory tract. Atomizers and nebulizers are used for spraying medication in to the respiratory passage

2. Moist inhalation:

          Breathing warm and moist air produced by a vaporizer is called as moist/steam inhalation. The value of steam inhalation chiefly in the moisture and heat. Although the medicine are also helpful as they act as respiratory antiseptics.

                                   ·        Steam inhalation

·        Breathing warm and moist air produced by a vaporizer for a local effect is called as moist/steam inhalation

·        Methods of steam inhalations:

·        By jug method (Nelson's Method).

·        Steam tent.

·        Electric steam inhaler

          Purpose of steam inhalation

·        To relieve the inflammation and congestion of mucus membrane of the respiratory tract and paranasal sinuses, thus to produce symptomatic relief in acute cold and sinusitis.

·        To soften thick, tenacious, mucus and help its expulsion from the respiratory tract, thus to relieve cough in bronchitis, post operative cases etc

·        To provide heat and moisture to prevent dryness of the mucus membrane of the lungs and upper airway passage following any surgery.

·        To relieve the spastic condition of the larynx and bronchi.

·        Provide antiseptic action on respiratory tract (menthol, eucalyptus).

Drugs used for inhalation:

·        Tr. Benzoin 5ml/500ml of boiling water.

·        Eucalyptus 2ml/500ml of boiling water.

·        Methyl salicilate, a few drops per 500ml of boiling water.

·        Menthol, a few crystals per 500ml of boiling water

·        Camphor, a few crystals per 500ml of boiling water.

1.     Jug method:

 In this method, a Nelson's inhaler is used for inhalation. Boiling water is filled in the jug and patient breathes the vapor.

2.    Steam tent:

 When a high concentration of steam is required a steam tent may be used. The steam can be directed in to the tent from the spout of a kettle. Make a canopy over the client's bed using a woolen blanket. Steam may be given for 20 to 30 minutes at a time and may repeated in every 4 hours. Care should be given to avoid scalding.

3.    Electric steam inhaler:

Small electrical vaporizer can be used to give steam inhalation. It consists of small jar with a heating element. As the water boils, vapor is produced and is inhaled by the patient

 Steam Inhalation By Means Of Nelson's Inhaler:

1. Assessment:                       

·        Check Patient's name.

·        Check the diagnosis.

·        Check physician's order for any restrictions.

·        Assess the level of consciousness.

·        Check the articles

2. Equipments:

         A tray containing

·        Nelson's inhaler with a mouth piece tightly fit to the neck of the inhaler.

·        Bowl or basin large enough to hold the inhaler.

·        A flannel or a piece of towel. ( to wrap around inhaler to prevent heat loss)

·        Gauze piece( to wrap around the mouth piece)

·        Cotton swabs( to plug the spout)

·        Bath blanket or bath towel. (to put over the patient head and the jug to prevent the loss of steam.

·        Face towel.

·        Inhalant according to prescription.

·        Teaspoon or a minim glass.(to measure the inhalant)

·        Kettle with boiling water .

·        Kidney tray

3. Preparation of the patient:

·        Explain procedure to the patient.

·        Place the patient in a fowlers position with a cardiac bed. if the movements are restricted then place patient in a side lying position.

·        Provide a sputum cup in the easy reach of the patient.

·        Provide a face towel to the patient to wipe the sweating from face during inhalation.

·        Close the doors and windows and put off fan to prevent draught

                    4. Procedure:

·        Warm the inhaler by pouring a little hot water in to the jug and empty it. It helps to maintain a constant temperature for a longer period.

·        Pour the required amount of inhalant in to the inhaler and fill it with 2/3 of hot water. the water remain just below the spout.(prevent scalds)

·        Place the mouth piece and close the jug tightly. See that the mouth piece is in the opposite direction to the spout.

·        Cover the mouth piece with a gauze piece and plug the spout with a cotton ball. (Covering the mouth piece with a gaze will prevent burns of the lips. Cotton ball in spot will prevent escape of steam.)

·        Cover the jug with a flannel or towel. (To insulate the jug and prevent heat loss

·        Place the inhaler in the basin and take it to the bed side without losing time.

·        Place the apparatus conveniently in front of the patient with the spout opposite to the patient.(it reduces the chance of burns)

·        Remove the cotton plug and discard it.(helps to keep up the patency of the spout for the air)  

·       
Instruct the patient to place the lips on the mouth piece breath in the steam, and breathe out after removing the lips from the mouthpiece .

·        Alternatively, encourage the client to breathe through the nostrils.

·        Cover the patient's bed and jug with a bath towel or blanket.

·        Continue the procedure, 15 to 20 minuets

·        After care

·        Replace the articles

·        Return the patient in a comfortable position.

·        Record the procedure.