Use and Care of Nebulizer

A nebulizer is a device driven by a compressed air machine. It allows your patient to take asthma medicine in the form of a mist (wet aerosol). It consists of a cup, a mouthpiece attached to a T-shaped part or a mask, and thin plastic tubing to connect to the compressed air machine. It is used mostly by three types of patients:

• Young children under age 5.
• Patients who have problems using metered dose inhalers.
• Patients with severe asthma

A nebulizer helps make sure that patients get the required amount of medicine

How to Use a Nebulizer (Advice for the patient)

1. Directions for using the compressed air machine may vary (check the machine's directions), but generally the tubing has to be put into the outlet of the machine at first.
2. Measure the correct amount of normal saline solution using a clean dropper and put it into the cup. If medicine is premixed, ignore this step.
3. Draw up the correct amount of medicine using a clean dropper or syringe and put it into the cup with the saline solution. If you know your number of drops, you can count them as a check.
4. Attach the mouthpiece to the T-shaped part and then fasten this unit to the cup OR fasten the mask to the cup. For a child over the age of 2, try to use a mouthpiece unit because it will deliver more medicine than a mask.
5. Put the mouthpiece in your mouth. Seal your lips tightly around it OR place the mask on your face.
6. Turn on the air compressor machine. 7. Take slow, deep breaths in through the mouth.
7. Continue until the medicine is gone from the cup and no more mist is produced (approximately for 10 minutes).
8. Store the medicine as directed after each use.

Cleaning

Regular cleaning of the nebulizer is important because an unclean nebulizer may cause an infection. A good cleaning routine keeps the nebulizer from clogging up and helps it last longer.

Nebulizer should be cleaned once every day

1. Remove the mask or the mouthpiece and T-shaped part from the cup. Remove the tubing and set it aside. The tubing should not be washed or rinsed.
2. Wash the mask or the mouthpiece and T-shaped part - as well as the dropper or syringe - with a mild dishwashing soap and warm water.
3. Rinse under a stream of water for 30 seconds. Use distilled (or sterile) water, if possible.
4. Shake off excess water. Air dry on a clean cloth or paper towel.
5. Put the mask or the mouthpiece and T-shaped part, cup, and tubing back together and connect the device to the compressed air machine. Run the machine for 10 to 20 seconds to flash out and dry the inside of the nebulizer.
6. Disconnect the tubing from the compressed air machine. Store the nebulizer in a ziplock plastic bag.
7. Place a cover over the compressed air machine.

Delivery devices for asthma medications in children

Mode of  Administration	<2 Years	2-4 Years	5-7 Years	>8 Years
Nebulizer	Yes	Yes	Yes	Yes
MDI+Spacer with mask	Yes	Yes	--	--
MDI+Spacer without mask		--	Yes	Yes
MDI (alone)	--	--	--	Yes

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