[drkev]

Hi all, been away for a while as I have been studying and I am now on clinical placements with ambulance service.

Just a quickie for some of the docs on the site.

When administering humidified oxygen, is it ok to use saline if normal water is not available?

I needed to nebulise some water for a patient and I only had saline steripods available. I could not remember whether it was OK to put saline through a nebulising oxygen mask or if we can only give water. I cannot imagine that it would be safe for a casualty to inhale nebulised saline but I am sure I read that we can use saline.

Any ideas guys?

Live long and Love life

Kevin Fisher

[iko]

You surely have a reference manual for any procedure and equipment used in the ambulance.  If you cannot find this particular detail, ask your supervisor and recheck all the standard operating procedures for your patients' safety.
Otherwise we could easily be moved from Nebulised saline topic to the malpractice one.
Take care
iko

[ukmicky]

HI  KEV

As its medical you should check first however from what ive read its seems that it ok to use for certain chest complaints but you should still check first.
 

quote:The effects of nebulised isotonic saline and terbutaline on breathlessness in severe chronic obstructive pulmonary disease (COPD).

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9673744&dopt=Abstract


 

quote:Patients with a dry cough should be treated with:

local remedies such as sucking lollies or chewing chewinggum

humidifying the room air

making sure that the patients is not dehydrated

nebulised saline (5-10ml isotonic saline in a nebuliser) may moisten the airways.

antitussives.

http://www.symptomcontrol.com/82.0.html


Michael

[drkev]

I have checked and have been given different answers. One tutor says "Yes saline is fine" another tutor says "No only use water"

A&E doctors and nurses say "yes saline is fine, we use it"

Reference manual i.e. JRCALC and IHCD manual mention water but not specifically saline!

I am happy to use water which is what I have been taught but in the absence of water could saline be used? I think the answer is yes but I am not 100% sure. I just wanted another opinion on the matter.

Medicine is not a science it is an art! And I can't draw!

Live long and Love life

Kevin Fisher

[iko]

quote:You surely have a reference manual for any procedure and equipment used in the ambulance. If you cannot find this particular detail, ask your supervisor and recheck all the standard operating procedures for your patients' safety.
Otherwise we could easily be moved from Nebulised saline topic to the malpractice one.
iko

You know what Kevin? I don't think it would matter so much saline instead of distilled water if you do not dissolve any drug to be nebulized.  It could be a minor problem of saline deposit and/or corrosion in the device.
Nevertheless I see a major problem in not having a very clear written procedure and a check list of what you take with you in the ambulance, because sterile distilled water flasks or bags should be kept far away from patients during emergency procedures.
You probably wouldn't do it today, but someone else another day (...another_someone!) could use your H2O instead of a saline drip for a patient.  It isn't impossible, believe me, I could do it in a rush, and I would probably realize too late my mistake.
Distilled water would cause hemolysis in a critical patient and worsen clinical conditions in a short time.
Did you get my point?
Enrico

P.S.  I can draw and I think Medicine is a science and 2+2 should make 4 even here.  There is nothing 'artistic' in taking care of the ailing.