2.5 What is a nebulizer?

The term nebulizer is often used to describe both the pump that pressurizes the air, and the part that holds and "nebulizes" the medication. There are hand-held nebulizer units and ones with masks that you strap onto your face.

The pressurized air typically comes from a portable pump unit that internally consists of a motor-driven air pump that resembles the fancier types of aquarium pumps. It forces air through a plastic tube into the plastic nebulizer unit. Inside, the nebulizer unit acts much like a perfume atomizer, creating a fine mist that is directed either through a tube that you inhale through or a mask that directs the mist into your nose and mouth.

Since the nebulizer takes a few minutes to deliver the medication, you inhale it over a longer period of time than if you were using an inhaler. This can really help, especially if your passages are not fully open and you're taking a bronchodilator. As you breathe the medication, your lungs can gradually accept more and more of the medication. In addition to the medication, many people find the accompanying mist (typically a sterile saline solution) to be soothing.

For very young children, the nebulizer is the only practical means of administering inhaled medications. Older children and adults have the options of using inhalers and a variety of spacers to make the timing a bit easier. The doctor overseeing the treatment decides which is the most effective/appropriate delivery mechanism.

At least in Massachusetts, the nebulizer pump unit, the hand-held nebulizers, the medications, and the sterile saline inhalation solution are all prescription items. Replacement parts for the pumps are not available to the general public (if there are sources, I'd like to hear about them).

The portable nebulizer pump units cost little ($100-$300) relative to the cost of an emergency room visit, so some health plans / insurers provide them to patients for times when an asthma episode is "manageable but not dangerous." This seems to be a trend in the management of pediatric asthma.

Our family has been able to successfully avoid a few trips to the ER, and have even been able to head off some more severe allergic asthma episodes with early intervention. After a few rather gruesome visits to the Mass. General Hospital's waiting room on a Saturday night, we welcome opportunity to treat our children at home, when it's safe. We tend to go in to the doctor or ER for the more severe episodes or those that don't respond well enough to early intervention.

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