hypertonic saline nebs for rsv

[ucarn71]

any expereince or using of hypertonic nebs for rsv pt?

[annabeap, MSN, APRN, NP]

Sure. Check the order/MAR, make sure you know what percentage hypertonic saline you grab, pour in a nebulizer face mask/blow-by, and turn up the O2. You'll see vapors until all the fluid's gone. Our docs like to listen before the administration sometimes... depends on the pt. Otherwise I listen before and then after. Usually we have awesome RTs that do these, but every so often... Make sure if the pt has O2 running via nasal cannula or whatever, to grab an extra O2 setup/humidifier for the neb. Our RTs refused to give NS nebs since the pt might have tracheal spasms. So know your unit's policy. :)

[ucarn71]

thanks for the response. Actually i am more interested in use/effects not how to give but any expereince in therapuetic effects of hypertonic saline neb 3%. before and after effects on peds pt and any side effects expereinced from your pts for example bronchospasms, c/o throat pain, effects on lungs that are not chronic lungs ( Like cf) normal healthy lungs and any residual effects later on, thinning of mucus with easier suction etc. thanks

[NotReady4PrimeTime, RN]

We rarely use it but it's fairly effective. What a hypertonic saline neb does more than anything is induce sputum. It makes them cough. Coughing moves around the secretions and makes them more available to suctioning. Since secretions are the biggest contributing factor in small children with RSV, any way we can get rid of them is worthy of consideration. I wouldn't say that it necessarily thins secretions, but it might, I suppose. Coughing may provoke bronchospasm, which should respond to albuterol. I haven't heard any complaints of throat pain, but the kiddies we'd use it on wouldn't be able to tell us anyway. There should be no long-term consequences to its use.

[canuck2texan]

I use it all the time for rsv and really coorifice pedis. It works in the lungs the same way 3% hypertonic iv admin. It draws the fluid into the vascular space thus drying them up. One of my docs reccomended reading an iseral study. To find it I googled iseral & 3% hypertonic neb tx and up it came. Very interesting. I love 3% saline and high flow o2 between the two we really decreased our intubations