Please remember that I am posting information that I am familiar with as it pertains to us. This is not meant to be an all-inclusive manual on how to care for your respiratory equipment, but an example of what works for one family.

There are a wide variety of types of nebulizer cups and just as many ways to clean them. It is no longer advised to use vinegar as a disinfecting agent for nebulizer parts ~ vinegar is not strong enough to kill CF germs! Alcohol and hydrogen peroxide are still considered suitable agents. My favorite method is to wash the nebulizers in hot, soapy water and then boil Allison’s nebulizers (after every use) for 10 minutes and then air dry (a baby bottle rack works well for this purpose). We use the Pari LC Plus neb cups and a Pari ProNeb Ultra nebulizer machine. When traveling, we also have a Pari Trek portable nebulizer and have been known to use the occasional disposable nebulizer set (Airlife Brand Misty Max 10 Nebulizer) when camping or on the road. Disposable sets may cost you around $1-$1.50 a piece, but can be re-used a few times if you disinfect them properly between uses. DO NOT BOIL DISPOSABLE NEBULIZER CUPS. I make sure to replace my Pari neb cups every 4 months or so (at the most), although the manufacturer recommends every six months. (Be sure to mark it ahead on your calendar and change when necessary. Many online places do not require a prescription for ordering nebulizer kits; others do. Do your research and find out what your insurance will cover before buying mass quantities of medical devices.)

*I also mark all pieces of the nebulizers with a permanent marker to make sure they are used for only one specific medication; I have enough nebulizer kits going that I only have to clean and sterilize once a day. You may find that you need to re-mark them periodicially.*

Here are a few disinfecting tips:

• Boil for 5 to 10 minutes
• Microwave in water for 5 minutes
• use the dishwasher if the water is hotter than 158 degrees for 30 minutes
• soak in bleach: 1 part bleach and 50 parts water for 3 minutes
• soak in 70% isopropyl alcohol for 5 minutes
• soak in 3% hydrogen peroxide for 30 minutes

If using bleach, alcohol or peroxide, you will need to rinse your nebulizers ~ but remember to use STERILE water (you can sterilize water by boiling it for five minutes).

As a side note: I am meticulous about our nebulizer cup care. Many may consider my methods a bit much, but it is one thing that is in my control, and really, is boiling water for 10 minutes a day really that hard??? These are her lungs we are talking about!

As for the nebulizer tubing, if you have the availability to do so, I like to replace my weekly. (Make sure your tubing is dry at the end of each nebulizer session; run the nebulizer a few minutes longer to help dry it out if necessary.) Pari now also has an extended use tubing that will last you a little longer. You may also consider getting some medical grade silicone tubing that is dehp-free. (Check with GrandmomBev’s pharmacy in Florida ~ they are wonderful!)