I currently work at a hospital where an older pulmonary MD orders ultrasonic nebs in line with a small volume nebulizer/IPPB's. I find this practice(in my opinion) to be totally worthless. If it was on for a longer period maybe, but for 10"-15" every 4hrs+-. I've looked for studies on this practice and can't find anything. If anyone else has an opinion or information please pass let me know.

GJ,RRT

Sir, I do have an opinion..

I do agree with you. The technology and the way it is prescribed... I do not think that your patient will get anythnig good with it.

If you want to humidify the patient airway, I still think that a good Fisher-Paykel device will do the job (or any other good company; in my area, most hospitals use F-P techno).

Has far as IPPB's are concerne, well ... we (in the area) think that the 1980' are long past. A good respiratory physiotherapy will do just the same (if you have the staff and if you teach it well).

ps: sory for my way of saying things, English is not my natve tongue...

ps 2: the area: Québec province, canada

Are you giving medications via small volume neb and also mixing this with USN humidity?

If so....

I recall studies or abstracts showing that this actually will decrease the medication delivery. The particle size gets bumped up and deposition isn't as good. I remember a while back at an AARC conference a group of RT's from Vancouver showed how placing a neb inline with a cool mist (i.e. to trache collar) basically made it so you might as well just dump out the bronchodilator. I'm not sure if this was ever published.

Jeff,
The answer to your question is yes. If you know of any studies or abstracts i would be grateful. This also supports my statement with regards to residents/interns/attendings and pulmonary MD's under the ABG DRAWS topic. A good RT will make more appropriate decisions with regards to respiratory then any other discipline.

JeffWhitnack wrote:

quote:

Are you giving medications via small volume neb and also mixing this with USN humidity?

I am not familiar with the term: USN humidity ( could transalte it and after anser your question!! (I don't know if that is the anser, but we give most of our medication via Puffers with spacers...)