How to Use a Nebulizer: A Step-By-Step Guide

People living with chronic lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, or cystic fibrosis often experience trouble breathing and other symptoms. In such individuals, healthcare providers may recommend nebulizer treatment for inhalation of respiratory medicines. The performance of the nebulizer machine and the effectiveness of the medications depend on properly using the nebulizer device. Please continue reading for instructions on how to use a nebulizer machine.

What is a nebulizer?

A nebulizer is a small, portable, or tabletop electrical device that is used to deliver respiratory medications directly to your lungs. It turns liquid medicine into a fine mist (tiny aerosol particles that float in the air), which can be breathed into your lungs over a period of 5-20 minutes.

Most nebulizers consist of an air compressor that uses pressurized air to turn liquid medicine into a fine mist; a nebulizer chamber or medicine cup that holds the liquid medicine; and a mouthpiece or facemask that is placed between the teeth or over the nose and mouth so that the mist of medication can be inhaled.

You will need a prescription from your doctor to get a nebulizer. Most health plans cover the cost of nebulizer devices.

What are the different types of nebulizer machines?

There are three main types of nebulizer machines that use different methods to turn liquid medicine into a mist:

Jet nebulizers use compressed air to turn the liquid medicine into a mist
Mesh nebulizers use a fine mesh which the medicine passes through to create a fine mist
Ultrasonic nebulizers use high-frequency sound waves (vibrations) to turn medicine into a mist

Your healthcare provider will help you choose the best type of nebulizer for you. In general, ultrasonic nebulizers create larger mist particles, are quieter, and tend to be more expensive.

What medicine do you put in a nebulizer?

Some commonly nebulized medicines include:

A sterile saline (saltwater) solution to loosen mucus in the lungs
Beta adrenergic agonists such as albuterol and levalbuterol
Long-acting beta agonists such as arformoterol
Anticholinergics such as ipratropium bromide
Inhaled steroids such as budesonide, fluticasone, triamcinolone, and flunisolide
Combination medications such as DuoNeb, which contains albuterol sulfate and ipratropium bromide
Inhaled antibiotics such as tobramycin, colistin, and aztreonam

What are the pros and cons of a nebulizer versus an inhaler?

Both nebulizers and inhalers send medications directly into your lungs. The advantage of a nebulizer is that it can be easier to use, especially in young children, as they only need to breathe normally to inhale the medicine. Some people prefer nebulizers because they can see and feel themselves breathing in the medicine.

However, the disadvantages of nebulizers are that they are bulky and cannot be carried around in your pocket or handbag like an inhaler. In addition, it takes longer (5-10 minutes) to deliver the medicine with a nebulizer. Also, inhalers deliver the exact dose of medicine and cause fewer side effects like fast heartbeat and jitteriness. Moreover, inhalers are less expensive compared to nebulizers. Learning to use an inhaler can initially be tricky, but most people pick it up quickly.

How do you inhale albuterol with a nebulizer?

You can inhale albuterol or any other medication with a nebulizer simply by breathing normally. Take calm, deep breaths for 5-10 minutes until the mist stops forming.

How to use a nebulizer machine correctly?

Here is a step-by-step guide on using a nebulizer:

Place the nebulizer machine on a flat, stable surface.
Wash your hands with warm, soapy water.
Connect the hose to the air compressor.
Put the liquid medicine in the medicine cup. Many respiratory medications for nebulizer treatments come in pre-measured doses. This helps prevent you from taking too little or too much medicine. If the medicine dose is not pre-measured, measure it carefully.
Close the nebulizer cup tightly to prevent spills.
Connect the other end of the hose to the mouthpiece.
If your nebulizer is not battery-operated, connect it to a power source. Turn on the nebulizer device and check for misting in the medicine cup.
Sit in an upright position. Place the mouthpiece between your teeth and keep your lips tightly around it to ensure all the medicine goes into your lungs. Small children may do better with a face mask that goes over the nose and mouth.
If you are using a finger valve, cover the air hole to force the air to the nebulizer and start the mist. If you are not using a finger valve, the nebulizer will mist continuously.
Breathe calmly for 5-10 minutes, keeping your lips firmly around the mouthpiece. Some people like to pinch their noses closed to ensure they breathe in through their mouth.
Turn off the nebulizer machine when the medicine is finished, and the nebulizer is no longer misting.

How many minutes should you use a nebulizer?

Breathing treatment with a nebulizer can take at least 5 to 10 minutes, but can be up to 20 minutes. Turn off the machine and remove the mouthpiece after the nebulizer cup is empty and all the liquid is gone.

How to care for a nebulizer?

It’s important to keep your nebulizer equipment clean to prevent bacterial and fungal growth. Pathogens growing on an unclean nebulizer can make their way into your lungs and cause serious infections. Here are some tips on caring for your nebulizer:

Unplug the device before cleaning it.
After each use, rinse the medicine cup and mouthpiece with running warm water and allow it to air dry on a clean towel. Do not wash the hose or tubing.
Once it is dry, turn the nebulizer on and let the air run through it to ensure all the parts are completely dry.
Store the nebulizer in a clean, dry area after washing.
Once a day, you can add mild dish soap to the cleaning ritual described above.
Once or twice a week, you can soak the nebulizer cup and mouthpiece in a solution of 1 part distilled white vinegar and 2 parts warm water.
Clean the outside of the nebulizer machine with a warm, damp cloth as necessary.
Follow the manufacturer’s instructions on when and how to change the air filter.

What not to do after nebulizing?

Do not use a nebulizer without a doctor’s advice. It can be harmful in some conditions.
Do not use expired medications for nebulizer treatment.
Do not loosen the mouthpiece or facemask, as this will allow some of the medicine to escape into the air.
Do not nebulize a sleeping child or use a nebulizer while you sleep.
Do not store the nebulizer without cleaning it. This can lead to the growth of bacteria or mold.
Do not sterilize the nebulizer equipment using boiling water. It contains plastic parts which are heat-sensitive and can be damaged by high temperatures.