How to Use, Clean, Sanitize and Troubleshoot Your Nebulizer

By Lily – Registered Respiratory Therapist

A nebulizer turns liquid medication into a mist using pressurized air generated by a compressor. Nebulizer treatments can be prescribed for those who have difficulty using inhalers or need medications that can only be delivered via nebulization. 

Nebulizer treatments are prescribed for asthma and COPD exacerbation as well as for symptom management of those with chronic lung conditions. 

Commonly nebulized medications include bronchodilators (medications that open up the airways), such as salbutamol, corticosteroids, such as beclomethasone, as well as mucolytics (mucus thinners), such as acetylcysteine and hypertonic saline. 

If you’ve been prescribed nebulizer treatments by your healthcare provider, it is important that you familiarize yourself with your nebulizer to ensure you receive your proper dosage.

Your home nebulizer system consists of an air compressor, a nebulizer cup (with tubing to connect to the compressor), and a mouthpiece or face mask. 

Face masks are recommended for children and anyone who finds it difficult to hold a nebulizer steady throughout the 10 to 20 minutes of the treatment.

Connect the tubing to your nebulizer cup and compressor. Place the compressor on a flat surface, such as a table, and plug in the power cord to a wall outlet. Wash your hands with soap and water. 

With clean hands, unscrew the lid of your nebulizer cup and add the proper dosage of medication into the cup. Nebulizer cup capacity can vary across manufacturers, so it is a good idea to check this before purchasing. 

The Philips disposable and reusable sidestream nebulizer cups hold a maximum capacity of 10 ml. Screw the lid back on and attach the mouthpiece or mask to the top of the nebulizer cup. 

Please make sure to hold the nebulizer cup upright to avoid spillage. Turn on the compressor and check to see if the nebulizer is producing any mist. If you don’t see any misting, please check that your connections are secure and your compressor is on.

When you are ready to take your medication, sit upright in a chair to promote lung expansion and hold your nebulizer upright to prevent spillage. If you are using a mouthpiece, place it between your teeth, making sure your lips form a tight seal around the mouthpiece. 

Remember to breathe through your mouth and try to take a deeper breath every fourth or fifth breath to help the medication enter deeper into your airways. If possible, hold your breath for 2 to 3 seconds, as this will help the medication settle in your airways. 

You can exhale through your mouth and nose as you do normally. If you are using a face mask, make sure it is snug enough that there isn’t any mist escaping from the sides of the mask. Keep breathing from the nebulizer until all the medication is gone. 

This can take up to 20 minutes, and you will hear the nebulizer splutter as the medication runs low. When you are done with your treatment, turn off the compressor and disconnect the tubing from the compressor and the nebulizer cup.

Children should use face masks for their nebulizer treatments as it can be difficult for them to hold the nebulizer steady. Please have your child sit up straight and ask them to breathe normally through the face mask. 

If they are calm, ask them to take deep breaths and hold their breath for 2 to 3 seconds. This increases the amount of medication that settles in the airways. 

If your child has trouble sitting still for the duration of treatment, consider watching a show together or giving them a small reward after the treatment. 

Alternatively, you can be more strategic with when you give treatments, i.e., choosing a time during the day when your child has less energy. Try giving treatments when your child is calmer, such as after meals, during naps, and before their bedtime. 

Another tip for giving nebulizer treatments to children is to make it fun. Kids don’t like having a mask on their faces, and younger children may even be scared of the mask. 

There are various pediatric nebulizer masks available with a variety of kid-friendly designs to appeal to children. You can also decorate the mask with your child so they don’t see it as a medical item.

You can set a routine for nebulizer treatments to familiarize them with the equipment. Once children know what to expect, they will not be as averse to taking their nebulizer treatments. 

If your children are older, consider letting them play an active role in their treatment by letting them put the mask on themselves and turn the compressor on.

Q: How do you maintain a nebulizer?

Please take apart your nebulizer cup and wash it with warm soapy water after each treatment. You should also wash your mouthpiece and mask with soap and water after each treatment. Rinse all parts thoroughly in sterile water and let the pieces air dry. 

Some nebulizers are dishwasher safe – please refer to your nebulizer user manual. There is no need to wash the tubing that connects the nebulizer cup to the compressor. In fact, you want to make sure to keep the tubing dry. 

Q: What happens if you don’t clean your nebulizer?

A: It can become louder and burn out the motor sooner. Cleaning the cup is important to avoid bacterial build-up.

Aside from cleaning your nebulizer after every treatment, you should also disinfect the equipment once a week. Disinfection methods differ for disposable and reusable nebulizers, so please make sure you are familiar with your nebulizer and check your user manual before proceeding with disinfection.

Q: How do you sanitize a nebulizer?

A: Cleaning the cup should be done with soap and water.

Find Cleaning Supplies Here

You can disinfect disposable nebulizers by soaking the parts in a solution of one part vinegar and three parts hot water for 30 minutes to an hour. Please rinse with sterile water after soaking to remove the vinegar smell and let the parts air dry. 

You can also disinfect your disposable nebulizer by soaking the parts in 70% isopropyl alcohol for 5 minutes or by soaking them in 3% hydrogen peroxide for 30 minutes. 

Once again, please remember to rinse your disinfected nebulizer with sterile water after soaking and let the parts air dry.

Reusable nebulizers can be disinfected by boiling the nebulizer parts in water for five minutes or by placing them in a bowl of water and microwaving them for five minutes. You can also use a baby bottle sterilizer.

Disposable nebulizers should be replaced every 10 treatments, and reusable nebulizers should be replaced every six months. This ensures that you receive all the medication you need because nebulizers do not mist as effectively when they are past their recommended lifespans. 

Q: How often should you change the tubing on a nebulizer?

A: Monthly.

Face masks should be replaced every six months as the material degrades over time. Nebulizer tubing should be replaced every two months or immediately if it is cracked or damaged in any way. 

It is always a good idea to have spare tubing and nebulizers on hand in case you need to replace them immediately. You may want to consider having at least two nebulizers and two mouthpieces/face masks so you have a set to use while you are waiting for the other set to dry.

Q: Do you clean nebulizer tubing?

A: Nebulizer tubing is not cleanable; discard and replace.

Q: Can I boil my nebulizer parts?

A: No.

Your compressor comes with air filters that need to be changed regularly to prevent dust from entering the machine. Changing your compressor filter regularly will prolong the lifespan of your compressor and save you money down the road. 

Please check your compressor user manual for the recommended filter replacement schedule and check your filter monthly for discoloration. If you notice that your filter has become discolored before the recommended replacement time, please replace the filter and do not wait until the replacement time to change your filter. 

Please use your compressor on a flat surface; avoid using it on the floor to minimize the amount of dust entering it. Unplug the compressor when it is not in use and store it in a cool, dry place. Please use a damp cloth to wipe the exterior clean, as needed. 

Find Nebulizer Filters Here

If your nebulizer is not delivering medication, the problem usually lies in the nebulizer set and not in the compressor. Please unplug the tubing from your compressor and check to see if you can feel any air being delivered by the compressor. 

If you can feel air but it feels weak, please check your filter as your compressor is probably overdue for a filter change. If the compressor is putting out air as expected, please check your tubing for damage. 

If your tubing is in good condition and not yet two months old, please check your nebulizer cup. Otherwise, please replace the tubing and try again. If you cannot remember the last time you replaced your nebulizer cup and you have a disposable one, please replace it. 

If you have a reusable one, please make sure it is less than six months old. If it is over six months old, please replace it with a new nebulizer set. 

If your reusable nebulizer cup is less than six months old, please try heat disinfection (please see Disinfection of Reusable Nebulizers above) to clear out any blockage.

Sources:

https://kidshealth.org/en/parents/cooperate-nebulizer.html

https://my.clevelandclinic.org/health/drugs/4254-home-nebulizer

https://www.nationaljewish.org/conditions/medications/asthma-medications/devices/nebulizers/instructions