How long does a nebulizer treatment last

Once you’ve been diagnosed with chronic obstructive pulmonary disease (COPD) your doctor may prescribe for you to take breathing treatments at home. So what is a breathing treatment and how do you take one?

When you have inflammation of your skin that causes it to become dry, red, and itchy, you generally apply a topical lotion directly on the irritated skin. When the air passages inside your lungs are inflamed and likewise irritated, the only way to apply a topical is by inhaling it. It was for this reason that breathing treatments (and inhalers) were invented. Check out my related post "How to Properly Use an Inhaler."

There are essentially four things required in order to take a breathing treatment:** 1. Nebulizer**: A small hand-held device equipped with a cup for medicine and a mouthpiece. When connected to an air compressor the nebulizer turns the solution to a fine, white mist that can be easily inhaled.

2. Air compressor**:** This is a small device that turns energy into a flow of air.

3. Oxygen tubing**:** This is used to connect the air compressor to the nebulizer.

4. Medicine**:** The solution form of the medicine is usually premixed with 3cc of normal saline (water) and stored in a plastic, easy-to-open amp. Once opened, the solution is poured into the nebulizer cup. The purpose of a breathing treatment is to turn this solution into a mist.

In order to get these four things you will need a prescription from your doctor. A nebulizer and air compressor are usually purchased from a home health care company. In most cases, the company will send a representative to your home with the equipment, and teach you how to use it. Later on, as you need replacement supplies, all you have to do is talk to this representative.

Many medicines can be inhaled by using a nebulizer. Here are the most common ones that are used for COPD:

Albuterol: It’s a beta adrenergic, meaning the medicine attaches to beta receptor cells lining the air passages (bronchioles), and this causes the smooth muscles lining them to relax. This dilates the airways, making it easier to breathe. This is a fast-acting medicine, and is also referred to as a rescue medicine. It can either be taken as needed or up to every 4-6 hours, whichever your doctor prescribes.
Levalbuterol: It’s also a beta adrenergic, and it works the same way albuterol does. It can either be taken as needed or up to every 6-8 hours.
Ipatropium Bromide: It’s an anti-cholinergic, meaning the medicine sits on the neurotransmitter acetylcysteine to prevent it from causing smooth muscles that surround the air passages from constricting or spasming. This is essentially a preventative medicine that keeps the airways open. It is taken either four times a day, or up to every four hours.
Combo: It’s a combination medicine that includes both albuterol and ipatropium bromide. It is prescribed either four times a day, or up to every four hours.
Budesonide: It’s an inhaled corticosteroid that, once inhaled, helps treat inflammation that is present in COPD lungs. It’s a preventative medicine that is only taken twice daily.
Arformoterol: It’s a long acting beta adrenergic, meaning that it attaches to beta receptors inside the lungs to keep them open long term. It is taken only twice a day.

Now, how do you take a breathing treatment? It’s not hard, although, how to do it should be explained to you by either a respiratory therapist, nurse, doctor, or the home care representative who brings you the equipment. The best technique is described at nationaljewish.org:

Plug in the air compressor
Using the oxygen tubing, connect the nebulizer to the air compressor
Squirt the medicine inside the nebulizer cup
Place either a mouthpiece or a mask on the nebulizer cup
Clench the mouthpiece between your teeth, close your lips. Or, strap the mask over your mouth and nose.
Sit up, either in a chair or on the edge of a bed. This will help create a direct route for the medicine to get to where you want it: your air passages.
Turn the air compressor on. The flow of air created should generate a fine, white mist from the nebulizer for you to inhale.
Take slow, deep breaths. Breathe in slowly and deeply over 3-5 seconds, holding your breath for 10 seconds at the end of inhalation. This allows the medication to deposit deep into the airway.
The treatment should last 5-10 minutes. If you put more than one medicine inside the cup, the treatment may last up to 20 minutes. The treatment is over when the white mist stops coming out of the nebulizer, or when the solution starts to sputter. To get the full effect of the medicine, make sure you take the entire treatment.
Turn off the air compressor. Take the nebulizer apart, wash with soap and water, let it dry, and then store it in some location that is easy to get to.
About every couple days, or at least once a week, the nebulizer should be taken apart, and all the pieces (except the mask) soaked in a solution of one part distilled white vinegar and three parts water. After soaking, remove from solution, let dry, and store.
A nebulizer and compressor can last a long time if taken care of properly.

As far as breathing is concerned during the treatment, many respiratory therapists simply recommend that you breathe normal. This, I find, is easier to explain and understand, and also creates the smooth flow needed for good deposition of medicine to the airway.

However, as a compromise, some respiratory therapists recommend breathing normal, while occasionally taking a slow, deep breath with a breath hold. Whichever breathing method you decide to use is the best breathing method.

That pretty much covers everything you need to know about breathing treatments. Here are some videos that show proper nebulizer technique:

How to use a nebulizer
How to use a nebulizer with a mouthpiece or a mask

We hope this helps you get the most out of your inhaled medicine.

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A nebulizer is a special device that warms or otherwise changes a liquid solution into a fine mist that’s easy to inhale. Some people call nebulizers breathing machines. Nebulizers are useful in treating certain respiratory conditions. Doctors often use them for babies. They allow infants to take in medication while breathing as they normally would. When a baby breathes in the mist from a nebulizer, the medicine can go deep into their lungs where it can work to make breathing easier. Doctors prescribe nebulized medications, but you can learn how to give these medications to your baby at home if needed.

Doctors may prescribe nebulizers for chronic conditions in infants. Asthma, for example, is a condition that causes an immune response that irritates the airways. Other conditions a doctor may prescribe a nebulizer for include:

Croup. Croup is the result of one of the viruses that causes the common cold. It causes airway swelling that leads a child to develop a barking cough, runny nose, or fever.
Cystic fibrosis. This genetic disease can cause thick mucus to build up in the airways, clogging them and making it harder to breathe.
Epiglottitis. This rare condition is a result of the Haemophilus influenzae type B bacteria that can cause pneumonia. It causes severe airway swelling that leads to an abnormal, high-pitched sound when breathing.
Pneumonia. Pneumonia is a severe illness involving inflamed lungs. It usually requires hospitalization in babies. Symptoms include fever, shortness of breath, and changes in a baby’s alertness.
Respiratory syncytial virus (RSV). RSV is a condition that often causes mild, coldlike symptoms. While severe symptoms aren’t common in older children, infants can develop inflammation of the small airways (bronchiolitis).

Nebulizers can be an alternative to inhalers. These devices deliver short bursts of medication when a person inhales. Nebulizers deliver medication over a course of time, usually 10 to 15 minutes. They don’t require a baby to cooperate to take the medicine in. While inhalers can be fitted with masks and used even with young infants, nebulizers are preferred, depending on the medication and why it’s being used.

Two different power options exist for nebulizers:

a jet or compressor nebulizer
an ultrasonic unit

A compressor nebulizer has a piston-style motor that uses compressed air to create the mist. This compressor type can be loud as it works to create the mist. It often has adjustable particle sizes and can vary in terms of treatment time. An ultrasonic nebulizer generates ultrasonic vibrations that transform water into a mist for delivering the medication. This method means the nebulizer is very quiet compared to a jet compressor. An ultrasonic nebulizer will typically deliver a treatment in about six minutes. However, not all medications can be delivered with an ultrasonic nebulizer. It heats the medicine, which may affect the quality of some medications. If you’re considering an ultrasonic nebulizer, always talk to your child’s doctor first to make sure you can use an ultrasonic nebulizer for the treatments. Nebulizer manufacturers have worked to make nebulizers more child-friendly. Some of the delivery methods include a face mask or a pacifier attachment for infants. A mask is preferred for infants, because they often breathe through the nose instead of the mouth. As a child gets older (usually age 6 or older), they may use a handheld mouthpiece instead of a mask. This allows more of the medication to enter the lungs instead of escaping around the mask.

Doctors may prescribe different medications that a nebulizer can deliver. Examples of these medications include:

Inhaled antibiotics. Some antibiotics are available via nebulizer treatment. An example is TOBI. It’s a form of tobramycin used to treat certain bacterial infections.
Inhaled beta-agonists. These medications include albuterol or levoalbuterol. They’re used to relax the airways and make breathing easier.
Inhaled corticosteroids. These can treat inflammation due to asthma.
Dornase alfa (Pulmozyme). This medication helps treat cystic fibrosis by loosening thick mucus in the airways.

While some of the elements of using a nebulizer depend on the specific type, here’s a general example of the nebulizer process:

Collect the medication for the nebulizer. Some are available in liquid form that have the medicine added. Others are a liquid or powder that must be mixed with sterile water or saline solution. Read the directions carefully before pouring the medication in the cup.
Connect one end of the tubing to the cup of medication and the other to the nebulizer.
Connect the mask or pacifier to the cup.
Hold the mask to your child’s face. While many of the infant masks come with strings to put around a baby’s head, most babies don’t tolerate these strings very well. It may be easier to gently hold the mask touching the child’s face and cover their nose and mouth.
Turn the nebulizer on.
Hold the mask to your child’s face while the treatment bubbles and creates a mist inside the mask.
You’ll know when the treatment is complete when the mist becomes less noticeable and the little cup appears almost dry.
Clean the mask and nebulizer after each use.

Babies can be squirmy, which makes administering nebulizer treatments a challenge. Here are some tips that can help:

Use the nebulizer at times your baby is more likely to be sleepy and tolerate treatments better. This includes after meals, before a nap, or at bedtime.
If noise seems to bother your baby, place the nebulizer on a towel or rug to reduce noise from the vibrations. Using longer tubing can also help, because the noisiest part isn’t close to your baby.
Hold your child upright in your lap during the treatment. Sitting upright helps deliver more medication throughout the lungs because they can breathe more deeply.
Swaddle your baby if they’re more comfortable that way during treatment.

If you have specific questions or concerns related to giving your baby a nebulizer treatment, talk to your child’s doctor.

It’s very important you clean the nebulizer after every time you use it. Bacteria and fungi thrive in warm, moist environments. If the nebulizer isn’t cleaned, these germs can build up. When you use an unclean nebulizer on your baby, the bacteria and fungi can be delivered directly to your baby’s lungs. If you don’t have special instructions that came with the nebulizer regarding cleaning, here are general guidelines:

Unscrew the plastic portion of the device. Soak it in warm, soapy water for at least 15 minutes.
If you like, you can also disinfect the nebulizer with 2 teaspoons of chlorine bleach with 2 cups of tap water. Always keep disinfectants out of reach of children.
After letting it soak, rinse thoroughly. Allow it to air-dry.
Store the nebulizer in a clean, dry environment when not in use.

Read the manufacturer’s instructions carefully as to when you should change the nebulizer’s filters. If any part of the nebulizer unit appears dirty, replace it or clean it.

Some of the pros and cons for nebulizer treatments include:

Nebulizers are available for purchase from most major retailers and at drugstores. Many insurance companies will often cover a portion or all of the costs of nebulizers, as they’re considered durable medical equipment with a doctor’s prescription. However, it’s best to talk to your insurance company before purchasing a nebulizer to ensure insurance will cover the costs. Here are some examples of nebulizers you can buy online.

Nebulizers are a safe and effective way to deliver medications to an infant. Always contact your child’s doctor if for any reason your child appears to have more difficulty breathing after a breathing treatment. Some infants can have the opposite expected reaction following a treatment. Reviewing the possible side effects with your child’s doctor can help you identify these symptoms more quickly.

Last medically reviewed on September 26, 2018