Clinical Update: T-piece nebulisers

Following the introduction of the new standard loading lists there have been several questions raised around the above piece of kit.

In 2017 AACE/JRCALC issued guidance that T-piece nebulisers should not be used in line with a bag valve mask during resuscitation. EEAST adopted this guidance, and it remains in place.

It appears following the release of the 2017 guidance some areas removed T-pieces whereas others did not. This has resulted in some confusion where they have now been “reintroduced”. T-piece nebulisers have remained available on stores since the 2017 guidance and can and should be available for use in all areas.

The situations where this is possible is where a patient is able to hold the device and use it adequately. Some evidence suggests that the use of a T-piece nebuliser is more effective than a mask nebuliser as more of the drug is inhaled deeper.

The second situation is when a patient has a pre-existing condition that pre-disposes them to higher than normal intraocular pressures e.g. glaucoma. The use of a mask nebuliser exposes the eyes to drug containing mist more so than a T-piece does. Therefore in these cases where a patient has one of these conditions and is able to hold and use the device effectively the T-piece nebuliser if the preferred option.

Published 31st January 2023