Home Nebulization Treatments

Many medicines are most effective when inhaled directly into the lungs. To be inhaled into the airways of the lungs, medication must be changed from a liquid to a fine mist. To create this fine mist at home, you need a nebulizer and an air compressor. A nebulizer is a plastic container that changes liquids into a fine mist using a jet of air. The compressor, run by electricity or battery, provides the jet of air to the nebulizer.

How is the home nebulizer used?

1. Place the compressor on a hard surface. Make sure the filter is free of dust and dirt. If it is dirty, rinse it with water and then dry it. Plug in the compressor.
2. Place the prescribed amount of medicine(s) into the nebulizer with a dropper or syringe. If you have a question about mixing medicines, call your health care provider.
3. Some asthma medicines come premixed with sterile saline. Other medicines need saline added. You can buy sterile normal saline in two ways: in unit dose plastic vials or a pressurized canister (Bronchosaline). Two squirts from the canister should be enough. Never put a homemade saline solution into a nebulizer.
4. Attach the nebulizer to the compressor tubing. Turn the power on. (The medicine will immediately begin to be nebulized.) Place the mouthpiece in the mouth and breathe in and out slowly through the mouth until all the medicine is gone. If the child is able, tell the child to take an extra deep breath every 10 breaths or so, hold that breath for 10 seconds, and then breathe out slowly. This technique permits the medicine to stay in the lungs longer for better effect.

If a child is too young to use a mouthpiece, use a mask. To provide the best delivery of the medicine, the mask should be secured snugly over the nose and mouth.

Most nebulizers must be held in an upright position to work well. If the mixture has coated the sides and isn't being nebulized, gently tap the side of the nebulizer occasionally during the treatment. An average treatment takes 10 to 15 minutes. The treatment is over when all the medicine is gone, mist is no longer being generated and the nebulizer makes a constant sputtering noise.

Some children cough up mucus after breathing treatments. Note the mucus color and thickness. Normal secretions are usually thin and white or clear. Thick, sticky mucus that is yellow or green may indicate infection. Call your health care provider to report a change.

If your child needs more treatments than prescribed by your provider, or if the treatments do not improve the symptoms, call your provider.

How and when should the nebulizer be cleaned?

After each treatment, rinse the nebulizer, mouthpiece or mask, and T-piece under hot running water. Shake off excess water, place the pieces face down, and let them air dry. Store the pieces in a clean bag. It is not necessary to clean the compressor tubing.

If you use the nebulizer frequently, you should clean it about 3 times a week. Wash your hands before handling the nebulizer.

If you have a dishwasher:

Take the unit apart and place all parts (except the tubing and tubing adapter) in the top rack of the dishwasher. After each cleaning, dry the nebulizer before reusing it for treatments. You do not usually need to wash the tubing. The inside of the tubing stays dry and clean because of the air blowing through it.

If you have do not have a dishwasher:

1. Soak the nebulizer and mouthpiece or mask in warm water. Using a cloth, use friction to wash any excess mucous or debris off of the nebulizer and mouthpiece or mask.
2. Rinse each piece thoroughly in clean, warm running water.
3. Soak the equipment in a vinegar solution. To make the solution, mix 1/2 cup white vinegar with 1-1/2 cups of water. Soak the equipment for 20 minutes and rinse well under a steady stream of water. Shake off the excess water and allow to air dry on a paper towel. Always allow the equipment to completely dry before storing in a plastic, zipper bag.

What special instructions should be followed?

Your provider has prescribed nebulizer treatments to be given ______ times a day. The medicine(s) to be used is(are) _______________________________ (the amount is ___________), and is mixed in _____ ml of normal saline (other: _________________________).