T-Piece nebuliser removed

Q&A: A question has been raised as to why the T piece nebuliser is no longer included in the JRCALC guidelines. NASMeD was made aware of patient safety concerns relating to the practice of in-line nebulisation, typically for the administration of nebulised salbutamol through a T-piece to intubated patients in cardiac arrest as a result of asthma. NASMeD requested that JRCALC review available clinical evidence, and consider the relative merits or risk or harm of in-line nebulisation in the pre-hospital environment. JRCALC have recommended that, on balance, the risk of harm should be considered greater than the likely benefit. Therefore, NASMeD recommends that the practice of in line nebulisation through a T-piece as a therapy for patients ventilated through an endotracheal tube should be discontinued.