It is very unfortunate that we often do not think about how much drug we will give in nebulization, how much we will give minimum solution. I give a dose like that. I have seen many consultants give nebulizing advice with 1.5 ml solution.
There are a few things to keep in mind.
-Particle size
-Residual volume
-Fill volume
The type of nebulizers we use are air driven jet nebulizers. Here very small respiratory particles are produced under air pressure.
Only if the size of these particles is within 1-5 microns, they will be deposited in the lungs.
Residual volume is that after some nebulization some solution remains in the chamber. The machine shows the sound of the show. If you run the machine in this condition, the particle size will not come within 1-5 microns. Nebulization must be stopped.
The jet nebulizers we use have a residual volume of 1 ml.
The developed world has ultrasonic nebulizers whose residual volume is negligible.
Fill Volume
If the minimum amount of solution is taken, the particle size will be within 1-5 microns.
It is a minimum of 3 ml. (In the case of the jet nebulizer used in our country. The ultrasonic nebulizer that is available in the developed world, even if you pay less)
If you take a total of 2 ml solution then 1 ml will remain residual and will not be at particle size and 1-5 microns. It is the same to give or not to give.
If the feel volume is further increased, the particle size remains good but it takes more time to nebulize.
For children, use a minimum tie which is 3 ml.
It will take 20 minutes. There is no way to give less than this. Even if it is given, it will not be of maximum benefit in nebulization.
Windel Plus is a pre-mixed solution of 3ml ampoules. There is no need to mix norsal if you want to give 3ml fill volume. In case of adults, you can give 1 ml of Norsal if you want (particle size will be better, residual loss will be less).
(One ampoule of Sulprex contains 2.5ml. At first it was Windel Plus and 2.5ml. Later, at the request of the Primary Care Respiratory Society brought 3ml. The square is also called.
At 3ml of Windel Plus
Salbutamol 2.5 mg
Ipra 0.5mg or 500 mcg
I am calculating every ten kg.
Salbutamol comes in 1-1.5 mg as .1-.15 mg / kg / dose.
And,
Ipra- 25 mcg / kg / dose comes to 250 mcg.
So what is the calculation?
Salbutamol -1.25mg at windel plus half ampoule and ipra - 250 mcg
That's what we want.
So windel Plus- Half ampule (1.5 ml) for 10 kg baby
Fill volume - Take another 1.5 ml of Narsal to make 3ml.
In a nutshell, 1.5ml windel plus + 1.5ml norsal for 10kg baby
Now if you just want to give Salbutamol, don't give windel plus (there are 20ml bigger bottles available than buying 3ml premixed again and again, which is affordable).
Bottles of salbutamol are available under the name Azmasol / Sultolin.
It contains 5mg / 1ml.
ipra is available as iprex.
It contains 250 mcg / 1ml.
So for every 10 kg salbutmol you need 1-1.5 mg.
Since 5mg per ml,
So 0.3ml Salbutamol (Azmasol / Sultolin) / 10kg
Topics Salbutamol (Azmasol / Sultolin) -
0.03ml / Kg / Dose
On the other hand
As Ipra- 25mcg / kg,
250mcg per ten kg
That means 1ml ipra is needed.
The point is,
Ipra (iprex) - 0.1ml / kg / Dose
Take Home Message
There is no benefit with Salbutamol for less than 2 months.
I Only ipra can be given in Neonate.
There is no need to give ipra if older children of 2 months do not need it. Bronchodilation is possible with Salbutamol (can be given in Acute Asthma)
★ Salbutamol 0.03 ml / Kg / Dose
(This dose is for bottles of Azmasol / Sultolin. Not for Premixed ampoules such as Windel plus / Sulprex)
★ ipra 0.1ml / Kg / Dose
(For iprex bottles)
★ Whatever you give, fill volume is 3ml. After giving salbutamol / ipra, make the remaining 3ml.
Calculated at ★ 10 kg.
Just give Salbutamol,
0.3ml Salbutamol (Azmasol / Sultolin) + 2.7ml Norsol
★ If you give both salbutamol + ipra,
0.3 ml Salbutamol (Azmasol / Sultolin) + 1 ml ipra (iprex) + 1.7 ml Norsal
And if you want to give premixed Windel Plus,
In ten kg,
1.5 ml windel plus + 1.5 ml norsal
0 Comments