Days are getting shorter and nights are getting colder. On the street, leaves fall and drizzle, which means that autumn has come again and its constant companions - colds and SARS. A cold dad came home from work, a neighbor sneezed in the elevator, someone nearby in the public transport coughed loudly and blew their nose - and now the whole family is sick. If the cough and runny nose pester your baby during the day, and at night do not let you fall asleep, it's time to get a nebulizer from the shelf. What it is? How to make inhalations when coughing with a nebulizer for a child? What are the contraindications? Is it possible to do cough inhalations for children at home?
What is a nebulizer?
Remember one of the common pictures of your childhood when, during a cold, your mother covered you with a thick blanket with a boiling pan, added potato or Zvezdochka balm there - depending on the qualification of the treating mother - and you were breathing with teary eyes over an improvised home "inhaler"?
Those distant times are long gone, and today in almost every house where there is a child, a nebulizer has settled - an apparatus that turns liquid medicine into an aerosol and delivers it through the larynx through the trachea to the bronchi and bronchioles. Mucosal edema decreases, medications have an anti-inflammatory effect, improve sputum discharge, and the baby feels better. Thus, a child's cough inhalation is a quick and effective way to help him cope with the disease.
The first nebulizer was presented to the public by Seils-Gerons in France in 1858. He worked on the principle of a bicycle pump. In 1864, the inhaler was improved and introduced to the inhabitants of Germany. And only by 1930 did atomizers begin to take on the form we were familiar with and work on electricity. In 1964, an ultrasonic nebulizer was first tested, the principle of operation of which is still currently used in humidifiers.
Mechanism of action
The mechanism of action of the inhaler is based on dispersed spraying of the drug, which is fed to the patient through a mask or a special tube-mouthpiece. Since the drug is sprayed onto the microparticles, the active substance is delivered almost instantly to the accumulation of sputum and is easily absorbed by the body.
Types of Nebulizers
The modern market offers us a huge assortment of nebulizers. It is very difficult for an ignorant person to navigate in all this variety and choose a suitable inhaler. Let's try to figure out which one is better.
Ultrasonic nebulizer
Such an inhaler creates an aerosol using a system of resonant vibrations. The size of the sprayed particles does not exceed 5 microns. Such particles can penetrate the trachea and bronchi, but the effect on the bronchioles will be minimal.
The obvious advantage of this device is the absence of noise during operation and the small size.
Ultrasonic nebulizers are great for inhalation with saline when coughing in children. Unfortunately, they are not intended for spraying antibiotics, corticosteroids and sputum thinners, as they destroy their structure. This extremely limits their scope.
Compressor Nebulizers
Compressor nebulizers are the most common type of inhalation device. In them, the drug is converted into a fine suspension using a directed air flow. The main disadvantage of such devices is the high noise level.
The inhaler consists of two parts: a container where the medicine is poured, and a compressor. Suspension is formed at the moment of a meeting of an air stream and liquid. The medicine in the form of tiny drops ranging in size from 1 to 5 micrometers is inhaled by the patient through a mask or tube.
Compared with ultrasonic compressor inhalers are designed for a wider range of drugs. Any means suitable for nebulizer therapy can be poured into them, including bronchodilators, corticosteroids, antibiotics.
Compressor nebulizers are quite bulky and heavy - the device can weigh up to two kilograms. Such devices are very non-mobile, since they work from a direct current source, but are relatively cheap and reliable.
All compressor nebulizers can be divided into three types regarding their principle of operation:
Convection. These are continuous inhalers. After activating the "Start" button, the inhaler begins to produce aerosol. Part of the drug is dispersed in the air.
Manual nebulizers. In such inhalers, aerosol is also produced continuously, while the patient activates the flow of medication by pressing the “inhale” button.
Respiratory devices. Such nebulizers have a specially designed valve that opens upon inhalation, and aerosol production is simultaneously activated.
Dosimetric nebulizers. The most modern model of an inhalation device. Such devices have a special electronic sensor that responds to inspiration. Such models are quite expensive, but according to studies provide a qualitatively different level of inhalation.
Convection models are recommended for inhalation when coughing with a nebulizer for children and the elderly, as they have insufficient inspiratory force to use any other valve inhalers.
Membrane Inhalers
Membrane models (or mesh nebulizers) combine the advantages of ultrasonic and compressor nebulizers. They do not make noise, small enough to be mobile, allow you to work with any medications and solutions.
The basis of such a device is an electronic network through which an inhaled substance passes through ultra-low-frequency vibrations. Mesh sprayers can run on batteries. The device itself is quite tight - this is the only nebulizer model that allows you to perform the procedure in a lying position. This is a definite plus when working with people bedridden.
A membrane inhaler has only one significant drawback - its high cost. Such a device will cost the buyer almost three times more expensive than its compression or ultrasonic counterpart.
Choose a nozzle
A set of nebulizers, as a rule, includes several different nozzles:
Masks (one for children and one for adults). They are used for inhalation of young children or patients bedridden. They are convenient to use, but during the procedure, a significant part of the drug is dispersed into the environment. Part of the drug may settle on the patient’s skin, which is undesirable for babies.
It is ideal to use a mask for a nebulizer when inhaling saline for children with cough.
Mouthpieces. A similar nozzle is recommended for babies over 6 years old, adolescents and adults. With its use, almost all the medicine is delivered to the destination - to the bronchi and alveoli, thereby achieving the best effect from inhalation.
Nasal tubules. A thin bifurcated tube designed to be inserted into the nose. When using this nozzle, the drug settles mainly on the nasal mucosa and in the sinuses. Such inhalation with a wet cough in children will not help, but it will relieve rhinitis, sinusitis and significantly facilitate the course of sinusitis.
To choose the model of inhaler that is right for you and the necessary nozzle on the nebulizer, you need to consult with your otorhinolaryngologist. It will help you choose the device based on the individual characteristics of the patient.
Indications
There is still no unequivocal opinion among doctors of world practice whether to inhale a child with a cough and runny nose with a nebulizer or not. It is believed that when inhaled, the amount of active substance that enters the nasal mucosa is extremely small and cannot have any significant effect in the treatment of the common cold. While some luminaries of science claim that inhalation therapy is indicated only for obstructive bronchitis and false croup, others prescribe a nebulizer for any type of cough, and for babies up to a year, and with a runny nose.
Common mistakes when using a nebulizer
Self-medication.
You can not decide for yourself what inhalations a child coughs. First of all, the baby should be shown to the attending physician so that he can determine what kind of cough the patient has, how viscous sputum, whether there is a narrowing of the bronchi or swelling of the mucous tissue. Only on the basis of all the data listed above, the doctor can choose a drug that will be most effective in this case.
Inhalation with oil solutions.
Do not add solutions to the nebulizer that are not intended for inhalation. Fats contained in oil solutions can clog the alveoli, settle on the walls of the bronchi and lead to irreparable consequences.
To be inhaled too often.
How many times a day, how long and how to make inhalations when coughing with a nebulizer for a child is decided only by the attending physician. Most drugs should be used no more than three times a day. However, some need to be used every six hours. All the subtleties and nuances are familiar only to a specialist.
Consider temperature as a contraindication for inhalation.
Remember the steam inhalations that we talked about at the very beginning? The ban applies only to them. They can increase fever, cause severe tissue swelling and complicate coughing. Using modern nebulizers for inhalation when coughing for children during the heat is completely safe.
Use one inhaler for the whole family.
The fine suspension that the nebulizer forms may contain microbes and bacteria that the previous patient left on the mask or tube. Therefore, using one inhaler for everyone is at least unhygienic. In the best case, it is worth buying a separate mask for each family member, or at least thoroughly washing the equipment every time after use.
Inhalation technology
Despite the apparent simplicity of the treatment procedure, parents should take into account that inhalations should be carried out in compliance with the following rules:
you can not inhale a child earlier than two hours after eating;
the baby should wear loose clothing that will not impede movement or breathing;
Do not give any mucolytic drugs before the procedure;
if a mask is used for inhalation, and not a mouthpiece, after the procedure, the baby should be thoroughly washed;
It is not recommended to feed the baby for half an hour after the procedure;
You can not carry out the procedure later than four hours before bedtime.
Scheme of inhalation:
An adult needs to wash his hands with soap.
Wash all parts of the nebulizer thoroughly, it is advisable to boil them or pour over boiling water.
Assemble the inhaler with clean hands.
Pour the medicine into the container at the dosage prescribed by the doctor.
Dilute the drug with saline to the concentration indicated by the attending otorhinolaryngologist or pediatrician.
It is convenient to sit down, it is advisable to put the baby on your lap.
Use a mask for the baby or a mouthpiece for older children.
Turn on the inhaler and track the time.
After the procedure, be sure to wash the child's face.
The dosage, duration, frequency of inhalation, as well as the duration of treatment should be prescribed by the attending physician of the child based on the collected history, severity of the disease and the age of the baby.
Mineral water
For most children, cough inhalation at home helps. If you notice the first signs of a cold in your baby - a slight runny nose or cough, be sure to sign up to the doctor. At the same time, while waiting for an appointment with a doctor, you can start inhalation with mineral water. Use the mineral water “Narzan”, “Essentuki” No. 4 and No. 17, “Borjomi” for this. This will slightly dry the nasal mucosa and stimulate the release of sputum.
For inhalation, it is necessary to pour 2-4 milliliters of pre-prepared mineral water into a clean nebulizer tank. It is recommended to carry out inhalation for 3-5 minutes no less than three times a day. It is quite possible to avoid the disease at the early start of therapy.
Isotonic solution
Isotonic solution (saline) is very widely used in medical practice. Doctors prescribe it to replenish water balance or detoxify, use it to wash wounds and dilute drugs. Many people know that saline is extremely effective for colds as a means to rinse the nose.
Inhalation with saline to children when coughing with a nebulizer is similar to inhalation with mineral water. Often, it helps to solve the problem at the very initial stage and prevent the development of the disease.
Dosage of inhalation with saline to children with cough: 2-4 ml of the solution approximately every 4 hours.
Saline solution can be easily prepared independently - just mix 9 grams of ordinary table salt and 1 liter of cooled boiled water. The resulting mixture will be an isotonic solution. If desired, you can replace table salt with sea salt. The concentration of nutrients in sea salt is very high and therefore inhalation with such a solution will bring even greater benefit. Inhalation with saline when coughing in children helps with both dry and wet cough.
Berodual
With a dry cough, a child can be inhaled with a solution of Berodual. It must also be used under the supervision of a physician. “Berodual” has established itself as an extremely effective remedy for bronchospasm, therefore, in most cases, inhalation during coughing in a child, “Berodual” is prescribed for obstructive bronchitis, bronchiectatic pulmonary disease, laryngitis and asthma. It becomes easier after 10 minutes after the procedure.
The standard dosage for children over 12 years old and adults is 1-2 milliliters (or 20-40 drops) up to four times a day, but not more than 8 ml.
For children under 12 years of age, the dose of the drug should be reduced. In children 6-12 years old, the maximum dose of the drug is 2 milliliters of solution, divided into 4 inhalations per day.
For babies under 6 years of age, the dosage is calculated based on body weight. Moreover, the total volume should not be higher than 0.5 ml per procedure.
Berodual can be used to treat cough in infants. The dosage in such cases is selected individually by the attending physician.
Atrovent
Another effective remedy for inhalation with a dry cough for children is the Atrovent drug solution. He is appointed by the pediatrician’s attending pediatrician if inhalation with Berodual has not been successful.
This drug should be used with caution. In the treatment of children under 5 years of age, the use of Atrovent is prohibited. For children under 12 years old, Atrovent is prescribed 10-20 drops diluted to a volume of 4 ml. Inhalations are carried out only under the supervision of medical staff.
Salgim (solution)
"Salgim" in the form of a solution is a rather rare means of inhalation with a dry cough. He is prescribed to children with caution. As a rule, it is necessary for exacerbation of asthma or in advanced cases of obstructive bronchitis. This medicine is not suitable for cough inhalation in children at home - treatment is carried out strictly in a hospital. For one inhalation, 2.5 milliliters of the drug is required. The minimum interval between procedures should be at least 6 hours.
Ambrobene
In the previous sections, we figured out how to do inhalations with a dry cough for a child. If a dry cough turns into a wet one and becomes productive, which means that it is time to change the tactics of treatment. Usually, the doctor prescribes mucolytics - drugs that increase the amount of sputum and improve its discharge. One of these drugs is Ambrobene, one of the trade names for Ambroxol. It should be used only when prescribed and under the supervision of a physician.
"Ambrobene" is a solution that can be used both orally and as an inhalation. It is prescribed for acute and chronic bronchitis, pneumonia, asthma. Inhalation of a child with a cough with Ambrobene is carried out according to the following scheme:
children under two years of age are inhaled with 30 drops of the solution twice a day;
children from 2 to 5 years old - 45 drops of the drug twice a day;
children over 5 years old and adults - 70-80 drops of the drug three times a day.
It must be taken into account that during inhalation, the medicine must be diluted with saline to a volume of 5 milliliters. It is not recommended to use therapy with Ambrobene for longer than 4-5 days. If relief does not occur during this time, consult an ENT specialist, general practitioner or pediatrician.
"Lazolvan"
"Lazolvan" is another trade name for the already known Ambroxol, but with a slightly different concentration of the active substance. It is available in the form of syrup, dragees and inhalation solutions. When coughing, "Lazolvan" should be prescribed only by the attending physician according to the following scheme:
children over 5 years old, adolescents and adults 15-20 mg, four times a day;
children under 5 years old - 10-15 mg twice a day.
Before making inhalations with "Lazolvan" when coughing in a child younger than two years old, consult a pediatrician.
Sinupret
Sinupret is a homeopathic phytopreparation that has proven itself as an effective remedy for sinusitis, sinusitis and tracheobronchitis with complex expectoration of sputum.
There have been no official studies on the use of Sinupret as a means of inhalation for a wet cough with a nebulizer, however, medical practice shows that the drug helps to quickly cope with the acute stage of bronchitis and even treats the so-called "chronic" residual cough after an acute illness .
Recommended Dosage:
adolescents over 16 years old - 1 ml of the drug is mixed with 1 ml of isotonic salt solution;
children 6-16 years old - 1 ml of Sinupret and 2 ml of isotonic salt solution;
for babies from 2 to 6 years old - 1 ml of the drug is diluted with 3 ml of isotonic solution.
It is advisable to carry out at least three inhalations during a cough in a child per day.
Pulmicort
Pulmicort is a medicinal solution, a synthetic analogue of the adrenal hormone that regulates the water-salt metabolism in the body. It is used to treat obstructive bronchitis. What are Pulmicort inhalation dosages for children when coughing? Is using such a strong drug safe in childhood?
Pulmicort facilitates breathing by expanding and relaxing the bronchi, it has a good anti-inflammatory and anti-allergic effect. As a rule, this drug is well tolerated, in rare cases, can cause side effects. It is indicated for bronchitis, lingitis, asthma, rhinitis.
Dosage:
children from 6 months to 1 year - 0.25 mg per day;
children 2-3 years old - 0.25-0.5 mg per day;
children 4-5 years old - 0.5-1 mg per day;
from 6 years and older - 1-2 mg per day.
Steam inhalation
With all the variety of modern antitussive drugs, one should not forget about the well-known and proven for many years using hot steam inhalations.
With any form of fever, such treatment is prohibited and can lead to irreparable consequences. If there is no heat, steam inhalation will not do any harm. Due to the possibility of extensive burns, caution should be exercised in steam inhalation in infants.
The scheme is simple and known since childhood - boil water in a saucepan, add optional herbs or aromatic oils and inhale steam with your nose for several minutes, and exhale with your mouth.
The most popular and well-known from the time of ancient Rus steam inhalation is inhalation in pairs of boiled potatoes. No matter how paradoxical this may sound, very often the “breathe over potatoes” method helps prevent the disease at its earliest stage, and also relieves swelling of the mucous membrane with a stuffy nose.
The second most popular steam inhalation in Russia is inhalation with Zvezdochka balm. The oils contained in the Zvezdochka oil effectively soften cough, dilute and improve sputum discharge, and help with nasal congestion or excessive discharge.
With a dry cough, steam inhalation with decoctions of herbs: mint, thyme, needles, eucalyptus and oak will bring relief. Expectorant herbal preparations are available at your local pharmacy.
With bronchitis, laryngitis and tracheitis, it is useful to breathe in garlic vapor - add 2-3 crushed cloves to boiling water and breathe for 5-7 minutes. Often such inhalations help to cope with the disease at the very beginning.
However, do not postpone the visit to the doctor, because only he can decide which inhalations when coughing are indicated for children and safe, and which will lead to even greater obstruction. Traditional medicine can be used only as an addition to classical therapy, but not as a full replacement for it.
Cough Prevention in Children
We must not forget that the problem is always much easier to prevent than to solve. In the yard there is an autumn-winter period with its drizzling rains, changeable weather, slush and a piercing wind. Now is the best time for viruses and germs, so you should think about prevention in a timely manner, so as not to run to the doctors later and not calm the tired sick child at night.
Drink. The first and main prevention of all kinds of colds is heavy drinking and long walks. What exactly to drink does not play a special role - the main thing is not sugar carbonated drinks and concentrated juices. Otherwise, you can rely on personal taste - fruit drinks, fruit drinks, various teas, oxygen cocktails, herbal infusions will help wash all bacteria out of the body before they can spread and cause the disease.
Fresh air. Long walks in any weather share the first place with plentiful drinking.
Practical Germans often say - there is no inappropriate weather, there are inappropriate clothes. Therefore, in the locker of the kindergarten of a small German citizen there always lies a panama hat, sun cream, raincoat, rubber boots, and thick waterproof pants. Walking tempers children, and fresh, cool air gently stimulates the body's immune systems.
Timely course of multivitamins. It's no secret that the vast majority of modern children suffer from a lack of nutrients. The nutrition of a modern kindergartner and schoolchild is rather poor in the content of microelements, and therefore, in the dank autumn season, a multivitamin course will be most welcome.
Physical activity is appropriate for age. Children were born in order to jump, climb, run, and not all the time to sit still in a music or art school. It has been scientifically proven that children involved in sports, primarily swimming, are less susceptible to colds, and they also cope with diseases much faster than their peers.
Vitamin C. No wonder they say that there is no overdose of vitamin C. It significantly increases the barrier forces of the body.
It is useful for children to drink a glass of freshly squeezed orange juice a day, add lemon slices to tea, eat unlimited kiwi. In the fall, you can make it a rule to give your baby a couple of ascorbinkas in the morning.
Sleep in a cool, well-ventilated room. Children who sleep in ventilated rooms are three times less susceptible to acute respiratory infections and acute respiratory viral infections, recover more quickly from illness, less likely to receive complications.
Hardening. If the child runs around the apartment barefoot, and the parents believe that the floor is too cold, do not rush to pull socks and slippers on the baby. The foot is designed in such a way as to compensate for the temperature of the floor surface, thereby protecting the body from meaningless heat loss. Ice cream loved by all children will perfectly harden the throat and help reduce the incidence of laryngitis and sore throat.
When it comes to children's health, many parents become very scrupulous. And this is the only right approach. A well-known axiom is that there is medicine in a spoon and poison in a cup. The same applies to such a seemingly simple and harmless procedure as inhalation. It doesn’t matter if the patient is prescribed a three-time irrigation of the respiratory tract every three hours with “Berodual” or if the patient is coughing with nebulizer in saline solution, the doctor’s dosage should remain unchanged. Each extra milliliter of the drug can be the very last drop that turns the drug into poison.