Getting emergency treatment through a nebuliser

In an emergency, nebulisers can give you rescue treatments more easily when you’re struggling to breathe.

Find out why nebulisers can be lifesaving in an emergency, what medicines you might be given through a nebuliser, and when an ambulance crew or medical staff might use them.

Get more information about using nebulisers at home when you have severe asthma.

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What is a nebuliser?

A nebuliser is a device that can deliver high doses of medicines quickly and easily.

It works by changing liquid medicine into a fine mist. This mist can then be breathed in through a facemask or mouthpiece.

Anyone can be given medicine through a nebuliser. For babies and small children, different size facemasks can be used. For older children and adults, either a facemask or a mouthpiece can be used.

When is a nebuliser used to treat asthma attacks?

Nebulisers are mostly used in A&E and hospital, or by paramedics treating you at home or in the ambulance. They may also be used by GPs in medical centres or clinics. 

Not everyone will need to be treated using a nebuliser. Most asthma attacks can be treated just as well using a blue reliever inhaler, with a spacer.

But if you’re having a severe attack, you may be given rescue medicine through a nebuliser instead. This is so you can be treated quickly with high doses of medicine in an emergency.

Young children, or people who cannot use an inhaler and spacer well, may be treated using a nebuliser even if their attack is not considered severe.

Nebulisers at home

For most people with asthma, nebulisers are not recommended for treating asthma symptoms, or asthma attacks, at home.

Even those with severe asthma, who regularly use a nebuliser at home as advised by their asthma specialist, should get medical help quickly if they need to use it for an asthma attack.

What nebuliser medicines are used for an asthma attack?

To treat an asthma attack, medicines are given to open the airways and provide quick relief from symptoms.

  • Salbutamol, a reliever medicine which opens up the airways and calms down the inflammation, is usually the first treatment given. It’s the same medicine as in your reliever inhaler but at a higher dose.
  • Ipratropium bromide may be added if your symptoms don’t improve with salbutamol alone. It also opens the airways and can help reduce mucus.

Nebulisers can also sometimes be used to deliver higher doses of inhaled steroids or antibiotics into the lungs.

How long will you need to be on a nebuliser?

How long you need to be on a nebuliser depends on how you respond to treatment, and how severe your asthma attack is.

A single dose of nebulised salbutamol (reliever medicine) usually lasts around 5-10 minutes. If this single dose is not enough to get your symptoms under control, you may have repeat doses every 15-30 minutes.

Sometimes, if you have not responded well to these spaced doses, you may be given ‘back to back’ or ‘continuous’ nebulisation, and other medicines may be added to the nebuliser, such as ipratropium.

It may be a few hours before your doctor feels happy to stop nebuliser treatment and move you back onto a reliever inhaler and spacer. 

Are there any side effects?

The higher doses of reliever medicine given through a nebuliser can cause some side effects. These include a faster heartbeat or slightly shaking muscles.

These side effects can feel uncomfortable, but they usually pass quickly and are not dangerous.

There’s some risk of glaucoma from nebulised ipratropium particularly when used alongside salbutamol, so doctors will take care to protect your eyes during treatment.

Continuing with a nebuliser at home 

Most people should be weaned off nebuliser treatment, and moved back onto regular inhaler treatment, before being discharged.

But some people may be told to continue using a nebuliser at home as part of their asthma attack recovery plan. This is usually a short-term loan, and someone from the respiratory team will visit you regularly to keep an eye on how you’re doing.

Make sure you understand your discharge plan, how to use the nebuliser, and when to get medical help.

Once you’re well enough, you can go back to using your usual preventer medicine, and your reliever inhaler when you need to deal with symptoms.  

If you have severe asthma and, as advised by your asthma specialist, you already have a nebuliser at home, you still need to make sure you’re well enough to leave hospital after your attack.

Make sure you speak to your asthma specialist or consultant as soon as possible after your discharge from hospital, so they know you’ve had an asthma attack and can adjust your home nebuliser plan.

 

If you have any questions about nebulisers, you can call our Helpline on 0300 222 5800 (9am - 5pm; Mon – Fri and speak to one of our respiratory nurse specialists. Or you can WhatsApp them on 07378 606728.

 

Last updated April 2021

Next review due April 2024

Helpline quote on asthma medicines

 

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