Cough inhalations for dry and wet coughs
Last reviewed: 07.06.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Coughing is one of those unpleasant symptoms that do not let you forget about yourself for a minute. It is especially difficult when a slight cough and occasional urges to cough up the contents of the respiratory tract turns into an agonizing attack or constant dry/small cough. This can not be an accident, because such a cough is an indicator or a consequence of the body's unhealthiness and irritation of the respiratory tract, a reflex reaction designed to help remove pathogens, allergens and other foreign substances from the lungs and bronchi. And cough inhalation is one way to help your body in this difficult task.
Is inhalation necessary for a cough?
Inhalation is a simple and relatively safe method of administering medicines or folk remedies by inhaling vapors or a gas mixture. Let us remember that oxygen is also a gas, and the atmospheric air we breathe in includes several gases in different proportions, but by gas mixture for inhalation we mean a suspension of particles of medicinal mass in the air.
Natural inhalations, based on inhalation of healing air at resorts or in coniferous forests, are recognized by doctors as general health-improving and preventive. But for the treatment of diseases they are usually not enough, so it is necessary to resort to artificial introduction of medicinal compositions into the respiratory tract.
Inhalation treatment is used either to provide an inhibitory effect on the body (inhalation anesthesia), or in diseases of the respiratory tract of an inflammatory nature (colds, allergies). But the question of whether inhalation is necessary for coughing, even from this position remains relevant. After all, this symptom can have a different character. So distinguish between wet and dry cough, and the latter can be unproductive or without sputum secretion at all (excruciating, barking).
With a moist cough, when sputum comes out without difficulty, inhalation treatment is irrelevant, and sometimes dangerous. After all, additional stimulation can provoke bronchial blockage with secretions, bronchospasm, asphyxia. But with a dry and unproductive cough, such treatment will be just right.
Cough inhalations may have different effects depending on the medications and formulations chosen:
- dilate the bronchi, which makes it easier to expel phlegm and,
- reduce the viscosity of inflammatory mucus and reduce the strength of its adhesion to the bronchial epithelium,
- relieve inflammation and therefore irritation of the bronchial mucosa. All this should contribute to the removal of excess mucus and pathogens from the respiratory tract,
- reduce the viability of disease-causing microbes.
Does inhalation help with a cough?
There is no unambiguous answer to this question, because everything depends on the correct selection of inhalation composition and the body's reaction to it. Doctors themselves unequivocally recommend inhalation for dry and unproductive cough, because it is one of the fastest ways to relieve the patient's condition. This is a relatively safe method of treatment, because the drug practically does not get into the blood and does not have a pronounced systemic effect. But the inhalation method helps to deliver the therapeutic composition directly to the focus of the lesion, which gives a quick and often quite decent result.
Indications for the procedure
As we have already noted, the cough can be dry (non-productive) and with sputum production. Treatment tactics in both cases are different, but when prescribing inhalation treatment, doctors pay attention not only to the nature of the cough, but also to its cause.
Inhalation for coughing with phlegm is not always necessary. If the mucus comes off without any problems with non-intensive coughing, the body does not need help. Here it is important to observe that the nature of the symptom has not changed. Plenty of warm water and massage can help to relieve expectoration.
If sputum accumulates in the bronchi, but it is very difficult to cough it out, coughing causes pain in the throat and along the airways, cough inhalation with mucolytics and expectorants - just what is needed to relieve the patient's condition. Such procedures are relevant for both colds and allergic cough, because allergy is a kind of inflammatory reaction caused by a specific irritant.
Inhalation for dry barking cough is prescribed only after studying the cause of the symptom and the time of its occurrence. This is a reaction to bronchial irritation, usually in response to a viral attack. At the beginning of the disease, the symptom may appear in parallel with or without a sore throat. The spread of inflammation to the vocal cords provokes the appearance of a rough barking sound when coughing.
Quite quickly the cough turns productive, and at this stage you need to be careful. If sputum is separated with difficulty or in small amounts (low-productive cough), it is necessary to facilitate its secretion and increase the productivity of coughing. In low-productive symptoms, preference is given to drugs that stimulate the production of mucus and optimize its rheological properties.
Quite often it happens that a person has had a disease, but the cough has not gone away. But when coughing up, nothing is expelled from the bronchi. The remaining unpleasant symptom and throat irritation that has not completely passed exhausts a person already weakened by the disease. In this case, it is inappropriate to use inhalation mucolytics or secretomotor means. But anti-inflammatory agents and those that suppress the cough reflex (eg, lidocaine) will be just right.
Inhalations with cough suppressants are often prescribed to children, if the painful symptom prevents the child from sleeping and eating, exhausts the baby, preventing rapid recovery.
In colds, doctors often prescribe inhalation for runny nose and cough. With a runny nose are relevant anti-inflammatory drugs and mucolytics, but they are used with nasal congestion to facilitate breathing. Liquid discharges do not need to be treated with inhalations.
Inhalations from coughs can be carried out in different ways, so there is a distinction between dry and wet procedures, the latter are divided into wet, warm-moist and steam. If the patient does not have a temperature, you can choose any of the options. If the thermometer rises to 37.5 degrees, it is better to forget about thermal procedures.
Cough inhalations at a temperature above 37.5 degrees can be carried out only with the permission of a doctor, using a nebulizer. In this case, dry and wet (up to 30 degrees) inhalations are relevant, if the patient has no contraindications.
Fever is usually associated with viral infections, but sometimes such a reaction of the body can also occur in response to the introduction of bacteria into the respiratory tract. If tests show the presence of bacterial infection, in addition to other prescribed inhalations with antibiotics. In case of severe inflammation and swelling, hormonal agents (inhaled corticosteroids) are prescribed.
Preparation
When it comes to preparing for cough inhalation, everyone immediately thinks about the therapeutic composition, missing one important detail. First of all, it is necessary to think not about what and how to treat a cough, but about knowing a reliable diagnosis and the cause of the disease. The first stage of preparation for inhalation should be consultation with a specialist and conducting the necessary diagnostic tests (if necessary).
It is important to know not only the name of the disease, but also its causative agent. For example, inhalations with antibiotics are carried out only in bacterial diseases or complicated course of viral diseases. In most cases, however, respiratory diseases are viral in nature and with proper timely treatment pass without complications.
If the doctor prescribed inhalation treatment, he will also recommend drugs and sometimes folk remedies that help with this disease and are suitable for inhalation. It will only be necessary to determine the method of the procedure (with or without the use of an inhaler) and properly prepare the inhalation composition.
So for steam procedures decoctions of herbs and potatoes, healing essential oils, soda. Decoctions are heated to a temperature of 45 degrees, and oils are dripped into hot water.
If you do not use an inhaler, it is very important to take care of the utensils that will contain the healing composition and the necessary accessories (towel on the head in steam inhalations, although this treatment option doctors consider quite dangerous because of the risk of hypoxia and facial burns).
If you use a special device for inhalation, you need to make sure it is clean, if necessary, put the components together and check the performance of the device. If you are using the inhaler for the first time, it is important to carefully study the instructions for it beforehand and treat the internal parts of the reservoir and the mouthpiece with antiseptic compositions.
Technique Cough inhalations for dry and wet coughs
If a person is in the hospital, he does not have to equip himself with knowledge about the technique of cough inhalation. This is taken care of by the medical staff, and the patient only has to clearly fulfill his requirements. But in most cases, inhalation is carried out at home, because this procedure is effective for many diseases of the respiratory system, which do not require hospitalization. And if there is no medical relative at home, willy-nilly have to look for information on how to properly conduct the procedure.
Consider the technique of carrying out and the features of inhalations of different types.
Steam cough inhalation
Steam inhalation is considered one of the methods of folk medicine, the most effective for diseases of the upper respiratory tract. Moist warm air, entering the respiratory tract through the mouth, moistens and softens the mucous membrane, makes sputum less viscous, relieves symptoms of the disease, and by adding healing compositions to the water you can achieve a therapeutic effect.
Compositions for steam inhalations can be: potato decoction, infusions and decoctions of herbs and medicinal collections, mineral water, weak soda solution, essential oils, propolis and even known since Soviet times aromatic balm "Zvezdochka". It is important to understand that baking soda is an excellent antiseptic and emollient, most herbs have anti-inflammatory and disinfectant properties, propolis is a strong antimicrobial component, mineral water softens and moisturizes the mucosa, and potato steam is a popularly recognized remedy that has a beneficial effect on the respiratory system, eliminating congestion in the bronchi.
Inhalations with potatoes for coughs are safe for children and pregnant women who are not suitable for medicines and herbs that can cause allergic reactions. It is not difficult to conduct them and even pleasant, if you do not overdo it with the temperature of the composition. Very useful in dry coughs.
To prepare the composition, take 3 medium potatoes, wash and boil them in water until ready, then slightly mash or use only the decoction. You can breathe steam over a pot or any other utensil, where the decoction was poured, having cooled it down a little beforehand, so that the steam does not burn the skin when you have to bend over the pot. In order that the steam does not dissipate, the head can be covered with a towel, leaving the bottom edge free so that the air can penetrate under it.
It is considered sufficient for an adult to breathe potato steam for 10-15 minutes. For a child, a 3-5 minute procedure is sufficient.
By analogy, steam inhalations with decoctions and infusions of herbs are carried out. Prepared decoction is first slightly cooled. To prepare an infusion, the herb is poured with boiling water and left to infuse in the heat, then give a little cool. Usually herbs for inhalation from coughs are taken in this ratio: 1 tbsp. Of crushed herb or collection of herbs for 1 cup of water.
The following herbs can be recommended for inhalation procedures:
- Chamomile. Cough inhalations with this plant, which has a mild antiseptic and pronounced anti-inflammatory effect, are effective for dry and wet coughs, runny nose, sore throat. Decoction is prepared according to the above scheme on a water bath for 20-30 minutes, then bring hot boiled water to a volume of 1 liter.
- Eucalyptus for cough. Inhalations can be done using a self-prepared infusion of the herb, pharmacy alcohol tincture, essential oil of the plant. To prepare the infusion, the ratio of components is standard. After 15 minutes of insistence in a bowl add 3 cups of boiling hot water and inhalation. Alcohol tincture can be used in an inhaler, but in this case add it not to hot water, but to saline solution at room temperature (15 drops per glass of sodium chloride).
- Inhalations with sage for coughs. The plant is very popular in the treatment of coughs, because it is rich in essential oils, thanks to which it has anti-inflammatory, tonic, antiseptic and expectorant properties. Grass in inhalation compositions are used both independently and in combination with others, for example, with chamomile and mint. Decoction for inhalation is prepared as follows: 2 tbsp. Of grass (or 1 tbsp. Of sage and chamomile) pour a glass of boiling water and kept on low heat for 2-3 minutes, then remove. Strained and cooled enough decoction can be used in inhalers or breathe healing vapors over a bowl.
The above herbs are universal, they can be used to prepare inhalation composition for any cough. With a dry cough should pay attention to plants that increase the amount of sputum secreted, contribute to its easier excretion, relieve irritation of mucous membranes and make the cough less painful: mother and stepmother, linden, clover, jagel, cowpea. In wet cough with difficult expectoration of sputum can be offered: thyme, honeydew, mint, fennel, juniper, comfrey, pine needles, pine buds, lavender.
In folk medicine, herbal collections for cough inhalation are also used. With the right selection of plants, they will mutually reinforce each other's action and the effect will be stronger. In addition, in collections you can combine plants with different therapeutic effects, getting a cure for almost all symptoms at the same time.
For inhalation treatment of low-productive cough can be advised the following collection: leaves of eucalyptus, mother and stepmother, mint and sage, birch buds, oregano herb, chamomile flowers in equal amounts. 1 tbsp. Collection per glass of boiling water. Standing composition, strain and cool to a temperature of no more than 70 degrees.
Ideally, for steam inhalations from coughs, it is recommended to use compositions with a temperature in the range of 40-50 degrees. At higher temperatures should not lean heavily over the steaming dishes and tightly covered with a towel, because this can lead to burns to the face and mucous membranes of the eyes.
With the help of this collection can be achieved simultaneously such effects: moisturizing mucous membranes and relieving irritation, elimination of throat parching and swelling of the respiratory tract, liquefaction of sputum, a marked decrease in the activity of pathogens.
Also with a dry cough, the following collections can be advised:
- Herb mother and stepmother, mint leaves, linden and calendula flowers.
- Raspberry, sage and mint leaves.
- Chamomile and calendula flowers, St. John's wort and mother and stepmother herb.
- Flowers of linden, raspberry, mother and stepmother (for bronchitis).
To soften the mucous membranes and easier expectoration of phlegm in the ready-made herbal composition for inhalation immediately before the procedure, you can add baking soda, which is especially effective in bronchitis.
In pregnancy, it is very important to carefully select herbs, because some of them can provoke uterine contractions and miscarriage. Doctors consider these plants to be optimal for inhalation treatment of expectant mothers:
- For the treatment of dry cough: chamomile, St. John's wort, thyme, althea, plantain.
- For treatment of difficult wet cough: eucalyptus, yarrow, yarrow, succession, bogulniki.
Features of steam inhalations
When carrying out steam inhalations, it is very important to observe a special dietary regimen. Do not carry out the procedure earlier than 1.5 hours after eating. And after the procedure it is worth refraining from eating and drinking water for 40-60 minutes, giving the particles of the inhalation solution some more time to act on the surface of the mucosa.
During the procedure you should breathe deeply enough, but evenly, avoiding too deep an inhalation. Hold your breath for a couple of minutes on the inhalation. Superficial breathing is inadmissible when it comes to treating coughs. You must not talk or be distracted by other things. It is important to focus on the procedure and proper breathing.
To treat coughs, there is a special scheme of breathing during inhalation. Inhalation is done through the mouth, and exhalation is better done through the nose.
Using for inhalation herbal compositions, do not think that the higher the concentration of the solution, the better. All decoctions and infusions are diluted with water, most often in a ratio of 1:3.
The temperature of the inhalation composition for adults is recommended to keep within 40-50 degrees, in some cases, if the nature of the herbal collection requires it, you can raise to 70 degrees, but maximum care is required. For children, a temperature of 30-40 degrees is considered optimal. At the same time, the smaller the child, the lower the temperature should also be. For small children inhalation in general is difficult, so it is better to get a special device - an inhaler.
In order to avoid burns, do not lean over the pot with hot solution. The optimal distance is about half a meter.
Light, loose clothing made of natural fabrics is suitable for inhalation. It is very important that it does not squeeze the throat and does not prevent deep breathing.
As for the duration of steam inhalation, doctors recommend for adults - 5 minutes, for children - 2-3 minutes.
For steam inhalation to be effective, it is important not to interrupt the procedure to breathe. Under the towel specially creates the effect of a sauna, "leave" which before the end of the procedure is not recommended. If there are difficulties with breathing, the inhalation is finished early.
Not all people tolerate the effect created under the towel well. Other methods of steam inhalation can be considered as an option:
- use of a funnel, which provides a narrow directional movement of healing vapors,
- use of a kettle with a tightly closing lid and a rubber tube on the spout,
- inhalation over a thermos.
In this case, you can prepare the inhalation composition in the same dishes, using purified, distilled or boiled water for its preparation.
Essential oils for cough inhalations
Treatment of cough with herbs implies the use of plants and flowers, as well as essential oils in inhalation compositions. It is not for nothing that plants rich in oils are chosen for inhalation: eucalyptus, mint, sage, thyme, coniferous plants, etc.
Essential oils for inhalation from coughs can be purchased in pharmacies and stores. They are useful because they promote the breakdown of phlegm and stimulate its excretion, relieve inflammation, effectively fight pathogens that cause disease and irritation in the throat, heal wounds. Also essential oils soothe inflamed mucosa, reducing the number of painful coughing attacks, calm the nervous system, normalize sleep, which is so necessary for a sick body to restore strength.
Cardamom, peppermint, cypress, anise, rosemary, chamomile, sage oils are used in the treatment of coughs. Useful effect in infectious diseases accompanied by cough, will also have a useful effect in the ether of fir, cedar, pine, eucalyptus, tea tree. With good tolerance, all of them are allowed for use in early childhood and during pregnancy.
With essential oils can be carried out 2 types of inhalations: cold and hot, more precisely warm-moist, because at high temperatures (above 40 degrees Celsius) esters can lose their healing properties. Cold dry inhalations are carried out with the help of such devices as aroma lamp, aroma fan, aroma medallion, etc. As an option, you can apply a few drops of oil on a handkerchief or pillow. But in this case it will not be very convenient to breathe with the mouth, which is a condition for the effectiveness of cough treatment. It is important to remember that during inhalations from coughs, the breath should be taken through the mouth.
Warm-moist inhalation is based on the use of water (1 liter is enough), to which 3 drops of any of the recommended oils are added. Covered with a towel, breathe healing vapors for 10 minutes.
For the treatment of children, an aroma lamp or another folk method is better suited. In a glass of hot water add 4 drops of eucalyptus, tea tree or other oil with antibacterial effect, and leave it in the room where the patient is. In this way you can treat coughs and disinfect the room.
To inhalations from cough with essential oils are the same requirements as for steam: compliance with dietary regimes and dosing of inhalation composition, proper breathing during the procedure with inhalation through the mouth. The duration of the procedure should be 10 minutes. Usually inhalations with oils are carried out 1 time a day. It is better not to use several oils at the same time, if this is not required by the selected recipe.
Inhalations are not carried out on a full stomach, so as not to provoke a gag reflex and not to distract the gastrointestinal tract from its work on food processing. But even on an empty stomach, such procedures should not be carried out, especially if you take into account that for the next hour you will have to give up food.
Inhalation with mineral water
There is such a way of treatment, which is approved by doctors. Mineral water in cough inhalation is not only a source of pure water necessary to moisturize the mucosa of the respiratory tract and liquefy sputum. It contains useful minerals necessary for the normal functioning of the body. It is a treasure trove of unique substances that increase the body's internal strength to fight the disease and beneficial effect on the respiratory mucosa, reducing inflammation and swelling, promoting rapid regeneration of damaged tissues.
In sanatoriums for procedures take hydrogen sulfide, carbon dioxide or radon water. Cough inhalation at home is most often carried out with the use of mineral water Essentuki, Borjomi, Narzan, but in their absence you can use and other mineral water. True, the effect in this case will be weaker. Although moisturizing the mucous membrane itself can alleviate painful cough syndrome and make the cough more productive.
Mineral water can be taken without gas or leave the bottle open for a couple of hours or more to allow the gas to escape, otherwise the cough may only get worse. The procedure can be carried out in two ways:
- using an inhaler (take 4-5 ml of the solution, pour it into the reservoir of the device and breathe the healing air for 10 minutes),
- with the help of improvised means (steam inhalation: in a bowl or kettle we heat mineral water to 40 degrees and inhale vapors for 5-10 minutes).
Inhalations with mineral water can be carried out up to 5-7 times a day. They are safe for children, the elderly, pregnant women and nursing mothers.
Requirements for inhalation from cough mineral: compliance with the diet, proper breathing, consideration of contraindications (especially for steam inhalation), adequate care after the procedure.
Inhalation with Asterisk for coughs
Balm with this name, many of us remember from Soviet times. With its help, our mothers and grandmothers treated colds, headaches and toothaches, diseases of the musculoskeletal system and blood vessel pathologies, took care of the skin and eliminated toxins. But Vietnamese medicine gained special popularity in the treatment of cold viral diseases accompanied by headaches and dizziness, nausea, broken joints, increased body temperature, cough, runny nose.
When treating coughs, such useful components of the natural remedy, such as essential oils (peppermint, eucalyptus, cloves, cinnamon), as well as menthol and camphor, come to the forefront. As an auxiliary remedy for respiratory diseases balm found recognition among both folk healers and qualified doctors.
However, cough inhalations with Zvezdochka have not gained much popularity. In addition, they are prohibited in the treatment of children under 3 years old, patients with bronchial asthma and a tendency to bronchospasms. Balm is not used in inhalers.
But for steam procedures in the absence of contraindications, it is a very useful and effective remedy. In hot water (40-60 degrees) you need to add 3-4 mg of balsam and breathe the vapors for 5-10 minutes (children up to 3 minutes). Inhalations can be carried out up to 4 times a day, taking into account the requirements for steam procedures.
Cough inhalation with baking soda
When it comes to inhalation treatment of colds, folk remedies are not much inferior to pharmacy drugs in terms of effectiveness and popularity, but are even safer, which is agreed by doctors. It is not without reason that at the first stages they recommend inhalations from cough with baking soda and herbal compositions, and if they do not help or can not be used, resort to the help of drugs.
Inhalation with baking soda is undoubtedly one of the most popular methods of fighting unproductive coughs. The popularity of the procedure is due to the fact that baking soda is at home in almost every kitchen, and the method of cough treatment itself in most cases works without fail. As they say, cheap and surly.
Inhalations with soda for dry coughs are classified as steam inhalations. The patient inhales water vapor with tiny crystalline particles that envelop the mucosa, soften and disinfect it. Moisture in the form of steam liquefies sputum and facilitates its expulsion.
The procedure is carried out by adhering to the rules of steam inhalation. Inhalation solution is prepared by adding powder to hot water. For a liter of water you need to take about 1 spoon of soda after the procedure of inhalation from coughing with soda, the symptom increases, but becomes less painful. Phlegm is expectorated more easily and without acute pain in the throat. As an antiseptic soda fights with settled on the mucosa microbes, which means that the healing process is faster.
Pharmacy products for inhalation treatments
Despite the fact that doctors do not refute the effectiveness of folk cough treatment with steam and warm-moist inhalation and even sometimes recommend it, not always soda and herbs can give the expected result. In addition, with malaise and weakness, inhalation in this way is better not to carry out in order not to further aggravate their condition.
Small children who do not know how to breathe properly and follow the rules, the procedure is incredibly difficult to carry out. And given the contraindications of steam inhalation, it becomes clear that this is not a universal remedy. So we have to pay attention not to pharmacy drugs and devices that help with maximum benefit and safety to carry out a useful procedure.
In the assortment of pharmacies there are solutions, drops, mixtures, cough inhalation preparations, which can be used in modern inhalers that do not require heating the liquid. Steam inhalation in this case is not an option, because many drugs are destroyed by high temperatures, which does not contribute to the cure of cough.
Cough inhalation with a nebulizer is the most modern method of cough treatment, which is suitable for patients of different ages, including newborns. A wide range of devices (compressor, ultrasonic, mash inhalers or membrane) and the possibility to choose a stationary or portable nebulizer for home use make this type of treatment quite popular.
Despite the different mechanism of action, when using nebulizers at the output we have an aerosol cloud with the smallest particles of the drug, which when inhaled get deep into the respiratory tract directly to the focus of the lesion. The depth of penetration of the particles depends on their size. Different nebulizers give particles of different sizes, but some models allow this process to be adjusted. For the treatment of coughs are suitable devices, the size of the received drug particles in which does not exceed 5 microns, otherwise they will be deposited only in the oral cavity and nasopharynx.
Modern nebulizers come with different attachments. To treat coughs in adults, it is preferable to use a mouthpiece or mouthpiece. In this case, the inhalation is done through the mouth, without unclenching the lips, tightly encircling the mouthpiece, and the exhalation after 1-2 seconds through the nose.
Cough inhalation for children is more convenient to carry out with a mask. In this case, the child can breathe freely, and the treatment goes on as usual. If the child is small, the procedure can be carried out even during sleep. The mask does not interfere with the baby's sleep, it is only important to ensure that the inhaler is in an upright position. The optimal option will be a stationary nebulizer. If a portable one is used, the child should be in a sitting or semi-lying position.
Cough inhalations for adults should be carried out in a sitting position. If the person is in a serious condition, then his treatment is carried out in the hospital with the help of inhalers. The mask is attached to them by means of a hose, which makes it possible to carry out treatment lying down.
For the procedure, use a clean, previously disinfected device. The solution for inhalation is prepared by diluting the medicine with saline solution, as prescribed by the doctor or according to the instructions for the drug and the device. We do not use herbal decoctions and essential oils in nebulizers, only pharmacy preparations.
Treatment can be started no earlier than 1-1.5 hours after eating or heavy physical exertion. Inhalations are carried out up to 3 times a day, trying to do it between meals.
During the procedure, you should sit upright with your shoulders loosely spread. It is necessary to breathe not too deeply, but not superficially. After inhalation makes a small pause (1-2 s), so that the drug had time to settle on the mucosa. Clothing put on loose, preferably from natural fabrics. During inhalation, nothing should not stiffen the chest and neck area.
Cough inhalation is a therapeutic procedure that requires a certain concentration on the process. Doctors do not recommend talking, reading or distracting yourself with other things that affect the characteristics of breathing: its depth, frequency and so on. Adhere to this rule is not so difficult, if you take into account that inhalation for an adult should be carried out for no more than 15 minutes (ideally, while the drug is consumed in the reservoir of the nebulizer), and for a child under 5 years - 3-10 minutes. The procedure can be ended earlier if it begins to cause the patient noticeable discomfort and deterioration of well-being.
But let's return to the drugs that doctors recommend for inhalation, and the peculiarities of carrying out procedures with their use.
Inhalation for cough with saline (sodium chloride)
Saline solution is a liquid similar in osmotic pressure to blood plasma, so our body does not perceive it as something foreign. Inhalation for cough with saline solution using a nebulizer is one of the safest procedures, similar to inhalation with mineral water. Such treatment can be safely carried out by children and pregnant women, because saline solution does not contain substances that can harm health, has no odor and taste.
However, the effectiveness of saline in the inhalation treatment of cough is relatively small. Such treatment is more suitable for moisturizing the mucosa of the respiratory tract, which relieves groundless urges in dry cough and facilitates the expulsion of sputum in low-productive.
In the nebulizer pour 4 ml of saline solution (a child can 2-3 ml) and breathe for 5-10 minutes. The procedure is carried out up to 3 times a day.
As such, the therapeutic effect of 9% sodium chloride solution does not have a therapeutic effect, but there are other drugs that have secretolytic, expectorant, bronchodilator action. In inhalation solutions, they are used together with sodium chloride.
Inhalations for coughs with "Lazolvan"
"Lazolvan" is a preparation of ambroxol, a substance with a pronounced secretomotor, secretolytic and expectorant action. In addition, it facilitates penetration into the bronchial secretion of antimicrobial agents. The drug is available in tablets, and in the form of syrup, and in solution. The latter is most conveniently used for inhalation for coughs.
For inhalation procedures, the drug can be used from a very young age, when babies are not yet able to expectorate sputum, so stimulated expulsion is required.
The procedure can be carried out with any modern inhaler, except steam inhaler. The solution can be used pure in an amount of 2-3 ml or mixed 1:1 with saline to improve the moisturization of the mucosa. For children under 6 years of age, 2 ml of "Lazolvan" is enough.
It is recommended to carry out 1-2 procedures per day. Prepared solution is preheated to body temperature and breathe it in the usual way.
If you have bronchial asthma and tendency to bronchospasms, you should take bronchodilators before inhalation with expectorant medications or use inhalation procedure with these drugs.
Inhalations with "Lazolvan" can be carried out and children and pregnant women. However, it is worth being cautious in the 1st trimester of pregnancy, having consulted a doctor about the safety of such treatment. Nursing mothers during the use of ambroxol preparations are also better to refrain from breastfeeding, although there are no proven cases of negative effects of the drug on the child's body.
Cough inhalations with Berodual
When talking about the peculiarities of inhalation with ambroxol preparations, we mentioned the need for bronchodilators in some cases. Berodual" belongs to the category of such drugs. This is a non-hormonal two-component drug with a complex action: bronchodilator (one of the active substances is an antispasmodic agent of directed action), anti-inflammatory, normalizing (decreases sputum hyperproduction, leading to bronchial congestion), drainage.
The use of the drug helps to reduce the number of painful attacks, relieve breathing, get rid of wheezing. Moreover, these effects are observed within the first 20 minutes.
Appoint inhalation with "Berodual" for allergic and infectious diseases of the central and lower respiratory tract, accompanied by bronchospasms, bronchial obstruction, which is often diagnosed in inflammation of the respiratory system in children.
For inhalation, you can use a solution in bottles or aerosol "Beroduan H" (designed for 200 doses, so it is convenient as a first aid tool for bronchial asthma). The solution can be used in any inhalers, except steam inhalers. Do not allow contact with the eyes.
Aerosol is used according to the scheme: in acute attacks 2 injections (inhalations), then if there is no effect, the procedure is repeated. No more than 8 doses can be used per day.
Solution "Beodual" is used in nebulizers of any type, having previously mixed it in equal proportions with saline. The total volume is 3-4 ml. Inhalation solution should be at room temperature.
Inhalations for coughs are carried out until the entire solution is used, but doctors recommend this duration: for adults - no more than 7 minutes, for children - 3-5 minutes. At the same time, children's doha will be much smaller: up to 6 years - 0.5 ml of "Berodual", 6-12 years - up to 1 ml of the drug 3-4 times a day.
"Berodual" as an antispasmodic and potent drug has quite a few contraindications that must necessarily be taken into account. As an antispasmodic, it can be dangerous to expectant mothers in the 1st and 3rd trimester of pregnancy. It is also not recommended when breastfeeding.
The active ingredients of the drug affect blood vessels, causing their contraction, so it should not be used in cardiomyopathies and tachyarrhythmias. Caution should be observed in people with heart disease and endocrine disorders, cystic fibrosis, prostate adenoma, closed-angle glaucoma, bladder neck obstruction.
For inhalation treatment, the drug is allowed from infancy until late old age. It can be used even with fever.
A dry mouth sensation is most often experienced after the procedure. In case of individual sensitivity, coughing and skin rash may occur.
Inhalations for coughs with Miramistin
"Miramistin" - a well-known antiseptic, which has a wide range of action and high efficiency in respiratory diseases. This is one of the safest drugs that can be used in the treatment of small children, pregnant women and nursing mothers, the elderly and the elderly.
"Miramistin" can be used to rinse the nose, gargle the throat, use the solution for inhalation. This helps to quickly cope with the disease caused by a bacterial infection or in the case of a bacterial complication of a viral infection.
Antiseptic does not have an expectorant or mucolytic action, so by itself cannot make the cough more productive and lighter. But microbes and their toxins cause irritation of the mucosa, its inflammation and sensitization, which are considered one of the causes of coughing. "Miramistin" helps to reduce the number of agonizing attacks and contributes to a faster recovery. And to inhalation for coughing had and expectorant effect, it is recommended to mix the antiseptic with saline solution, which will moisturize the mucosa and liquefy sputum.
Usually for inhalation take 0.01% solution of "Miramistin". In nebulizers for one procedure use 4 ml of antiseptic or 2 ml of "Miramistin" and 2 ml of saline solution. The dose for children is usually half as much. Inhalations are carried out 3 times a day, using the entire inhalation solution, which should have room temperature (in case of a strong cough, you can warm up to body temperature, but not higher).
Cough inhalation "Ambrobene"
This is a popular drug, widely advertised in the media, which in reality turns out to be a derivative of ambroxol hydrochloride, like the above-described "Lazolvan". The popularity of "Ambrobene" is explained by the high efficiency of the active ingredient and a wide range of release forms of the drug, one of which is a solution for inhalation. The drug differs from "Lazolvan" in the same form except for the auxiliary substances, which may nevertheless be important in case of intolerance to one of the additional components of "Lazolvan".
The solution "Ambrobene" for inhalation from coughs is used from a very young age. The procedure is carried out with non-steam inhalers, using 2-3 ml of the drug, which can be diluted with saline solution 1:1 to increase the effect. For children under 2 years old take 1 ml, children 2-5 years old enough 2 ml of the drug.
Inhalation treatment is carried out 1-2 times a day for no more than 15 minutes per treatment (for adults) and 5-10 minutes for children.
Contraindications to the drug are bronchial asthma (although in this case inhalation with berodual saves), convulsive syndrome and epilepsy. Caution should be observed in the exacerbation of peptic ulcer, severe kidney and liver disease, in the first trimester of pregnancy, breastfeeding.
Hormonal remedies for cough inhalations
Corticosteroids are potent anti-inflammatory agents that are very difficult to administer by inhalation. On the one hand, they could quickly clear severe inflammation of the airway mucosa, making breathing easier, reducing the amount of inflammatory exudate in wet coughs, and preventing bronchospasm. But on the other hand, the use of popular corticoids, such as hydrocortisone, prednisolone, dexazone, in nebulizers is undesirable, because in practice we get systemic rather than local action.
"Pulmicort" for inhalation for cough - the only drug to date that is recommended for nebulizer therapy. This is a drug with local anti-inflammatory action, which has much fewer contraindications and side effects.
The drug is available in the form of suspension for spraying. It can be used for dry and wet inhalation in bronchial asthma, bronchial obstruction, wet cough with increased sputum production in small children. For treatment of children topical corticoid is used in case of bronchitis, laryngitis, bronchial asthma, vasomotor and allergic rhinitis, cough of any kind.
"Pulmicort" can be used in nebulizers only compressor type. Dosage for adults - 1-2 mg (1 ml of suspension contains 0.25 or 0.5 mg of active ingredient), for children from 1 year to 12 years - 0.5-1 mg, infants 6-12 months - 0.25 mg twice a day.
Before use, the suspension should be diluted with saline (solutions of terbutaline, salbutamol, fenoterol, acetylcysteine, sodium cromoglycate, ipratropium bromide). The total volume of the inhalation solution for infants is 2 ml. For older patients use 2-4 ml of the ready-made composition for one procedure.
"Pulmicort" is not prescribed to children under six months of age, as well as with hypersensitivity to the drug. It is not prohibited to use the drug during pregnancy and breastfeeding, since inhalation treatment does not have a systemic effect. Still, doctors insist on very cautious use, especially when it comes to small children, whose treatment with hormonal agents is better to be carried out in the hospital under the supervision of medical personnel.
With prolonged use of the drug in children, growth retardation is possible, but this is more relevant to children with bronchial asthma who regularly use Pulmicort aerosol in doses of more than 400 mcg per day.
Inhalations with "Validol" for coughs
Perhaps this method of cough treatment will cause some people bewilderment and even indignation, but in fact the result of using a vasodilator is quite predictable. We are just used to seeing "Validol" as a means of effective help in cardiopathies and neuroses, so we can not immediately accept other, not fixed in the instructions of its application.
Inhalations with "Validol" are used to treat dry cough. It is believed that due to the substances included in the drug, it soothes the mucosa of the respiratory tract, removing excruciating attacks, dilates blood vessels, activating regeneration processes, due to which the swelling goes away and the sensitivity of the respiratory tract decreases. Since inhalation uses a solution of validol or vapor with the drug, there is additionally a softening of the throat and liquefaction of sputum, which facilitates its expectoration.
"Validol" is available in the form of tablets and drops, but for the preparation of inhalation composition, mainly the first form is used, although it is less convenient. In this case, 2 ways of using the drug are considered:
- Crush the tablet into powder, add it to 400 ml of boiled water and stir thoroughly. This composition can be used in any inhalers or breathe steam over a pot.
For adults for greater effectiveness it is recommended to add 7 drops of iodine and 1 tsp. Of baking soda to the solution. Inhalation, depending on the chosen method, is carried out from 5 to 15 minutes.
For children, it is recommended to reduce the dosage of the medicine: 1 tablet per 1 liter of water. Duration of inhalation 2-3 minutes.
- For steam inhalations from coughing over a pot, the tablets can be used in a different way. Add a couple of tablets of "Validol" in potato broth and breathe steam for 5-10 minutes.
Different sources advise adding to a hot solution of "Validol" onion gruel or infusion of eucalyptus in the absence of individual intolerance.
It is difficult to say who and when invented this method of cough control, and it is unlikely that you will be advised by a doctor (although there have been such cases), but in the absence of effective drugs it can be tried. A low dosage used for inhalation is unlikely to harm your health, but may still ease the condition in the absence of an alternative or ineffectiveness of purely home remedies.
Conditions of efficacy and safety of inhalation
Cough inhalation is one of the most effective methods of treating a distressing symptom, which is used for many diseases. The drug with the help of steam procedures or inhalers is delivered directly to the affected area, where it begins to act from the very first minutes. When taking the drug orally, it must take time for the drug to pass through the gastrointestinal tract and reach the respiratory tract with the bloodstream.
With the correct selection of drugs and folk remedies, as well as taking into account the recommended dosages, such treatment will not have a systemic effect, which avoids unpleasant side effects. This makes the procedure safer than taking effective cough medicines orally.
But there are some disadvantages to the procedure regarding certain points of the procedure.
Cough inhalation for adults is not difficult to carry out, no matter what kind of procedure you choose. But when choosing steam inhalations, you need to remember that high temperature steam can cause burns to the skin and mucous membranes, so do not lean too low over the pot with healing decoction.
Smokers will have to refrain from their favorite pastime as the day before inhalation, and after it, not to mention the fact that the procedure should not be interrupted for a smoke break. Ideally, the treatment of respiratory diseases implies a healthy lifestyle, at least for the duration of therapy.
Cough inhalation for children should be given by adults: health care workers or parents. They must explain to the child that it is not necessary to breathe deeply while wearing a mask. Older children can be explained that when coughing, the breath should be taken through the mouth, talking and fooling around during the procedure is not allowed.
To keep your baby in a calm state for a long time, you can turn on calm music, a light cartoon or just read an interesting book. Usually this is enough for 5-10 minutes of the procedure.
If the child is afraid, which often happens at the first acquaintance with the inhaler, you can translate the process of treatment into a game form or calmly talk to the baby, telling a story about a brave boy/girl who were not afraid of anything, so the kind Nebulizer helped them to cope with the enemies of kids: evil Cough and harmful Snot.
To treat infants, it is better to use an inhaler that allows the procedure to be carried out while lying down. If the baby is cranky, inhalation can be done when the baby is asleep.
Children can only be given steam treatments when they understand and follow the rules told to them by their parents. For example, close their eyes when leaning over the steam, do not bend low and do not spoil themselves. A hyperactive child can simply turn over a dish of boiling water. A baby covered with a towel can faint and there is no telling how such carelessness on the part of parents can end.
Nebulizer - the optimal device for inhalation of infants, toddlers, preschool and primary school age children. But even in this case, it is necessary to strictly adhere to the doctor's recommendations. Bronchospasm is the scourge of small children, so if the doctor prescribes inhalation with bronchodilators before the procedure with expectorants, they must be carried out.
The same can be said about hormonal remedies that prevent bronchial obstruction. Remember that babies are not yet able to blow their nose properly and cough up exudate accumulated in the bronchi, so they are at risk of bronchial obstruction, preventing normal breathing.
Usually, inhalation procedures are carried out for no more than 5 days, but if the doctor prescribes a longer course, this should be listened to.
Cough inhalation for pregnant women is prescribed by doctors as an alternative to oral administration of expectorants, mucolytics, antimicrobials. With inhalation treatment, a small part of the active substance enters the bloodstream, so the risk of systemic reactions dangerous for the child is reduced.
Most of the drugs used are relatively safe in pregnancy, with the exception of bronchodilators. Here we need to be very careful, because the drugs can also have some systemic effects, i.e. Relax the muscle muscles outside the respiratory system. In early pregnancy, this can cause miscarriage. Therefore, in any case, without consulting a doctor, expectant mothers should not carry out any treatment.
Caution should also be observed when carrying out steam inhalations. The vapors of potatoes, baking soda or herbal decoctions themselves may not be dangerous, unless it is a matter of intolerance to certain substances in their composition, but the reaction to vaporization in the future mother can be unpredictable.
Essential oils should not be abused either. Some of them, in addition to treating coughs, can also affect the uterine muscles, which is most dangerous in the first months and last weeks of pregnancy.
When performing the procedure for the first time, you should carefully monitor your condition (or the condition of the child). The fact is that individual sensitivity can be detected not only to plant extracts and esters, but also to pharmacy preparations. Moreover, it is very difficult to foresee such a reaction in advance.
If during cough inhalation the patient has any suspicious symptoms: reddened face, it became difficult to breathe, there is a runny nose or increased cough, etc., the procedure should be stopped and contact a medical center for help.
Any means used for the preparation of inhalation compositions may have contraindications, which must necessarily be taken into account. Special attention should be paid to this for people with heart disease, kidney disease, liver disease, endocrine system disorders, closed-angle glaucoma, some congenital disorders.
Effective cough inhalations are those that take into account all the nuances: the type of cough, individual reactions of the body to the drugs, safe dosages and requirements for inhalation, both steam and nebulizer.
Contraindications to the procedure
Contraindications to inhalation from cough - this is the factor that primarily causes the development of all sorts of complications. If they are not taken into account, an effective therapeutic procedure can become the cause of the patient's poor condition. In this case, the benefit of inhalation will be disproportionate to the possible harm.
But in what cases doctors do not recommend resorting to inhalation treatment:
- high body temperature in the patient,
- tendency to nosebleeds and a history of nosebleeds (this applies more to rhinitis inhalations and steam treatments),
- cardiovascular pathologies complicated by respiratory failure,
Caution should be observed and those who suffer from arrhythmia, hypertension, patients with arterial and heart failure, congenital vascular weakness, atherosclerosis of cerebral vessels, those who have recently suffered a stroke or myocardial infarction. In principle, inhalation nebulizer such people are not prohibited, given that even breathing in this case has the usual depth and rhythm. But steam procedures, which contribute to the expansion of blood vessels, can cause irreparable harm.
Inhalation procedures (especially with a nebulizer, which produces tiny particles of therapeutic solutions that penetrate the lower respiratory tract) should not be carried out in people:
- with severe pneumonia,
- pleurisy,
- for severe pulmonary insufficiency,
- polyposis of the respiratory tract,
- pulmonary hemorrhage and tendency to bleed,
- recurrent pneumothorax.
These are severe conditions where the beneficial effects of inhalation may have the opposite effect, i.e. Worsen the patient's condition. Such patients must be treated in a hospital setting.
Oil inhalations are not carried out with a nebulizer for two reasons: not to spoil the expensive device and not to harm yourself. The fact is that getting into the lower respiratory tract of oil particles can provoke the development of oil pneumonia. This is one of the complications after the procedure, arising from an incorrect approach to the choice of effective solutions and treatment methods.
Oils are not used to treat the lungs. They are preferable for diseases of the upper respiratory tract, and in bronchitis and inflammation of the lungs should pay attention to other means. In steam inhalations, the particles are larger and do not penetrate so deeply, but they are just used for therapeutic purposes.
As for children, the procedure should be carried out with special caution. It is not for nothing that doctors insist that infants should be treated only in a hospital.
During the disease, small children can become cranky, restless, start crying and spinning. In such a state, cough inhalation should not be carried out. It is better to wait until the child calms down and dozes off.
High body temperature is considered a contraindication for any inhalation in adults and children. But the temperature limits may differ. Steam inhalation is not recommended when the thermometer reads 37.2-37.5 degrees. But the procedure with nebulizer should be postponed if the temperature passes the boundary of 37,5-38 degrees. However, inhalations with antibiotics can be carried out even at higher values, which helps to combat hyperthermia.
Common to all, although a relative contraindication is considered an individual intolerance to the components of the inhalation composition. But there is nothing to be done, besides, the choice of inhalation solutions is large enough (including absolutely safe mineral water) to choose among them the most optimal.
And one more point. For the procedure, it is better to choose a single composition. Do not mix different drugs in one solution without a doctor's prescription. Drug interaction can both weaken the effect of drugs and increase the likelihood of side effects.
In addition, it is important to understand exactly what effect the chosen medicine has. Bronchodilators should be used before mucolytics and expectorants. But cough medicines should not be combined with the latter because of antagonistic reactions.
Consequences after the procedure
Inhalations are one of the most common cough treatments. Their popularity is due to a number of reasons. One of them is the absence of the need to drink medicines that cure one and cripple others. Even pharmacy compositions have mainly local action, and a very small amount of medicinal chemistry enters the bloodstream, which can not harm the body. With the right approach to the procedures, the risk of complications on vital organs (systemic action) and other unpleasant consequences is minimal.
Another reason for the popularity of inhalations can be considered fast action due to the fact that the "medicine" is delivered directly to the focus of the lesion. Already after the first procedure there is a noticeable relief. Attacks become less agonizing, breathing becomes easier, throat softens. True, during and immediately after inhalation cough may increase, but it will not be exhausting due to easier expectoration of sputum.
The fact that from inhalation coughing increases, should not be considered a bad sign. This is a natural process, because we ourselves stimulated the release of bronchial secretion, liquefaction of sputum, motility of the respiratory tract. Naturally, the symptom intensified, but it is better than suffering from unproductive cough. Coughing is necessary to remove from the bronchi and lungs everything that prevents them from functioning normally.
It is another matter if, in addition to coughing, a person begins to choke, which may indicate bronchospasm, bronchial obstruction or a severe allergic reaction accompanied by angioedema. These symptoms usually appear already during cough inhalation, which is a signal to stop the procedure and take measures to relieve dangerous symptoms.
Most often unpleasant consequences are noted after steam procedures. The use of too hot water (over 60 degrees, for children over 40-45 degrees), small distance from the source of steam, open eyes during the procedure, too deep breathing during inhalation, excessive wrapping, limiting air access, are fraught with serious complications. Among them are burns to the face, mucous membranes of the eyes, pharynx and larynx, loss of consciousness due to lack of oxygen, exacerbation of heart disease, nosebleeds. All of these can be avoided if you know the measure and treat the procedure consciously.
Care after the procedure
Doctors say that the outcome of treatment depends not only on what medications we take and what procedures we have, but also on what we do afterwards. Care after the procedure is no less important than the procedure itself, but many people simply do not pay attention to it, considering it not so important. Hence the second group of complications caused by incorrect actions after cough inhalations.
What happens if you go for a breath of frosty winter air right after steam inhalation? Nothing good. Any inhalation is a certain load on the mucosa of the respiratory tract, which for a while becomes more sensitive to any impact, including negative. So walks will have to be postponed for at least an hour, and even more in winter.
Do not combine treatment with sports activities. Physical activity immediately after the procedure is harmful, because they weaken the body, which has already spent energy on self-healing. Active breathing during exercise can cause dizziness, darkening of the eyes, loss of consciousness. The body should be given the opportunity to recover for 1-1.5 hours, after which to show any activity.
Smoking can nullify the effect of a useful procedure, and such a combination of procedures is not allowed for some drugs. Give your lungs a rest at least for the duration of your illness.
Since the end of the procedure is not yet the end of treatment (for some time, the particles of medicines in the respiratory tract will continue their work), eating should also be postponed for an hour and a half. In order not to feel hungry, doctors recommend that inhalation from cough 1-2 hours after eating, and the next meal should be postponed for the same period after the session. This is quite a normal interval for a healthy stomach.
If you do not adhere to the recommendations, the effectiveness of inhalation decreases (the drug does not have time to work normally, especially if it is an antibiotic), and from the GI tract may appear unpleasant symptoms: nausea, vomiting, heaviness in the abdomen.
Ideally, it is best to lie down to rest. Let the medicine particles continue to do their work, helping the body to heal. You can get some sleep or just lie down without straining your muscles or head. No temperature extremes or changing conditions. Set yourself up to heal from the illness sooner rather than quickly returning to your usual activities despite being sick.
Testimonials
Inhalation cough treatment is a common practice, which is followed even by doctors. This type of effective therapy is applicable to adults, children and the elderly. It is also available to expectant mothers and nursing women, replacing the ingestion of synthetic drugs that can harm the growing child's body.
Cough inhalation can be carried out by different methods, using different inhalation compositions: mineral water, herbal decoctions, soda solution, essential oils, pharmacy remedies. The effectiveness of different compositions may differ, which to a certain extent is due to a large disparity in reviews of the procedure.
For example, mineral water and saline soften the throat and only slightly liquefy the phlegm, so you should not expect an ah-ha effect from it. But ambroxol with its pronounced expectorant effect (even without straining) can already be used in more serious diseases, for example, in combination with antibiotics, which he facilitates the work.
Each person's body is different, so the reaction to even the most effective cough inhalations can differ. Someone remains satisfied with the result, and others do not see a pronounced effect. But this does not mean that it is necessary to abandon an effective procedure. Maybe it is worth changing the inhalation composition?
Sometimes you can find reviews in which moms complain that after inhalation the child became worse, the cough increased, the child is cranky. There is nothing surprising in this. A small child is not yet able to normally expectorate sputum, so the increase in coughing urges due to the accumulation of sputum can wear him out. Ambroxol is approved for use from an early age, and after it, sputum often comes off even without coughing. It may be worth considering this option.
Worsening of the child's condition after the procedure can also be explained by improper care. Walks and active games should be postponed for a while, and if this is not done, it is likely that the disease will progress and may even give complications. A weakened body is an easy prey for germs.
Among specialists there is an opinion that there are no ineffective inhalations, there is an incorrect approach to their implementation: mismatch of the stated effect of the drug to the real needs of the patient (for example, the use of cough suppressants at the height of the inflammatory process in the respiratory tract), improper preparation of solutions and the procedure, ignoring contraindications and care requirements after inhalation. In some situations, it is enough just to change the drug, the sensitivity of the body to which is either increased or on the contrary extremely low.
To inhalation from coughs brought the expected effect should treat them as a serious therapeutic procedure that has its own requirements and limitations. Their observance will guarantee not only the removal of distressing symptoms, but also a speedy recovery with little effort, which, however, does not exclude the complex application of other methods of treatment, minimizing the risk of complications.