Salbutamol with normal saline

[Puggy1001]

When the patient has difficultly breathing, o2 sats really low and has history of bad asthma, can we give salbutamol 5mg/2.5ml mix with nornal saline with nebuliser? Or just salbutamol by itself ? If we can give normal saline with it, why is it ? How much can we give ? I've seen this case scenario on osce exam and just wanna know if we can or not.

[MunoRN, RN]

Salbutamol (aka albuterol here in the US) comes already in a solution which is typically saline. Some formulations are already diluted with saline to an appropriate concentration for nebulization, others will include instructions for dilution with saline.

[heinz57]

MunoRN said:

Salbutamol (aka albuterol here in the US) comes already in a solution which is typically saline. Some formulations are already diluted with saline to an appropriate concentration for nebulization, others will include instructions for dilution with saline.

In the United States, Albuterol comes in both forms. It can be a diluted 2.5 mg unit dose or the undiluted form which can come by individual dose package or in a multidose bottle. The US has gotten used to giving a 2.5 mg UD dose of Albuterol for all ages regardless of EVM of the advantages of giving 5 mg because it is easier and anybody can do it.

To answer the OP, it can also depend on the nebulizer you are using. Some of the BAN or Circulaire type nebulizers can take small quantities with minimal waste. Standard nebulizers can waste about 40 - 60%. This number can be higher if given by mask or blowby. A straight 1 ml of 5 mg Salbutamol can be extremely effective and with minimal waste when given by a BAN type device.