Help me out here.........

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I'm a newer school nurse (2nd year) and have a new student (5th grade) that uses her Albuterol nebulizer treatments before gym and as needed. I have only ever gave nebulizer treatments for acute illnesses or to very small children that have troubles with inhalers. Why can't she use an inhaler? Am I missing something? Is this doctor/family preference thing?

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I haven't seen this. Like you said, I've only seen nebs for acute respiratory conditions (in the school setting). Maybe call/fax the doctor office to see why? And let us know the reason! Love to learn the rationale for that.

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Specializes in Pediatrics Retired.

There is no reason she should not be using an albuterol inhaler, with a spacer of course; unless her doctor is one of those who thinks the neb treatment is more effective - which it's not. If that's the case it's time to change doctors.

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I had this but for a much younger student. Her doctor wanted the nebulizer used because she was not able/willing to use an MDI properly, even with a spacer. This student was a 1st grader. She is currently a 3rd grader and has just moved up to using an MDI with spacer with no problems.

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Thanks guys. I was scratching my head. She has been missing ten minutes of gym (only 30 minute classes) for her treatments and then the LONG walk to the gym (have to walk outside to get to the gym).

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Specializes in Community Health/School Nursing.
There is no reason she should not be using an albuterol inhaler, with a spacer of course; unless her doctor is one of those who thinks the neb treatment is more effective - which it's not. If that's the case it's time to change doctors.

Exactly. Spacer is the key!

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Specializes in school nursing, ortho, trauma.

Yes!! Thank you!! When I am still getting nebulizer orders on middle school age children it floors me - especially when i'm told that it's minor asthma or something along those lines.

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Specializes in Peds, Oncology.

YES! I have a neb for a third grader. WHY? And then I get inhalers for Pre-k students who then come down SOB and have never seen an inhaler EVER. Sigh.

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There is no reason she should not be using an albuterol inhaler, with a spacer of course; unless her doctor is one of those who thinks the neb treatment is more effective - which it's not. If that's the case it's time to change doctors.

Absolutely agree!

Most doctors and patients misbelieve that a nebulizer is more effective than an inhaler for asthma

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Specializes in School nurse.

How I wish they all had spacers! The only emergency neb I have is for a kid with CF.

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Specializes in FNP.

Could be a cost issue? Inhalers are expensive and many people have trouble paying for them.

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