Quick Question About Nebulizer (Or Any Med Really...)

[Leanna]

DCM kept DCG (1) home today because she had a bad cough over the weekend. DCM took her to the doc who prescribed nebulizer treatments for her 3 times per day (the doctor prescribed this last time DCG had a persistent) cough as well. Well DCM texted me asking about the required paperwork for giving her the med. and my response was that if the doctor prescribed the nebulizer as PRN or "as needed" then I would be giving it to her only if she showed certain syptoms such as wheezing, coughing, etc. BUT that is the doctor prescribed it for 3 times a day she didn't really need to have it at daycare as they could administer it in the am, when she got picked up, and before bed.

Is this wrong of me? I will give meds when necessary (for allergic reactions, nebulizer treatments and inhalators for asthma, Tylenol or Motrin to prevent febrile seizures, etc). granted I have all of the proper paperwork. However, I see giving meds as a HUGE responsibility and if they can be administered at home, by the parent, they should be.

[Blackcat31]

I agree that meds should always be given at home if possible, but I think with a nebulizer prescribed "as needed" would mean that the child has to have the nebulizer available to her in case it is needed...kwim?

It isn't like an antibiotic where you just do it 3x's a day. Sometimes those 3x's are really close to each other....just depends on the child and the illness and the need.

I have several kids like that but they have asthma and I keep a neb here. In cases of kids who are prescribed nebulizer treatments due to a cough/cold or respiratory illness, I would exclude since I would not want to do nebs for something like that.

[CraftyMom]

I definitely agree! Is the doc thinking she has asthma? That would be different.
My daughter is prescribed nebulizer treatments, hers is every 4 hours if needed

[Starburst]

Usually (from my experience with asthma) nebulizers are used as regular breathing treatments and inhalers are used more on an 'as needed' medication. I used to always have to do my breathing treatments when I got home from school and would use my rescue inhalers for when I was wheezing between treatments.

I'm not sure if the girl has asthma or not (because you said it was for a cough) but with asthma even when it seems "under control" it can still cause lung damage if there isn't a regular treatment to keep the airways from inflaming. http://www.webmd.com/asthma/features...rmanent-damage

[Leanna]

I agree that meds should always be given at home if possible, but I think with a nebulizer prescribed "as needed" would mean that the child has to have the nebulizer available to her in case it is needed...kwim?

It isn't like an antibiotic where you just do it 3x's a day. Sometimes those 3x's are really close to each other....just depends on the child and the illness and the need.

I have several kids like that but they have asthma and I keep a neb here. In cases of kids who are prescribed nebulizer treatments due to a cough/cold or respiratory illness, I would exclude since I would not want to do nebs for something like that.

I definitely agree! Is the doc thinking she has asthma? That would be different.


My daughter is prescribed nebulizer treatments, hers is every 4 hours if needed

Right - this is what I am saying. It wasn't prescribed "as needed." That I have no problem with. It was prescribed as 3 times per day which I feel can and should be given at home.

DCG hasn't been diagnosed with asthma. This is the second time she has been prescribed nebulizer treatments for a persistent cough though.

[Blackcat31]

Right - this is what I am saying. It wasn't prescribed "as needed." That I have no problem with. It was prescribed as 3 times per day which I feel can and should be given at home.

DCG hasn't been diagnosed with asthma. This is the second time she has been prescribed nebulizer treatments for a persistent cough though.

If it wasn't prescribed "as needed" then I agree. The 3x daily medication treatments need to be done at home.

[KidGrind]

I am having an issue with medication right now. The DCPs want me to give it to DCK twice per day. Well that is not what the label says, it says as needed. So if I do not hear wheezing, coughing or labored breathing I am not administering it.

It’s a longer story but I am not going to vent to day.

[Cradle2crayons]

I have two on nebs right now.... One is every six hours... And he other has two different nebs... One is twice a day mixed with the second one and hen the second one is in between PRN every four... So needless to say I have a new machine going all day... And this morning had both going at the same time .

[itlw8]

3x a day one really needs to be during the day unless the child is picked up by 3. 5:30 and 8 are too close together in the evening. And the child is running and playing and needs to be able to breathe and not be coughing.

If there has to be 4 hours minimum between treatments and they pick up at 5. home at 5:30 they will have to delay bedtime until after treatment 930plua treatment TIME SO child will be up past 10 every night just to have treatments.

[nannyde]

I have two on nebs right now.... One is every six hours... And he other has two different nebs... One is twice a day mixed with the second one and hen the second one is in between PRN every four... So needless to say I have a new machine going all day... And this morning had both going at the same time .

Exactly why I quit giving them.

[Second Home]

3x a day one really needs to be during the day unless the child is picked up by 3. 5:30 and 8 are too close together in the evening. And the child is running and playing and needs to be able to breathe and not be coughing.

If there has to be 4 hours minimum between treatments and they pick up at 5. home at 5:30 they will have to delay bedtime until after treatment 930plua treatment TIME SO child will be up past 10 every night just to have treatments.

The parents could give the treatment to the child late at night when the child is sleeping , no need to wake her up just hold the mouthpiece up to her nose . My dd had to have treatments around the clock and this what we were told to do for her .

[nannyde]

3x a day one really needs to be during the day unless the child is picked up by 3. 5:30 and 8 are too close together in the evening. And the child is running and playing and needs to be able to breathe and not be coughing.

If there has to be 4 hours minimum between treatments and they pick up at 5. home at 5:30 they will have to delay bedtime until after treatment 930plua treatment TIME SO child will be up past 10 every night just to have treatments.

That's ok by me. I don't have a problem with parents managing all the treatments. It will be easier for the parents and kid if done during daycare. It won't be easier for me.

Better to have the give and take be with the parents, chikd, and their family time than with a provider who has a group of kids by herself.

[butterfly]

oh nebs... I have a bad taste in mouth from doing nebs. I've had the parents that weren't even prescribed them for their dcks but they have them on hand from a previous illness, so they'd show up with the machine and expect me to give them nebs 3 times a day. :confused: On top of other children actually being PRESCRIBED a neb several times a day. I was giving neb treatments constantly ALL. DAY. LONG!! It was after this, I adopted a NO MED policy. If the child needs meds, a parent or relative needs to come in and give them. It's amazing how the kids don't need the nebs now that I'm not the one administering them....

:hug:

[blandino]

Better to have the give and take be with the parents, chikd, and their family time than with a provider who has a group of kids by herself.

**Bingo**. About a month ago, my favorite daycare client brought me a nebulizer for her 13 month old. She said it was prescribed for 4x a day. I was a little shocked when she said that DCG needed 2 treatments here, because to me 1 seemed sufficient, if you do one in the morning, one after pickup, and one before bed at home. I have given breathing treatments before, so I really didn't think to much of it. The first one was to be given around noon, so as we are getting the kids done with lunch, and DCG is in a bucket seat at the table, we plug the machine in and put it on her. The noise freaks the other children out, and the mask s cares her to death. Turned it on for 3 minutes, and we were don't. Told DCM it was a disaster.

Turns out DCM was holding the mask up close to her face without actually putting it on her. Super easy for someone with 12 other kids to care for to dedicate a solid 25 minutes to only one child. Leaving the other person with 11 kids to care for. Sorry, not going to happen.

My assistant told us that at the center she used to work at, their policy was if the child was old enough to hold it themselves/wear the mask without fidgeting with it, then it was okay. I think that is going to be our new policy, or to not do them at all.

[Cradle2crayons]

Exactly why I quit giving them.

I don't mind so much... But when they are PRN and my asthmatic dck is wheezing... They get them here... I'm not making them wait 8 hours until they get home to get them...

As a mom of an asthmatic and an asthmatic myself.... I'd be livid if a provider agreed to do the nebs then decided oh never mind they can just wait hours until they get home.

Now, if a provider didn't do nebs or meds at all, then I would have never sent my asthmatic child there to begin with....