Asthma Nebulizers (Breathing Machine)

An asthma nebulizer, also known as a breathing machine, changes asthma medication from a liquid to a mist, so that it can be more easily inhaled into the lungs. Home nebulizer therapy is particularly effective in delivering asthma medications to infants and small children and to anyone who is unable to use asthma inhalers with spacers.

To obtain an asthma nebulizer, you need a prescription from your physician. Home nebulizers vary in cost (approximately $200-250) and are usually covered under the durable medical equipment portion of health insurance policies. However, most insurance companies will require you to work with a specified durable medical equipment supplier. Check with your insurance company before purchasing or renting to ensure it will be covered. Your health care provider should be able to assist you with these arrangements.

First, you will need the following supplies:

• Air compressor
• Nebulizer cup
• Mask or mouthpiece
• Medication (either unit dose vials or bottles with measuring devices)
• Compressor tubing

Once you have the necessary supplies:

• Place the air compressor on a sturdy surface that will support its weight. Plug the cord from the compressor into a properly grounded (three-prong) electrical outlet.
• Before asthma treatment, wash your hands with soap and water and dry completely.
• Carefully measure medications exactly as you have been instructed and put them into the nebulizer cup. Most medications today come in premeasured unit dose vials so measuring is not necessary. If you do measure, use a separate, clean measuring device for each medication.
• Assemble the nebulizer cup and mask or mouthpiece.
• Connect the tubing to both the aerosol compressor and nebulizer cup.
• Turn on the compressor to make sure it is working correctly. You should see a light mist coming from the back of the tube opposite the mouthpiece.
• Sit up straight on a comfortable chair. If the treatment is for your child, he or she may sit on your lap. If you are using a mask, position it comfortably and securely on your or your child's face. If you are using a mouthpiece, place it between your or your child's teeth and seal the lips around it.
• Take slow, deep breaths. If possible, hold each breath for 2-3 seconds before breathing out. This allows the medication to settle into the airways.
• Continue the treatment until the medication is gone (an average of 10 minutes). The nebulizer will make a sputtering noise, and the cup will have just a little medication remaining.
• If dizziness or jitteriness occurs, stop the treatment and rest for about 5 minutes. Continue the treatment, and try to breathe more slowly. If dizziness or jitteriness continues to be a problem with future treatments, inform your doctor.

During the treatment, if the medication sticks to the sides of the nebulizer cup, you may shake the cup to loosen the droplets.

Cleaning

Cleaning and disinfecting your home nebulizer equipment is simple and very important. Proper care prevents infection. Cleaning should be done in a dust- and smoke-free area away from open windows.

Follow these instructions when cleaning your equipment:

• After each treatment, rinse the nebulizer cup thoroughly with warm water, shake off excess water, and let air dry. At the end of each day, the nebulizer cup, mask or mouthpiece should be washed in warm soapy water using a mild detergent, rinsed thoroughly, and allowed to air dry. You do not need to clean the compressor tubing.
• Every third day, after washing your equipment, disinfect the equipment using either a vinegar/water solution or the disinfectant solution your equipment supplier suggests. To use the vinegar 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, zippered bag.

Storing

• Cover the compressor with a clean cloth when not in use. Keep it clean by wiping it with a clean, damp cloth as needed.
• Do not put the air compressor on the floor either for treatments or for storage.
• Medications should be stored in a cool, dry place. Check them often. If they have changed color or formed crystals, throw them away and replace them with new ones.

Other tips

• Always have an extra nebulizer cup and mask or mouthpiece in case you need it.
• Check the air compressor's filter as directed. Replace or clean according to the directions from your equipment supplier.

Reviewed by the doctors at The Cleveland Clinic Department of Pulmonary, Allergy and Critical Care Medicine.

Edited by James E. Gerace, MD, December 1, 2006. Portions of this page © The Cleveland Clinic 2000-2005