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Nasal irrigation is indicated in children with breathing difficulties due to upper airway obstruction from secretions. It should be performed one hour before or after a feed or a meal if possible. There are two methods: the instillation method and the volumetric method.
15.1 Instillation technique (done by parents, at home)
- Wash hands.
- Lay the child on his back.
- Instil 2 to 4 drops of normal saline in each nostril when the child inhales.
- Raise the child (to a semi-seated position) and collect the secretions from the nose and mouth with a tissue.
- Wash hands.
15.2 Volumetric technique (done by care provider at an outpatient visit or in the hospital)
- Wash hands.
- Lay the child on his back, head slightly elevated.
- Placing one hand under his neck, turn his head to the right to treat the left nostril.
- Insert the dropper tip of the normal saline vial at the opening of the left nostril.
- Squeeze the vial when the child inhales.
- If the child coughs, stop the instillation and let him settle down for a few minutes.
- Check that the saline and secretions have drained via the right nostril.
- Raise the child’s head slightly so that the fluid can drain more easily.
- Collect the secretions.
- Repeat the procedure on the other side.
- Monitor the child for a few minutes after the procedure.
- Wash hands.