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Nebulizer for asthma treatment

By Louis Neipris, M.D., Staff Writer, myOptumHealth

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What is a nebulizer?

A nebulizer is a machine that uses compressed air to deliver asthma medicine as wet aerosol, a mist that can be inhaled. Nebulizers are most often used for children younger than 5, people who have trouble using inhalers and those with severe asthma. They are also used to deliver medication in people with chronic lung diseases, such as emphysema.

The most common medications used in a nebulizer are bronchodilators (such as albuterol) to help open up air passages and inhaled steroids.

Nebulizers have three main parts:

• A cup that holds the medication
• A mouthpiece or mask attached to a T-shaped part
• A thin plastic tube that connects the mouthpiece to the compressor

There are home and hospital models of nebulizers, as well as portable units. Some portable machines can run on batteries.

How to use a nebulizer

Thoroughly read and follow instructions for your own equipment before using your nebulizer. Directions vary from one manufacturer to another. Here are just some basic guidelines. Instructions for your own medication or unit may be different.

The medication solution that you will use in an aerosol machine may come in a multi-dose bottle with a dropper, or in a small plastic vial.

Steps for using a nebulizer

1. Wash your hands before you prepare each nebulizer treatment, and make sure the equipment is clean.
2. If using a multi-dose bottle of medicine, use the dropper to put the correct amount of medication and solution into the cup according to your doctor's instructions. If your medicine is in single-use vials, twist open the top of the plastic vial and then squeeze the contents into the nebulizer cup.
3. Connect the mouthpiece to the T-shaped part and then fasten this unit to the cup, or fasten the mask to the cup. It is advised that children older than 2 years use a mouthpiece because it will deliver more medication than the mask.
4. Connect the nebulizer tubing to the port on the compressor.
5. Hold the nebulizer in an upright position to prevent spilling.
6. While sitting in a comfortable, upright position, place the mouthpiece between your teeth and close your lips around it. Or, put on the mask, making sure it fits well so mist won't go into your eyes.
7. Turn the compressor on and check the nebulizer for misting. When using a finger valve, cover the air hole to force the air into the nebulizer. If you are not using a finger valve, the nebulizer will mist continually.
8. Gently breathe out. As the mist starts, inhale slowly and deeply through your mouth, taking over three to five seconds for each breath, while keeping your finger over the valve hole.
9. At the end of a deep breath, uncover the finger valve hole to stop the mist.
10. Hold your breath for up to 10 seconds before exhaling. This gives the medication time to deposit in the airway.
11. Continue until the medicine is gone from the cup (about five minutes).
12. Occasionally tapping the side of the nebulizer helps the solution drop to where it can be misted. Treatment is finished when all the medication has been used from the container. The nebulizer will most likely start to sputter when it is empty.
13. Store the medication as directed.

How to clean a nebulizer

Clean the nebulizer regularly to keep the equipment from clogging and to help it last longer. Cleaning also helps prevent germs that can cause infection. Follow the manufacturer's instructions closely for cleaning and storage. Below are just some basic guidelines.

After each use:

Remove the mask or mouthpiece and T-shaped part from the cup. Remove the tubing and set it aside. The tubing should not be washed or rinsed.

1. Wash the mask or mouthpiece and T-shaped part with a mild dishwashing soap and warm water.
2. Rinse under a strong stream of water for 30 seconds. Use distilled or sterile water if possible.
3. Shake off excess water. Air-dry on a clean cloth or paper towel.
4. Put the mask or mouthpiece and T-shaped part, cup and tubing back together and connect the device to the compressor. Run the machine for 10 to 20 seconds to dry the inside of the nebulizer.
5. Disconnect the tubing from the compressor. Store the nebulizer in a sealed plastic bag.

Once or twice a week:

1. Remove the mask or mouthpiece and T-shaped part from the cup. Remove the tubing, which does not get washed or rinsed.
2. Wash the mask or mouthpiece and T-shaped part with a mild dishwashing soap and warm water.
3. Rinse under a strong stream of water for 30 seconds.
4. Soak for 60 minutes in a solution of one part distilled white vinegar and three parts distilled water. After use, throw out the vinegar and water solution. Do not reuse it.
5. Rinse the nebulizer parts again under warm, running water for one minute or rinse with distilled or sterile water, if possible.
6. Shake off excess water. Air-dry on a clean cloth or paper towel.
7. Put the mask or mouthpiece and T-shaped part, cup and tubing back together, and connect the nebulizer pieces to the compressor. Run the machine for 10 to 20 seconds to dry the inside of the nebulizer thoroughly.
8. Disconnect the tubing from the compressor. Make sure the nebulizer is completely dry before storing it in a sealed plastic bag.
9. Clean the surface of the compressor following the manufacturer's directions.
10. Never put the compressor in water.

View the original Nebulizer for asthma treatment article on myOptumHealth.com 

SOURCES:

• National Jewish Health. Using a nebulizer Accessed: 09/24/2009

• National Jewish Health. Using a nebulizer with asthma medication. Accessed: 09/24/2009

• American College of Chest Physicians. Using your small volume compressor nebulizer. Accessed: 09/24/2009

• Dolovich MB. Nebulizer Designs for Liquid Formulations. In: Adkinson NF, Bochner BS, Busse WW, Holgate ST, Lemanske Jr RF, eds. Adkinson: Middleton's Allergy: Principles and Practice, 7th edition, Philadelphia, PA: Mosby Elsevier; 2008.