Nebulised bronchodilators for adult respiratory symptoms.
Nebulisation is an aerosol-generating procedure (AGP). See PPE requirements.
In an environment where there are extremely low levels of both COVID and Influenza in our community, risks associated with the use of nebulisers are no longer at an associated high risk.
The use of nebulisers in adult respiratory illness is acceptable in situations where the probable benefits to the patient outweigh the risks to our crews.
Nebulised bronchodilators should not be used in patients known to be COVID or Influenza positive unless unavoidable.
Caution should be applied to the use of nebulised bronchodilators in children with infective symptoms. Metered-dose inhalers (MDI’s; ‘puffers’) via a spacer are the preferred method of delivering bronchodilators to this patient group. Again, should the use of nebulisers be unavoidable, the risks to our crew are very low.
Nebulised adrenaline should continue to be used for severe croup in younger children as per the current CPG. Croup does not seem to be caused by or linked to COVID in other locations.
Some additional guidance: