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Using a Nebulizer for Asthma

Child using a nebulizer for Asthmma

A nebulizer is a device used to deliver asthma medications into your lungs. This type of treatment is called inhalation therapy. A nebulizer turns liquid asthma medication into a fine mist that you can easily breathe into your lungs through a mask or mouthpiece.

A nebulizer can deliver the same medications as a handheld, metered-dose inhaler, but a nebulizer may be easier for children and some adults to use. Using an inhaler requires coordination to time when to take a deep breath, so it's often easier for children younger than 12 to use a nebulizer instead. A nebulizer may also be used during a severe asthma attack, when it is hard to take a deep breath.

How does a nebulizer work?

There are several different types of nebulizers. The most common are air compressors. The compressor attaches to a cup that holds liquid asthma medicine. A mask or mouthpiece attaches to the medication container. The compressor sends air through a tube to the medicine cup. The air turns the medicine into a liquid mist, which then travels through to the mouthpiece or mask.

One newer type—called an ultrasonic nebulizer—uses sound vibrations instead of an air compressor. Ultrasonic nebulizers are quieter, but they cost more.

There are small, portable nebulizers you can easily carry with you and larger nebulizers that can be left out on a table, like a desktop computer. Some nebulizers need to be plugged in, but others are battery-operated.

Work with your doctor to find the nebulizer that best suits your needs.

What kinds of asthma medications are given with a nebulizer?

A nebulizer can deliver both short-acting and long-acting asthma medications. Most people need both types of medication to manage their condition. Short-acting medicines are the ones you take at the first sign of an asthma attack. You do not use them every day; rather, you use them only as needed. Long-acting asthma medicines are taken every day to control asthma and prevent attacks, even when you don't have symptoms.

Medications commonly used in a nebulizer include:

  • Short-acting medications such as albuterol and ipratropium.
  • Long-acting medications such as budesonide (a corticosteroid) and formoterol.

Also, different combinations of short-acting and long-acting asthma medicines can be used with a nebulizer. Work with your doctor to find the combination that works best for you.

The type of asthma you have, your age, typical symptoms and the severity of your condition are all factors that determine which medications you need. Possible side effects may also help your doctor decide which medication to prescribe for you.

How to use a nebulizer

Follow the asthma treatment plan from your doctor. If you use a peak flow meter, do a breathing measurement before and after treatment and record it.

When using the nebulizer:

  • Wash your hands and gather your nebulizer supplies and medication. This may include sterile saline if you need to mix the medication
  • Find a comfortable place to sit
  • Connect the hose from the compressor to the medicine cup. Make sure the nebulizer is placed on a flat surface such as a table or the floor
  • Put the medication into the nebulizer cup
    • If the medication is pre-mixed, just pour it in
    • If you need to mix the medication with sterile saline first, follow the directions carefully
  • Make sure the cap to the cup is tightened securely
  • Attach the mask or mouthpiece to the medicine cup
  • Plug in and turn on the nebulizer
  • Check that there is a fine mist coming into the mask or mouthpiece. The nebulizer cup may need to be held upright to work properly
  • Place the mouthpiece into your mouth, and seal your lips around it tightly. (You may need to help your child or demonstrate how to do this properly.) If using a mask, make sure it fits snugly by adjusting the elastic band that goes behind the head and holds the mask in place
  • Start taking slow, deep breaths
  • Continue slow, deep breathing until the medicine in the cup is gone. This may take 10 to 20 minutes
  • Tap the sides of the cup to make sure all the medicine is used
  • Turn off the machine after completing the treatment

Taking care of the nebulizer

Read the manufacturer’s instructions for care of your nebulizer. Different types of nebulizers may have slightly different directions, but in general:

  • Disconnect the nebulizer cup tubing from the compressor after each treatment
  • Open the cup and wash the cup and mouthpiece (or mask) according to the instructions for your machine
  • Air-dry all the parts on a clean towel
  • Store the dried parts in a plastic bag

Once a week:

  • Rinse the cup and the mask or mouthpiece in a solution of vinegar and water. Follow any other instructions from your doctor or the manufacturer for disinfecting the nebulizer
  • Check the filter on the nebulizer machine. Replace it when it becomes discolored

Finally, make sure that you always have spare nebulizer parts and that you refill prescriptions on time so you always have your medication when you need it.

Article references

  1. Nationwide Children’s Hospital, Your Child’s Asthma: Nebulizer Treatments, https://www.nationwidechildrens.org/conditions/health-library/your-childs-asthma-nebulizer-treatments
  2. MedlinePlus, How to use a nebulizer, https://medlineplus.gov/ency/patientinstructions/000006.htm
  3. Archives of Pediatric and Adolescent Medicine, Effectiveness of nebulizer Use-Targeted Asthma Education on Underserved Children with Asthma, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2269706/
  4. Mayo Clinic, Asthma medication: Know your options, https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557