Back to basics - there is a debate about the volume in the nebulizer cup to achieve appropriate aerosol.  When administering 2.5mg of epi for croup or 2.5mgs of  salbutamol for bronchoconstriction  is it not best practice to add 2.5mls of saline to achieve appropriate aerosol? My co-workers and I are split on this debate.   

You are correct that to administer nebulized epinephrine that best practices are to dilute it with 2.5mL of saline. LexiDRUGS (prev LexiComp) suggests 2-3mL of NS to dilute epinephrine for nebulization. 

If the salbutamol you carry is not already diluted in NS (for example 5mg in 2.5mL solution), then it can also be added to 2.5mL of NS in order to give volume to nebulize. 

Airway/Breathing,Bronchoconstriction,Croup

Bronchoconstriction, Croup, Dilution, Medicine Administration, Nebulization, Nebulized

Epinephrine. Lexi-Drugs. UpToDate Lexidrug. UpToDate Inc. https://online.lexi.com. Accessed April 23, 2026. 

Albuterol (Salbutamold). Lexi-Drugs. UpToDate Lexidrug. UpToDate Inc. https://online.lexi.com. Accessed Aril 23, 2026.