Nursing

Procedure on
Steam
inhalation

SUBMITTED TO: SUBMITTED BY:

Ms. [Link], D. Mahalakshmi,

Associate Professor, 2 nd year MSc Nursing,

St. Joseph College of Nsg, St. Joseph College of Nsg

Nallapadu. Nallapadu.

INTRODUCTION:
 Steam inhalation is one of the most widely used home remedies to soothe and open the nasal

passages and get relief from the symptoms of a cold or sinus infection. It is also called steam

therapy; it involves the inhalation of water vapor. The warm, moist air is thought to work by

loosening the mucus in the nasal passages, throat, and lungs. This may relieve symptoms of

inflamed, swollen blood vessels in your nasal passages.

While steam inhalation won’t cure an infection, like a cold or the flu, it may help make you

feel a lot better while your body fights it off. But as with any home remedy, it’s important to learn

best practices so you don’t hurt yourself in the process.

DEFINITION:

i. Postural drainage is defined as the Deep breathing of warm and moist air (vapor) into the

lungs for local effect on the air passages or fora systemic effect.

ii. Steam inhalation in an application of moist heat to the respiratory passage and may-bi

plain or medicated. Inhalation may be for a long period or given for a short time at

specific intervals.

PURPOSES:

1. To relieve the inflammation and congestion of the mucous membranes of the respiratory

tract and paranasal sinuses thus to produce symptomatic relief in acute and chronic

sinusitis.

2. To soften thick tenacious mucus which helps in its expulsion from the respiratory tract.

3. To provide moisture and heat and to prevent dryness of the mucous membranes of the lungs

and upper respiratory passages following operation such as tracheostomy.

4. To aid in absorption of oxygen.

5. To relieve spastic conditions of the larynx and bronchi.

6. To provide antiseptic action on the respiratory tract (e.g.) by using menthol, eucalyptus, and

tincture benzoin.

7. To relieve inflammation of the mucous membrane in acute colds and in sinusitis.

 8. To soften thick, tenacious mucus and help its expulsion from the respiratory tract. e.g.

bronchitis, post-anaesthetic patients.

9. To warm and moisten air in acute bronchitis, whooping cough or after tracheostomy.

10. To relieve the spasms of the mucous membrane of the larynx and trachea in croup.

11. To provide antiseptic action on the respiratory tract, e., g. by using menthol-few crystals;

Tr. Benzoin 5ml in 500ml of H2O; Eucalyptus -2 ml.

12. To relieve congestion and oedema of the larynx.

INDICATIONS:

 Sinusitis.

 Oedema of the Larynx.

 Thick mucus in chest.

 Acute bronchitis.

 Whooping cough.

 After Tracheostomy.

 Spasm of the mucous membrane of the Larynx.

CONTRA-INDICATIONS:

Steam inhalation is contra-indicated for the following persons:

 Carcinoma of lung patients.

 Very young and very old patients.

 High fever patients.

 Patients with severe headache.

General Instruction:

 Explain the procedure to the patient before the preparation of the inhalaer.

 Ask the patient to empty the bladder to ensure that he will remain on the bed for some time

after inhalation.

 Auscultate the patient before and after the procedure.

  In the jug inhaler method, temperature maintained is between 120°F and 160°F.

 Water should remain just below the spout. Take precautions to armed scalding of the patient

during the inhalation period.

 Keep the patient warm to prevent draughts before, during and after inhalation.

 When drugs are used for inhalation, instruct the patient to close his eyes to prevent the drug

irritating the conjunctiva.

 Keep the sputum cup near the patient and a face towel to wipe perspiration.

 Effective steam inhalation should be at least for 15 to 20 minutes.

ARTICLES:

1. Tray containing:

a. Towel.

b. Nelson's inhaler in a bowl.

c. Sputum cup with antiseptic solution.

d. Inhaler mouthpiece.

e. Gauze piece.

f. Cotton balls.

g. Ounce glass.

h. Face towel.

i. Kidney tray.

2. Cardiac table.

3. Pillows.

4. Medication like tincture benzoin if ordered & required Boiling water (1 60°F).

Preparation of articles Rationale

1. A tray containing Nelson’s inhaler.  To use as a vaporizer.
 A bowl with tissue paper or a gauze  To wipe secretion

piece. A sputum mugs.  To cough out secretions

2. The spout of the inhaler is plugged

with a cotton swab and to seal the

 To prevent steam loss.
mouthpiece, it is wrapped with a

gauze piece.

3. An ounce glass  To measure Tr. Benzoin, etc.

4. Tr. Benzoin Co. in a bottle  To pour medicine.

5. Spirit in a bottle and swab sticks.  To clean the inhaler after use.

6. A towel to cover the inhaler and a

 To prevent burns.
bowl to keep the inhaler

7. A kettle with boiling water.

8. A pint measure.  To measure water

9. An extra blanket or a sheet.  To cover the patient, to prevent the

loss of steam.

10. A cardiac table.  To give a comfortable position to the

patient.

PROCEDURE:

PROCEDURE

NURSING ACTION RATIONALE

1. Check the physician's order and  Helps in promoting relaxation

nursing care plan.

2. Explain the procedure to patient and  Patient will have to remain in bed for 1

ensure that patient has emptied his hour.

bowel and bladder

3. Warm the inhaler by pouring a little  Reduces loss of heat from inhaler during

hot water into the inhaler and procedure.

emptying it after one minute.

4. Pour the required amount of inhalant  If the inhaler is filled up to the level of

into the inhaler and fill to a level spout there is possibility of drawing

below the spout with boiling water. water into the mouth when inhaling and

The water should remain just below cause scalds.

the spout.

5. Place sterile mouthpiece and close  If the spout is filled with water, it will

the inhaler tightly. See that the not act as an air inlet. This arrangement

mouthpiece is in the opposite keeps the spout away from the patient

direction to the spout. when inhalations are taken in.

6. Cover the mouthpiece with a gauze  Covering the mouthpiece with a gauze

piece and plug the spout with a piece will prevent burns on the lip.

cotton ball. Cotton ball in the spout will prevent

escape of steam.

7. Place a towel around the inhaler and  Insulates the inhaler and prevents heat

position it in the bowl. loss.

8. Take it to the patient without losing

time.
9. Switch off fan/AC and close

windows and doors.

10. Position the patient in high-fowlers

or sitting position.

11. Place the apparatus conveniently in  Keeping the spout opposite to the

front of the patient on cardiac table patient reduces the chances of burns.

with spout opposite to the patient. Removing the cotton plug helps to open

Remove the cotton plug and discard pout, so that it can act as an inlet for air.

it into the kidney tray

12. Instruct the patient to place lips on  Directly the stream out through the

the mouthpiece and take deep breath. nostrils relieves the congestion of the

After removing the lips from the mucous membranes of the nostrils.

mouthpiece, breath out air through

nose

13. Continue the treatment for 15 to 20  Helps in effectiveness of the procedure.

minutes if patient gets the vapours.

Observe the patient during

procedure.

14. Remove inhaler from the patient  Enhances comfort of patient.

after the stated time, wipe off

perspiration from the patient's face.

15. Give chest physiotherapy and

encourage patient to bring out

sputum by coughing.

16. Instruct the patient to remain in the  Reduces chances of dizziness and

bed for 1 to 2 hours. effects of sudden temperature variation.

17. Take articles to the utility room,  Cleaning of articles avoids

 empty the inhaler, clean the inside contamination and cross-infection.

with alcohol to remove tincture

benzoin. Wash it with warm soapy

water and then rinse with clean

water. Clean the ounce glass with

alcohol swab followed by soapy

water. Remove the gauze covering

the mouthpiece and wash the

mouthpiece with soap and water and

send for autoclaving. Dry the articles

and replace them. Wash hands.

18. Record the procedure in nurse's  Communicates to staff about

record with date, time, purpose and effectiveness and reinforcement of the

patient's response to the procedure. procedure.

POINTS TO REMEMBER:

 Avoid spilling and prevent scalding the patient.

 Never leave babies or a helpless patient along with an inhaler.

 Avoid draughts and chilling the patients.

 Check the inhaler and the mouthpiece for cracks and leakages before use.

 Clean tr. Benzoin drachm glass with spirit.

 Give treatment

SPECIAL POINTS

1) Steam inhalation can be given using a kettle or electric inhaler.

2) When a wide-mouthed vessel is used for inhalation, patient's head and inhaler may be

covered using a sheet or blanket to help increase the concentration of steam.

 3) During inhalation. if patient stops for a while for coughing or expectorating sputum, the

spout may be closed with cu ton ball to prevent escape of steam.

SUMMARY:

Oxygen therapy is to prevent or relieve hypoxia. Any patient with impaired tissue oxygenation can

benefit from controlled oxygen administration, but it is a substitute for other treatment. Oxygen

should be treated as drug. It is expensive, has dangerous side effects and must be continuously

monitored.

Steam inhalation is an effective procedure that helps to relieve inflammation, congestion and

oedema of the respiratory tract. It also aids in softening the secreations and facilitates effective

breathing. Care must be taken by the nurse to provide comfort to the patient and prevent burns and

scalds during the procedure.

KEYWORDS:

i. Anoxia : Absence of oxygen in inspired gases, arterial blood or tissue.

ii. Auscultation : listening to sounds in any internal part of the body.

iii. Hypoxaemia : Subnormal oxygenation of arterial blood.

iv. Hypoxia : Decreased below normal of levels of oxygen in air, blood or tissue

v. Nelson inhaler : Device used for giving steam to the patient.

vi. Scale : To burn by contact with a hot liquid or steam.

vii. Sputum : Expectorated matter especially mucus or muco-purulent matter

Expectorated in disease of the air passages.

viii. Tracheostomy : Formation of an opening into the trachea.

BIBLIOGRAPHY:

Text Book Reference:

1. P. Hari Prasanth “a text book of cardio thoracic nursing, Health science publishers, Page: 80-

86.
 2. Brunner and Siddharth, A Text book of “Medical surgical Nursing” Volume-1, South Asian

twelfth edition, Williams & Wilkens publishers.

3. Lewis “A Text book of Medical Surgical Nursing”, Volume-1, Second South Asia Edition,

Elsevier Publishers.

4. Javed Ansari Davider Kaur, A Text book of Medical surgical Nursing, Part-B, Exclusive

edition.

5. Joyce M Black, A Text book of Medical surgical Nursing, 8 th Edition Published by

Lippincott.

Net Reference:

a. [Link]

b. [Link]

c. [Link]

inhalation-patient-education

d. [Link]

e. [Link]