Nebulised therapy for use in anything other than acute asthma should only be supplied to patients who have been fully assessed by a respiratory physician.

Salbutamol via nebulisation for acute asthma attacks should be driven by oxygen.

In adult asthma patients the requirement for regular nebulised bronchodilators would be an indication for referral.

Severe cases of COPD should be reviewed regularly to ensure diagnosis correct and treatment optimised.

Nebuliser machines cannot be prescribed on the NHS.

Further notes for COPD patients, this also includes contact details for the different services.

Children

Children requiring long-term nebulised therapy should be under the care of a consultant paediatrician.

The provision of a home nebuliser for the management of acute asthmatic attacks is generally not recommended in children. The use of a nebuliser in acute asthmatic attacks in children under 2 years of age may result in a marked deterioration. Large volume spacers with metered dose inhalers are preferable to nebulisers, in the community.

In certain circumstances, nebulisers may be of use in delivering inhaled corticosteroids or occasional reliever therapy to those patients with asthma who have coordination/behavioural problems or disability comorbidity.

MHRA Drug Safety Update (August 2022): Nebulised asthma rescue therapy in children: home use of nebulisers in paediatric asthma should be initiated and managed only by specialists. The safety update also applies to adolescent patients.