Q: What are the most important elements RTs should look for in a nebulizer?
A: Each facility has a population of respiratory patients present every day. Some are asthmatics while others are COPD or pneumonia patients. There are suitable nebulizers that will perform well with a wide range of diseases and others that simply don’t cut it. For severe impending respiratory failure, we manufacture the Hope nebulizer, a high-medication-output nebulizer that delivers the greatest percent particles in the respirable range and whose performance is enhanced using heliox. Typical small-volume nebulizers are useful in mild to moderate asthma; however, with severe asthma and for those requiring back-to-back treatments, the Hope nebulizer is invaluable.

Q: How has the use of heliox therapy changed since its inception?
A: Heliox was introduced into medicine decades ago for treating obstructive airway-related problems. More recently, there has been an upsurge in its use, especially in emergency departments for severe asthma. The majority of the literature published on heliox therapy has been very positive because of its ability to act as a therapeutic bridge until conventional drugs take hold. The downside of heliox is related to driving the nebulizer. We are learning that oxygen should always be used to drive the nebulizer, and heliox added as a supplemental gas for optimal nebulizer performance. This is why we developed the high- output Hope nebulizer with a supplemental port for just that application.

Q: Why have you decided to bring out two new nebulizers—the OMNI~NEB and the OMNI~MAX—if the Hope already performs well with heliox?
A: There are several facilities that want a smaller, low-flow version nebulizer for use in critical care areas and for use in line with ventilators. These two new products—which are pending US Food and Drug Administration approval—will enhance our family of nebulizers and target specific needs within the hospital. The OMNI~NEB is a low-flow continuous nebulizer that can be used in the emergency department, the pediatric intensive care unit, or the neonatal intensive care unit. It operates at 5 L/min with a 12 mL output per hour and has an outstanding 2.7 MMAD and greater than 60% particles in the respirable range.

The OMNI~MAX kit includes the OMNI~NEB, tee piece and reservoir bag, partial rebreathing mask, and two supply tubings. This product is intended to be used as a direct patient heliox rescue nebulizer, with a reservoir bag to minimize medication and heliox waste. The idea behind it is to free the practitioner from having to assemble an ad hoc heliox nebulizer in a rescue situation. OMNI~MAX also has been tested at more than 60% particles in the respirable range with a 2.4 MMAD, which is also excellent.