Saliva collecting in nebulizer cup?
I'm using a nebulizer with a mouthpiece for the first time and it appears that saliva is collecting in the cup. Even when it doesn't seem like I'm secreting much saliva, there seems to be too much liquid in the cup at 6 minutes into the treatment and it is sometimes foamy.
Is there a way to avoid saliva collecting? I try to swallow, but then feel like I'm not getting all the medication (and it doesn't help with saliva collection). Is it best to keep using the nebulizer until all the liquid is gone, even if some of it is saliva? Or maybe it's not saliva at all and I'm leaving medication in the cup?
I was prescribed the nebulizer in the ER to keep me going until I'm able to see a pulmonologist. I wasn't given any instruction on using it and can't find information on the issue I'm having. Sometimes it doesn't feel like I get all the medication and I think I'm concerned I'm using it wrong.
Thanks in advance for your help!
Hi LMFS, and thanks for your post. You've posed an excellent question - it's a bit of a puzzler for me!
From my professional experience, I have not seen or given a patient a nebulizer treatment in which the patient's saliva has gotten back to the nebulizer cup. Having said that, I have also learned to listen to patients and try to look into their circumstances. In your case, I cannot be there with you but, what I can do is make suggestions.
Again, in my experience, it is more likely there is medication left in the nebulizer cup that has not been nebulized. This can be attributed to various causes which may include: the flow rate not being set high enough, a leak in the circuit, using too much medication or diluent, etc.
I am sorry you were not given any instruction on the use of this device - it is not necessarily something that is intuitive for a patient who has never used one. It is disappointing to me (as a therapist), that you were discharged this way, with no guidance.
You may want to look into the flow rate you are using, the volume of, and medication type, that has been dispensed and, the integrity of the device set up - is everything connected properly and the nebulizer cup tightened correctly? I realize that this may be difficult for you as this is your first 'go-round' with the equipment.
Depending on when the appointment is with the pulmonologist, you may want to reach back out to the emergency department staff, and have a respiratory therapist check out your situation.
Do you find the medication treatments, such as you are taking them, are working for you?
What do you think?
Leon (site moderator asthma.net)Thank you so much, Leon! This really helped. I had my husband watch when I used the nebulizer last night and he said it didn't look like the volume in the cup was increasing, but that it was hard to tell because of how the fluid moved around. But I was careful to let the saliva collect in my mouth and swallow when absolutely necessary. I ran the device until I heard the splutter (which I learned about elsewhere on the site) and definitely got more medication than I have been, so I think the real issue is that I was leaving medication in the cup. I did try to fill the cup with saliva when I was finished and I did, but I think if I'm careful, I can keep that from happening while I'm using the neubulizer.
Which leads to another question—is there a recommended way to clear saliva while using a nebulizer? I get so much that I have to swallow at least a few times in a session, but always worry I'm wasting medication when I do. (Though even if I'm wasting medication, it's a lot less than I was before!)Thanks again!
Hi again, LMFS, and thanks for your response - glad to have been able to help with this. It's really a good thing that you can have your husband watch you as you take the breathing treatment. Sometimes, someone observing what you are doing can provide invaluable input. It would seem then that the saliva is not migrating back to the cup. As said yesterday, I have never really seen that happen with patients.
Generally speaking, a breathing treatment can take anywhere from 5 - 10 minutes. This will depend on flow rate (depending on the equipment but, usually 5-7 liters per minute), volume of medication and one's own breathing rate during the treatment.
If you are finding that you have too much saliva in your mouth during the treatment, you can always just take the mouthpiece out of your mouth and spit out the saliva (into a separate receptacle). That should take no more than a few seconds and, once done, you can go right back to the treatment. You shouldn't have any concern about wasting medication - there is enough available for you to inhale during the treatment.
Candidly speaking, there is a built-in waste component inherent in all these treatments - it generally occurs during one's expiratory phase of the breathing cycle. And yet, the treatments are effective as is!
I do hope this brief reply has provided you with a practical answer for your second question.
If there is anything else we can assist you with, please let me or any other moderator / team member know. You are always welcome here!
All the best,
Leon (site moderator asthma.net)
Great information. Thank you so much! I can literally breathe easier while I'm waiting to see the pulmonologist next week.
Hi again, LMFS - glad to hear it!
I will wish you 'good luck!' for your appointment next week. Please do check back and let us know how it all turns out for you.
Enjoy the holiday!
Leon (site moderator asthma.net)
