Some people may use a nebuliser for their asthma medication.

Most people will be able to use a puffer alone or a puffer and a spacer. Your doctor will prescribe what is best for you. Your pharmacist will also be able to help you learn how to use and maintain your nebuliser. 

A nebuliser is used to change liquid medication into a vapour form for your use. Pressurised air is pumped through the liquid to form a fine mist which can be inhaled through a mask or mouthpiece. If you have been prescribed a nebuliser, it is important to choose the type most appropriate to your needs. 

• Low-flow pumps are best for occasional use, for delivering one type of medication. 
• High-flow pumps are heavy duty and are best when more than one person is using the pump, where more than one medication is being used, or for inhaled corticosteroids or antibiotics. 
• Also consider where the nebuliser will be used. There are battery operated pumps and 12-volt pumps that plug into a car cigarette lighter. 
• Place your pump on a firm surface when in use. This allows smooth running and stops particles of lint and other materials entering the pump. A pump should nebulise 80% of the medication in the first 8 minutes, and it is common to have some liquid left in the nebuliser bowl - this is the saline solution used to dilute the medication. If using a low-flow pump, watch that it doesn't overheat. 
• Pumps should be serviced and filters changed regularly, every 6-12 months depending on the amount of use. This will ensure they deliver the 6-8 litres of air needed for effective medication delivery. 

Your nebuliser will work best when well maintained. Correct cleaning will also reduce the risk of chest infections. 

• Nebuliser bowls, which contain the medication solution, are often for short-term use only and it is important to know when to replace them as their performance often deteriorates with repeated use. Make sure you check for cracks in the plastic. Multi-use nebuliser bowls are available and are most suited to home asthma care. Types most commonly used are jet nebuliser bowl, venturi nebuliser bowl, and ultrasonic nebuliser bowl. 
• Nebuliser bowls should be rinsed after each use. It is best to wash the bowl and face mask daily in hot water with dishwashing liquid, which will remove any grease from your hands or from the medication solutions. Allow the components to air dry. 
• Check the tubing regularly for cracks - you can blow air through the tubing with the pump's air compressor. 
• Store nebuliser bowls, masks and mouthpieces in airtight containers and keep a spare bowl handy. 

Useful tips: Masks are recommended for children under the age of five. Mouthpieces are normally suitable for all other users. It is wise to use eye protection when nebulising Atrovent or corticosteroid preventer medications such as Pulmicort. 

For more information on nebuliser therapy, contact your local Asthma Foundation: on 1800 645 130

Content Updated 20 September, 2005