Taking care when using nebulised drugs
Self management
The different parts of your delivery system
The difference between a nebuliser and a compressor
Using a compressor and nebuliser properly
Taking care of your delivery system
Keeping your delivery system clean
Travelling or going on holiday
You should only be using a nebuliser if your doctor has advised you to do so. The information on this page is for people already using a nebuliser. The information is only designed as a guide; you should always discuss the use of your drugs with your doctor or nurse.
Nebulisers are an extremely powerful drug delivery system. They should only be used if your doctor has specifically recommended that you would benefit from this form of treatment and even then, only under careful medical supervision.
The drugs that have been designed to reach the lung through directly inhaling. (ie. not through the blood stream) can be given by several different devices. A nebuliser is only one of the devices available.
Taking care when using nebulised drugs
When using a nebuliser you should be aware that:
- Nebulisers give a much higher dose than a puffer or a dry powder inhaler. Do not use more reliever (eg. salbutamol) than you have been prescribed. If you are feeling more than typically breathless, and your usual dose is not giving the relief that you normally expect, it could be that your tight chest is the early warning sign telling you to get in contact with your doctor. Taking extra doses of nebulised relievers will only disguise and delay the need to seek medical advice, even if a higher does seems very necessary to you.
- A higher dose will make any side-effects more noticeable.
- You should not buy, borrow or use a Nebuliser without seeking medical advice
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Self-management
Ask your doctor/nurse to write out instructions on how to use the nebuliser.
While using a nebuliser, it is particularly important to have your own written self-management plan agreed by your doctor or nurse which includes what to do if your condition gets worse. You should know about danger signs. Signals include: your normal dosages are not working; you need to use your reliever (eg. salbutamol) more often; your pulse rate rises.
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The different parts of your delivery system
There are three parts to a nebuliser:
- Face mask or mouthpiece. You will find that there is a choice. In consultation with your doctor/asthma nurse, choose which is best for you.
- Nebuliser Chamber. This is the part which actually changes the liquid solution of your drug into a mist.
- Power source. A compressor which supplies the nebuliser with the gas to change the solution into a mist
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The difference between a nebuliser and a compressor
Nebuliser: This is a small chamber were a Liquid drug is converted into a fine mist that we can inhale into our lungs.
Compressor: This is the power source which is responsible for providing the gas (air) that makes a nebuliser work.
We often mistakenly refer to a compressor as a nebuliser. This can make things confusing - the nebuliser and the drug used within it are available on prescription through the NHS - however, the compressor is sometimes not, and costs start at about 120.
Most compressors are connected to the mains electricity supply (220 to 240 volts) but compressors are available which are portable, and can be charged from a 12 volt supply (eg. a special rechargeable battery, or attached to a car cigarette lighter socket).
Some nebulisers work off a foot pump, so no powered gas source is needed, These are often a good back up, as they are not too expensive (see Nebuliser Suppliers for a contact address).
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Using a compressor and nebuliser properly
Whether you buy, hire or borrow a compressor with a nebuliser unit, make sure that you understand all the practical details: exactly how to use it; how to keep it clean and how to maintain it. Ask for written instructions on these aspects to be sure you are fully confident
You should practice putting the whole nebulised drug delivery system together, and using it, with your doctor, practice nurse or other health care professional as appropriate. You might also want to have a have a family member present so they can help you remember.'
If you have any questions ask your doctor, pharmacist, physiotherapist or respiratory nurse.
Remember:
- A tiny drop of nebuliser solution is always left at the bottom of the nebuliser chamber after use.
- Tap the nebuliser chamber when using it. This shakes down large droplets.
- When using the compressor put it on a clean hard surface, eg, a table. Always keep the compressor off the floor to help stop dust getting inside
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Taking care of your delivery system
You should have your compressor checked and maintained about twice a year and the actual nebuliser chamber about every two months. Filters may need to be changed more frequently. You will also need to ask about service arrangements and emergency provision if your existing compressor develops a fault.
Remember:
- Some hospitals have a Nebuliser service which provides help and advice on the care of your nebuliser. Find out if your local hospital has such a service (this is often operated by the chest unit).
- While your compressor is being serviced you will be without one. You may find that your manufacturer will lend you one. Alternatively, check with your doctor/nurse to see if they will lend you one during this time.
- You should have a back-up in case your compressor fails. You may want to have an inhaler plus a large-volume spacer on hand. Ask your doctor about this.
- Change your nebuliser chamber every two months.
- Find out how often you need to change the inlet filter and the outlet filter (if fitted). You can find out about this from the manufacturer or your local chest unit. Usually the filter needs changing when it becomes discoloured.
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Keeping your delivery system clean
If your delivery system becomes dirty, it may not work properly. You need to care for all the parts of your delivery system, especially the nebuliser chamber (where the solution is changed into a mist).
Ask your doctor/lung function laboratory/respiratory nurse to go through carefully how to keep your delivery system clean.
Some helpful tips include:
- Wash the nebuliser chamber daily in clean, warm water. Rinse and dry.
- Wash the face-mask or mouthpiece about 2 to 3 times a week in warm water, rinse and leave to dry.
- Keep the case of the compressor clean with a moist cloth (make sure you have turned off the compressor at the mains before doing this)
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Travelling or going on holiday
- Make sure you have enough medicine to cover you for the time that you are away.
- Check with your doctor to see if you need to take any extra emergency medicines.
- Ensure that your insurance will cover your equipment, and any complications you may have while away.
- If you are travelling out of the country make sure you have a letter from your doctor in case you are stopped at customs or security.
- If flying make sure that you have a doctor's note before booking the holiday and have checked with the airline that your needs will be met.
- Make sure that you have an adaptor (and alternative plugs) to be able to run your compressor on a different voltage if you are visiting another country.
- Ensure you can obtain the medicines that you need, in case you run out.
- Hire a portable compressor which runs from batteries or a car cigarette lighter.
Page last medically reviewed: Feb '05
