Clinical update: use of ‘in-line’ nebulised salbutamol

Yellow kit bag

In September 2016, JRCALC and NASMeD published a joint statement, ceasing support for managing patients with life threatening or near fatal asthma with ‘in-line’ nebulisation, and who are requiring assisted ventilations through an endo-tracheal tube.

There has been some confusion and some questions have been asked.

With immediate effect, if you are presented with a life threatening or near fatal asthma patient requiring advanced airway and assisted ventilation, do not add ‘in-line’ nebulisation of Salbutamol. 

You should consider the reversible causes, look to rapidly extricate and convey the patient and consider the administration of Adrenaline 1:1000 (IM).

Critical care support is available within the region and this can be accessed through CCD on channel 202.  The clinical advice line is also there to provide advice and guidance while you’re with the patient.

Full details of the statement can be found here.

To download and display the update at stations, please click here.

If you have any questions, please contact the clinical lead team by emailing

Published 24th August, 2017

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