Bronchiectasis Airway Clearance [.phrase]

Spent time explaining that the cornerstone of bronchiectasis treatment is aggressive airway clearance. This decreases cough/shortness of breath and has been shown to decrease exacerbations. Three primary methods are:

• Pharmacologic

o Hypertonic Saline (6MWT improvement and decreased healthcare utilization)

? 4mL of 3%, 4 mL of 7% as an alternative, or 4 mL of 0.9% is acceptable

o Albuterol Nebulizer before saline or airway clearance to thin mucus

o Mucomyst (10 mL of 10% mucomyst or 5 mL of 20% + 5 mL of 0.9% saline)

• Mechanical

o Manual percussion, Postural Drainage, Flutter Acapella, Chest Wall Oscillation

• Activity based

o Daily exercise including both aerobic or strength training

The order for Hypertonic:

Best at COSTCO

• sodium chloride 3 % Inhalation Nebu Soln

• 300 mL, Q6H PRN

• Dispense: 300 mL • Refills: 11 •

• Sig: 300 mL every 6 hours as needed for Other (cough).

sodium chloride (HYPER-SAL) 7 % Inhalation Nebu Soln

Dose, Route, Frequency: 4 mL, Inhalation, BID (AS SCHEDULED) Dispense: 240 mL Refills: 3 ordered

Order for Nebulizer + accessories kit :

Code 50240

Code 51359