Asthma Handbook

Nebulisers

Nebulisers deliver a high dose of the drug - usually a reliever. Nebulisers are used for emergency medical treatment. The drug that is put through the nebuliser is in a liquid form. The nebuliser has an air compressor. It forces air through the liquid which turns into a fine mist which you then breathe in through the mask. They deliver a dose which is 25 to 50 times stronger than an inhaler, which is why they appear so efficient. They usually relieve an attack very quickly. You can get portable nebulisers which have rechargeable batteries.

However, as a general rule it is not recommended that people have them at home unless the asthma is chronic and they are needed every day as part of a maintenance plan. People can put a lot of faith in the nebuliser because the relief is so immediate. But a nebuliser that gives a reliever dose is not treating the asthma. All it is doing is opening the airways. It is far more important for you to adjust your preventer medicine to keep the asthma in control than to rely on a nebuliser to treat acute attacks.

Nevertheless, there is a small minority of patients who may need to have a nebuliser to use at home, but this should only be under the supervision of a specialist or for short periods of time when the nebuliser is on loan form the GP. Elderly people with chronic asthma may be prescribed a nebuliser to use at home to deliver their maintenance medicine.

General Practitioners cannot prescribe nebulisers on the NHS, but a hospital consultant can. There are strict guidelines for doctors on who should and should not have nebulisers for home use. Sometimes people can arrange to borrow a nebuliser from a hospital on a long-term basis.

If you do have a nebuliser at home, please make sure that it is set up correctly and you know exactly how it works. Your doctor or the practice nurse at the surgery should be able to help you do this. You should also know how to keep it clean and when and how often it should be servicd. Also ensure that you know exactly how much of the drug you need to put in the nebuliser and when to take it. Write these instructions out clearly and keep them somewhere you can find them easily, even when you are feeling breathless and panicky.

You should also know what to do after you have used the nebuliser to treat a severe attack. Why did the attack occur? Have you let the management plan slide a little? Or is there some other reason for a deterioration in the condition?

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