Update: Check out Nebulizer Cleaning and Maintenance Part 2
I throw around the terms nebulizer, neb, treatment and breathing treatment often on this blog and thought it might be a good idea to explain what they are and how to maintain them.
A breathing treatment consists of inhaling a liquid medication, similar to what’s inside an inhaler, through a nebulizer that is attached to air, oxygen or an air compressor. The “air” moves through a tube into the nebulizer which then turns the liquid medicine into a fine mist. It used to be this type of medication took up to 20 minutes to complete. Today with technological advancements breathing treatments can take as few as 15 inhalations or a few minutes. For some people this is a more effective way to receive the medicine. Improperly used inhalers leave most of the medicine on your tongue or the back of your throat instead of down in your lungs where it needs to be. Others sometimes find a treatment more soothing on their throat than conventional inhalers. The only real drawbacks are size, portability and power – but you can buy air compressors today that are the size of a couple decks of cards and many have options for battery packs and car adapters as well as the standard AC adapter to plug into an electrical outlet.
Nebulizers can come in many shapes and sizes. Here is what I would call a classic example that I used to see in hospitals and doctor offices all the time. I started using them in the 90s at home.
You’ll notice tubing, the nebulizer cup with mouthpiece and an extra tube. The extra tube is attached opposite the mouthpiece to help channel the air you exhale. These nebulizers are disposable. They aren’t meant to be used for days, months or years (yeah, I used one for a couple years once without ever properly cleaning it) – and they should be rinsed after every use.
Eventually I started seeing nebulizers more like this where you can set them to dispense medicine only when inhaling or they blow wide open like the above example. Depending on the situation you may need one or the other, plus it’s always nice to have options.
This is what I have most often seen/used in hospitals the past few years. This nebulizer is an Aeroclipse R BAN reusable breath actuated nebulizer. The breath actuated part is useful to make sure the patient gets all the medication. As before, this should be rinsed out after each use as long as you’re not in an acute situation where you’re needing frequent treatments. It’s even dishwasher safe as long as you put it on the top shelf. Ever since I bought my first Pari Trek S compressor that came with the Pari LC Sprint nebulizers, I’ve been using those on both my Trek S and my old school Devilbiss Pulmo-aide.
This comes with wing-tip tubing, I think that means extra fancy like the leather shoes my grandpa loves, a mouthpiece and is basically breath actuated similar to the previous nebuilzer. The LC Sprint should be replaced every six months and Pari provides a sticker to slap onto your compressor which lets you know when six months is up.
Cleaning your nebulizer:
While cleaning your nebulizer probably makes sense, I know many people who do not. Besides the regular sterilization or clean arguments, you should remember that anything you breathe in through this apparatus is going straight to your lungs. It’s probably not a great idea to give yourself a cold, bronchitis or pneumonia from your medical equipment. A standard cleaning can include a quick rinse with water and air drying, cleaning with hot soapy water, placing on the top shelf of your dishwasher (only if dishwasher safe) or deep cleaning with a solution.
Since I’ve been doing anywhere from 7-11 treatments a day I don’t always rinse the nebulizer after every use, but I make sure it happens at least once a day. I also clean my nebulizers in a water/vinegar solution to kill everything off. I’m extremely allergic to most molds and fungi in my region of the world and these are two things which can easily grow and thrive in the moist environment of a nebulizer. In fact, if you have problems with mold at home, vinegar is what you need to clean and kill it. Many use bleach which just “bleaches” the color out of the fungus/mold and spreads it around. It’ll just grow back in a matter of time and the patch will be bigger. To do this deep cleaning, I dismantle my nebulizer into its four pieces, place them into a mixing bowl, and do a 1:1 or 2:1 ratio of water and white distilled vinegar. After the pieces soak for an hour I rinse them thoroughly, let them dry and I’m good to go. If your nebulizer is not dried out and you need to do a treatment, just let the air run through it for 15 seconds or so and that should do the trick.
Replacing your nebulizers:
Once you have a good handle on cleaning your nebulizers, another thing to think about is when to replace them. I do treatments all the time and really need to adhere to a standard replacement schedule. Pari suggests swapping out my LC Sprints every six months. To make this easy on myself I throw out my nebulizers, I keep one at home and a second in my EDC bag, on January 1 and July 1 of every year. That way I don’t have to remember exactly when I started using them. For those of you who might use your nebulizer much less frequently, once a month or maybe a few times a year, replacing your nebulizer probably isn’t that big of a deal as long as you make sure they stay clean.
One other often overlooked part in the nebulizer system is the air filter. Similar to keeping your nebulizer clean so you’re not making yourself sick, all air compressors have an air filter somewhere that has a replacement schedule and should be followed as well. Before I looked into this kind of stuff I had one nebulizer whose air filter wasn’t replaced for 6 years. Luckily when I finally took it out the thing wasn’t crusted and disgusting, but I really should have been changing that out every six months just like my nebulizer.
Where do I buy this stuff?
There are different places where you can purchase equipment. Some like to use durable medical equipment companies. I’ve never had too much luck with them. These companies often carry the minimum amount of options for inventory purposes and often will not special order. I recently bought a new nebulizer/compressor kit and the durable medical company didn’t even let me choose what they were going to sell me. I ended up buying online from JustNebulizers.com as I’ve been doing for some time. They often have sales, I’m always receiving coupons by email and if I buy in bulk I get a discount. Once I had a problem with my order and a quick phone call took care of everything. Their customer service is great. Buying online usually means you need to submit a form to your insurance for reimbursement or to have the amount added to your deductible. While this may seem like a pain, I’m actually costing my insurance company and me less by buying them on my own AND I actually use what I want. If patients need to be compliant with their treatment, it helps if they don’t hate it.
If you end up in the ER, hospital or doctor office receiving treatments often, just ask to take the nebulizer with you. They won’t give you the compressor, but after you leave they’re just going to throw away the tube and neb cup. Might as well get some use out of it at home.
Also, if you spend a decent amount on health care every year, you should save receipts and keep track of how much you spend on all this stuff. Itemizing your medical expenses can save you a lot of money on taxes depending on your situation.