HOME NEBULIZERS IN CHILDHOOD ASTHMA - SURVEY OF HOSPITAL SUPERVISED USE

Objective - To review the management of and outcome in asthmatic children using home nebulisers under hospital supervision. Design - Postal questionnaires sent to parents. Setting - Paediatric departments of a children's hospital and a district general hospital. Subjects - Parents of 93 asthmatic children who had been loaned home nebulisers for administration of bronchodilators with verbal instructions on their use. Main outcome measures - Drugs administered with nebuliser, side effects, frequency of hospital admission, and theoretical management of a severe attack. Results - 84 children took salbutamol and 37 received more than 10 mg a day during attacks; side effects were reported in 54 children. Parents of 16 children said that they would give another dose of bronchodilator rather than seek medical help if their child failed to respond to the first dose. Since being loaned nebulisers 65 children were admitted to hospital less frequently and 16 were not readmitted; over two thirds of parents thought that there had been a marked improvement in their child's asthma. Conclusions - Home nebulisers are valuable in childhood asthma. Excessive doses of bronchodilators may be given, however, and a weight related dose may be more appropriate. Parents should be given written as well as verbal instructions, especially regarding the management of severe attacks.