Wait time between nebulizing Albuterol and Saline

I have a question for Sue or anyone else who nebulizes 7% saline AFTER two or three puffs of the albuterol inhaler, do you find it works just as well as the nebulized albuterol? I would think the saline would wash away the albuterol powder. Please reply. Thank-you.

Yes, indeed, it works just fine for me.
The albuterol inhaler is a mist, and once it penetrates into the lungs, I don't think it washes away.
Sue

none

It was never separate until relatively recently! It was always a mix of albuterol solution with saline. When they started separating it, and I don't know why, I have continued to mix them together. I would be dead by now if it weren't ok. Been doing the mixture since 1972!

If you mix together, the concentration of the saline would be decreased. McShane mentioned that in her AC talk.

I mix my saline and albuterol together when I neb, over time I’ve asked 3 pulmos and at least 5 RTs if it mattered that their were mixed. The answer was no with the exception of 1 pulmo who said “…the saline is diluted and, thus, less salt is absorbed in the airways to hydrate and make them soft….”. Seemed like you’d still get the same amount of salt but I didn’t chose to challenge him.

I was told that the saline would dilute the albuterol. You need full strength albuterol to open the airways, making it easier for the saline to get in and do it's job afterwards.

Mixing albuterol and 7% saline decreases the concentration of the saline because the same amount of salt is mixed in a larger amount of fluid, decreasing the salt's percentage.
McShane specifically said that at the 30-31 min mark of video on airway clearance below. That and her comment about the lower concentration of salt in marsh water containing MAC (around the
27-30" mark) stuck with me when I first watched.
By the way, for those wondering about hypertonic saline's use in airway clearance, she goes thru the older British study showing its benefit, saying if study is good, it doesn't require frequent redos. She also reminds us that salt has been used as a preservative to preventing bacteria for years.
https://m.youtube.com/watch