How to Use a Nebulizer: 12 Easy Steps to Follow

Breathing easily is a luxury that many people take for granted. Health conditions such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis can affect your lungs and make breathing feel like a battle.

Thankfully, many treatments are available to help you breathe easier. You might be familiar with inhalers, the most common way to inhale medications into your lungs. But nebulizers are another option if needed.

A nebulizer is a medical device that turns a liquid medication into a fine mist. You can inhale the mist using a mouthpiece or a mask that's attached to the machine. Nebulizers can be a good option for people who have trouble using inhalers.

Once your nebulizer is set up, you can take normal breaths until your treatment is complete. But nebulizers aren't always easy to understand at first, so here's a breakdown of how to use them.

12 steps to use a nebulizer correctly

Many nebulizer types and models are available, each with slightly different parts. This guide covers the general steps to set up and use your nebulizer machine.

Setting up your nebulizer

1. Review your nebulizer's setup instructions. There are different types of nebulizers, each with minor differences in assembly.

2. Wash your hands. Because you're handling equipment for a medication that will enter your lungs, clean hands are important. Sanitized hands lower the risk of infection from bacterial or fungal growth.

3. If your nebulizer includes tubing, connect one end of the tubing to the nebulizer. If your nebulizer doesn't include tubing, skip this step - some nebulizers attach directly to a mouthpiece or a mask.

4. On a table, pour your medication into the medicine cup. Many nebulized medications come in single doses for easy use. If your medication doesn't come in single doses, use a measuring cup to measure the correct amount. Keep the medicine cup upright until you finish your treatment to avoid spilling the medication.

5. Connect the included mouthpiece or mask to the medicine cup.

6. If you connected tubing to the nebulizer in step 3, connect the other end of the tubing to the medicine cup and mouthpiece. If your device doesn't use tubing, attach the nebulizer directly to the medicine cup and mouthpiece.

Your nebulizer should now be fully assembled and ready to use.

Using your nebulizer

7. Sit in a comfortable, upright position if you can. This posture helps the medication flow efficiently into your lungs.

8. Place the mouthpiece between your teeth, then close your lips around it to form a seal. If you're using a mask, place it over your face, making sure it fits snugly and covers your nose and mouth. This helps prevent medication from escaping.

9. Turn on your nebulizer. (Some devices need to be plugged into an outlet before being turned on. These are sometimes called tabletop nebulizers. Other smaller, newer devices are made to be portable and run on batteries.) After you turn it on, make sure it's working correctly. You should see a gentle mist flowing through the nebulizer.

10. Take normal, relaxed breaths through your mouth. Do this until no more mist comes from the machine. This can take 5 to 20 minutes, depending on how much medicine you need and which nebulizer you have. If you start to cough at any point, turn the device off and rest. Continue the treatment when you're able.

11. Remove the mouthpiece (or mask) from your face, and turn the nebulizer off.

12. If you used the nebulizer to inhale a corticosteroid ("steroid") such as budesonide (Pulmicort Respules), be sure to rinse your mouth to help prevent thrush (an oral yeast infection). If you used a mask, be sure to wash your face too. You can skip this step for other medications - nonsteroid medications don't require a mouth or face rinse.

Tips for cleaning and maintaining your nebulizer

Try to keep your nebulizer clean. Doing so helps prevent bacterial and fungal growth. Otherwise, germs could enter your lungs through the nebulizer and cause an infection. Nebulizer maintenance also helps keep the device working efficiently.

After every treatment, you should:

• Wash your hands with soap and water.

• Wash your mouthpiece (or mask) and medicine cup with mild soap and warm water. Don't wash any tubing.

• Place the parts on a clean towel to air-dry.

• Once dry, reassemble the nebulizer, and turn it on without medicine to blow air through the parts. This will make sure the inside components are dry.

• Take the nebulizer apart again, and store it in a clean, dust-free place. It's recommended to cover the device with a clean, dry cloth.

At least once a week, you should:

• Disinfect the nebulizer's parts, following the instructions that come with the device. For example, some instructions may direct you to soak some equipment in isopropyl alcohol or hydrogen peroxide.

• Check your device's filter, mouthpiece or mask, and medicine cup, following your device's instructions. Also do this for the tubing and other parts that come with your model. Over time, these parts will likely collect wear and tear and may need replacing.

If the nebulizer itself gets dirty, you can wipe down the outside of the machine with a warm, damp cloth.

Understanding your nebulizer (breathing machine)

Nebulizers have evolved over time, becoming smaller and more convenient than they used to be. Some of them also deliver medication faster than others.

Types of nebulizers to choose from

All nebulizers turn liquid medication into a breathable mist, but they can be categorized based on how they produce the mist:

• Jet nebulizers create a mist using compressed air. These nebulizers are relatively common, but their size may be a drawback.

• Ultrasonic nebulizers create a mist using high-frequency vibrations. These are typically smaller than jet nebulizers, but they can't be used for medications that are sensitive to heat.

• Mesh nebulizers create a mist by forcing the liquid medication through a fine mesh. These make less noise and work relatively quickly, but they're typically more pricey than jet nebulizers.

Some newer smart nebulizers can match your breathing patterns when releasing the mist. This can help get more medication into your lungs, which may improve the medication's effectiveness. Smart nebulizers are an example of a digital health device.

A healthcare professional can help you decide which nebulizer is best for you.

Nebulizer parts and components

Nebulizers typically have three or four main parts:

1. The nebulizer machine

2. A medicine cup, also called a reservoir

3. A mouthpiece or a mask

4. Tubing (if needed)

Some ultrasonic and mesh nebulizers may not use tubing, and some nebulizer machines may also have a cap for the medicine cup. Be sure to check the parts and instructions included with your nebulizer.

Common medications that are inhaled through a nebulizer

A fair number of medications use nebulizers. Some common medications given through nebulizers include:

• Bronchodilators, such as albuterol, ipratropium, and arformoterol (Brovana): These medications open up your airways to breathe easier. Combination medications such as ipratropium / albuterol are also available.

• Corticosteroids, like budesonide: These medications help you breathe better by reducing inflammation in the lungs.

• Mast cell stabilizers, like cromolyn: These medications also reduce inflammation, but they do so differently from corticosteroids.

• Antibiotics, like tobramycin (Tobi): These medications are sometimes used to treat lung infections, typically in cystic fibrosis.