Stimulating cough and expectoration by nebulization of hypertonic saline

This is an automatically translated article.

This article is expertly consulted by Master, Doctor Nguyen Le Duc Hoang - Emergency Medicine Doctor - Emergency Department - Vinmec Danang International Hospital.

Stimulating cough to produce sputum by nebulizing hypertonic saline is a technique used to collect sputum for testing in case the patient cannot cough.

1. What is the stimulation of cough and expectoration by nebulization of hypertonic saline?

Aerosol is a method of bringing air directly into the lungs and to the places that need to be affected (such as sinuses, nasal mucosa, throat, larynx - trachea - bronchi, ...).
Nebulization and hypertonic saline is a technique used to induce sputum production in patients who are unable to cough up spontaneously.
Hypertonic saline used with aerosol method will be quickly absorbed and absorbed into the respiratory mucosa, helping to thin sputum and stimulate the patient to cough to spit out sputum.
However, the technique of stimulating cough and sputum with hypertonic saline nebulizer should be performed correctly and avoided overuse because aerosol is a method with a high risk of infection.

2. Indications and contraindications to perform the technique of stimulating cough and expectoration by nebulization of hypertonic saline

The technique of stimulating cough and expectoration by nebulizing hypertonic saline is indicated to collect sputum for testing in patients with respiratory diseases but unable to cough up on their own.
However, it should be noted that this technique should only be performed after bronchodilators have been used in patients with suspected or severe asthma, severe pulmonary hypoventilation, because hypertonic saline aerosol can can cause bronchospasm.
For patients with limited cough, consider and use this technique with caution, including: acute respiratory failure, pneumothorax, cardiovascular disorders, hypoxia, pulmonary embolism, cough unexplained bleeding, recent surgery, chest trauma (broken ribs).

3. Stimulating cough and expectoration by nebulization of hypertonic saline is done how?

Steps to perform the technique of stimulating cough and expectoration by nebulization of hypertonic saline are as follows:
Step 1: Place the patient lying down or sitting in a comfortable position. Step 2: Put the hypertonic saline solution needed to perform the aerosol method into the container. Step 3: Turn on the nebulizer, when you see the vapor coming out of the machine, start putting the mask on the patient and perform aerosolization for 5-10 minutes and then stop. Step 4: Instruct the patient to take several deep breaths to stimulate coughing. In case it is not possible to cough, ask the patient to perform a controlled cough. The nursing staff conducts physical therapy with patting the patient's chest to help cough up sputum. Step 5: Stop the nebulizer after 15 minutes when the patient spits out about 1-2ml of sputum for the required samples. Stop aerosol immediately when the patient has symptoms such as chest pain, shortness of breath or wheezing, the patient has symptoms of respiratory failure, nausea, headache. Step 6: At the end of the aerosol technique, the nurse removes the mask from the patient's face and disinfects and cleans the machine as well as the surrounding area.

4. Monitoring and treatment after performing the technique of stimulating cough and expectoration by nebulization of hypertonic saline

During the process of stimulating cough and sputum expectoration by nebulizer with hypertonic saline, it is necessary to monitor the following signs and indicators in the patient:
Blood pressure Breathing rate Pulse SpO2 Clinical development, signs Respiratory failure due to bronchospasm should be detected promptly. In patients with or suspected bronchial asthma, or with chronic obstructive pulmonary disease, bronchodilator prophylaxis should be given before performing sputum stimulation with a hypertonic saline nebulizer.
If the patient has signs of respiratory failure due to aerosol, it should be treated as follows:
Oxygen ventilation Perform nebulization with bronchodilator In case of need, artificial ventilation support and corticosteroids can be indicated. Aerosol and hypertonic saline is a technique used to stimulate cough to expectorate sputum for the purpose of collecting sputum for testing in patients who are unable to perform coughing themselves.
Patients need to be examined by a respiratory specialist immediately, otherwise it will cause sputum congestion and respiratory failure.
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