Reusable nebulizers: Use and maintenance

What is a reusable nebulizer

Using a reusable nebulizer is another way of giving a medication. A reusable nebulizer allows certain medications to be converted from a liquid into an aerosol (mist) form so they can be breathed in. It is important to clean and disinfect your child's nebulizer after every use to prevent the growth of germs in and on the device. This will help to reduce the risk of your child getting a lung infection.

Cystic fibrosis and reusable nebulizers

Cystic fibrosis (CF) is a genetic disease. It affects mainly the lungs and digestive tract.

CF causes a build-up of thick mucus in the lungs, which can make breathing difficult. Having a build-up of mucus in the lungs also allows bacteria to grow and this can lead to infections. A child with CF may have cycles of infection.

For children with CF, the delivery of aerosolized medication multiple times per day is an important part of their daily therapy regime. Proper use of the nebulizer includes giving the correct medication through the correct nebulizer.

Pari LC Star Pari LC Plus Pari LC Sprint

Amikacin

(injection solution)


Colistin

Either choice acceptable

Either choice acceptable

Dornase alfa

Note: Do not mix, use separate nebulizer for this medication



Hypertonic saline 7%

First choice

TOBI

(300 mg/dose)

Tobramycin

(80 mg/dose)

Vancomycin

(80 mg/dose)

Cleaning and disinfecting the nebulizer

Having a standard approach to cleaning and disinfecting reusable nebulizers reduces bacterial contamination and risk of infection. Cystic Fibrosis Canada guidelines recommend cleaning and disinfecting reusable nebulizers after every use.

Download the reusable nebulizer hygiene tip sheet PDF.  

During cleaning, dirt or foreign material is washed off. During disinfecting, germs such as bacteria and viruses are killed.

Download a one-page tip sheet to help you remember the steps for cleaning and disinfecting your reusable nebulizer.

Cleaning

  1. Wash your hands with soap and water or use an alcohol based hand sanitizer before handling the nebulizer.
  2. Take the nebulizer apart.
  3. Scrub the pieces with clean paper towels using dish soap and water.
  4. Rinse with sterile water. You can make your own sterile water by boiling tap water for 15 minutes and then allowing it to cool. Discard what you do not use.

Disinfecting

  1. The next step is to disinfect the pieces of the nebulizer using a method that uses either heat or a special solution.

    You can choose one of the following methods for heat disinfection.

    • Put the pieces in boiling water for at least 10 minutes.
    • Put the pieces in a microwave (2.45 GHz) for five minutes.
    • Put the pieces in a dishwasher and run it without detergent on a cycle where the temperature is greater than 70°C (158°F), for 30 minutes.
    • Use an electric steam sterilizer.

    OR you can choose one of the following special solutions for disinfection.

    • Soak the pieces in 70% isopropyl alcohol for five minutes.
    • Soak the pieces in 3% hydrogen peroxide for 30 minutes.

    Rinse all pieces with sterile water after using a special solution for disinfection.

    You can purchase 70% isopropyl alcohol and 3% hydrogen peroxide at your local pharmacy, they will not need to be diluted.

  2. After disinfecting the pieces of the nebulizer, place them on a clean, dry towel away from the sink to air dry. When the pieces are dry, store them in a sealed container or plastic bag.

Key points

  • It is important to administer the correct medication in the correct nebulizer to optimize therapy.
  • Reusable nebulizers must be cleaned and disinfected after every use.
  • Cleaning your nebulizer includes washing the pieces of the nebulizer with warm water, dish soap and clean paper towel.
  • Disinfecting your nebulizers using either heat or a special solution.
  • It is important to leave the nebulizer parts to air dry on a clean towel, away from the sink.
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Rebecca Wengle, RN

4/26/2017

Resources

Cystic Fibrosis Canada: www.cysticfibrosis.ca

The Cystic Fibrosis Foundation: www.cff.org

References

Saiman L, Siegel J et al. CF Foundation Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update. Infection Control and Hospital Epidemiology. The University of Chicago Press, http://www.jstor.org/stable/10.1086/676882





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