Frequently Asked Questions

Q. What is a nebulizer or nebulizer system?
A. A nebulizer is a medical device that turns liquid medication into a mist so that it can be breathed directly into the lungs through a face mask or mouthpiece. People with respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD) or cystic fibrosis may use a nebulizer to take their medications. Nebulizers are particularly effective in delivering medications to infants, small children and to seniors as well as to anyone who has difficulty using an asthma inhaler.
Q. What are the components of a nebulizer or nebulizer system?
A. A nebulizer or nebulizer system is made up of:
  1. A nebulizer handset or set, the component that is filled with liquid medication to create a mist or aerosol.
  2. A compressor, a jet nebulizer needs an air source to help turn the liquid medication into a mist. The nebulizer is connected to the compressor by tubing. Compressors can be electrically or battery powered. Most compressors have an air filter that should be checked periodically and replaced according to the manufacturer’s instructions. Often times, the term nebulizer is used to refer to both the nebulizer and compressor together.
  3. For newer nebulizer technology such as the eRapid nebulizer, components include a nebulizer handset and an electronic controller called eBase.
Q. How long do the nebulizer components last?
A. There are several things that can determine how long nebulizer components or parts may last. The manufacturer’s instructions that are found in the device packaging is the first step in determining how long your nebulizer should last. Generally speaking, with proper cleaning and care, a reusable jet nebulizer will last approximately 6 months and a disposable jet nebulizer will last approximately 2 weeks.
Q. Why do I need a prescription for a nebulizer and/or compressor?
A. A nebulizer is a medical device that requires a prescription by the FDA. The nebulizer must undergo an assessment by the FDA before the device can be sold and marketed in the United States.
Q. Where do I get a prescription for a nebulizer and/or compressor?
A. Please talk to your physician or healthcare provider about obtaining a prescription for a nebulizer. In general, your primary care physician or your respiratory specialist should be able to provide this prescription.
Q. How long does the prescription last until I need a new one?
A. To get a definite answer to this you may need to ask your health care provider. Sometimes, physicians indicate an expiration date on your prescription, but many times with medical device prescriptions (such as the scripts for nebulizer compressor systems) there is no expiration date required. If you are unsure whether or not you can use a specific prescription, please contact our customer service team or your doctor's office.
Q. Do I need a new prescription for replacement items such as nebulizer sets?
A. While you do need a prescription for replacement reusable nebulizer handsets (like the PARI LC Sprint), you do not need a prescription for replacement parts, filters, tubing or masks. On each product page, we indicate whether or not a prescription is required. If we already have your prescription on file, often you will not have to send us a new one. If you have questions about a specific item, please contact us!
Q. What is a jet nebulizer compressor system and how does it work?
A. A jet nebulizer and compressor system consists of 2 components: the jet nebulizer that turns liquid medication into an aerosol mist to be inhaled into the lungs and the compressor which is the air source that powers the nebulizer.

How a Jet Nebulizer & Compressor Work Together to Turn Liquid Medication into an Aerosol Mist:
  1. The jet nebulizer attaches to the compressor by a connection tubing. Once the compressor is turned on, compressed air flows from the compressor through the connection tubing to the bottom of the nebulizer and up through a jet nozzle inside the nebulizer. The flow of air through the jet nozzle creates a vacuum that pulls the liquid medication up through a small tube where it comes in contact with the air stream.
  2. As the liquid medication flows out of the tube the air stream from the compressor breaks the liquid medication into a very fine aerosol mist that is able to remain suspended in the air stream.
  3. The medication aerosol mist is then carried by the air stream to a baffle. The baffle is like a wall that breaks the fine medication mist into an even smaller (microscopic) size that allows the medication to be inhaled into the lungs.
Q. What is an ultrasonic nebulizer system?
A. An ultrasonic nebulizer does not need a compressor to create a mist. It is an electronic nebulizer that turns liquid medication into a mist by directly vibrating the medication at a high frequency. These vibrations go through the entire liquid medication and create a fountain at the surface of the liquid which creates a mist to be inhaled into the lungs. The medication solution heats up after a while because the vibration needs to be transmitted through it. For this reason, ultrasonic nebulizers are not suitable to use with certain types of medications such as Pulmicort Respules.
Q. What is a vibrating mesh nebulizer system?
A. A vibrating membrane or mesh nebulizer also vibrates at a very fast rate to turn the liquid medication into a mist, but instead of directly vibrating the medication like an ultrasonic nebulizer, the vibrating mesh nebulizer uses a stainless steel membrane that has thousands of very small holes to turn liquid medication into a mist. The membrane vibrates, but it is not in direct contact with the medication solution. The mist is created by liquid medication being pushed though the small holes of the membrane. The medication solution is not heated up like an ultrasonic nebulizer, because the vibrations go to the membrane and not into the liquid.
Q. How do I know which nebulizer system will give me the best treatment?
A. The efficiency of a Nebulizer System (jet nebulizer & compressor, vibrating mesh/membrane or ultrasonic nebulizer) is determined by how much medication the nebulizer is able to get into the lungs and how fast the nebulizer takes to complete a treatment. A faster nebulizer treatment is often preferred by people because they do not want to spend a lot of time managing their health condition. It is important that a nebulizer system not only deliver the inhaled medication quickly, but also provide the right medication dose to the lungs to relieve and control respiratory symptoms. There are a wide variety of nebulizer choices today with a significant difference in efficiency. It is important to discuss which nebulizer system is the best fit for your condition with your healthcare provider. The nebulizer system that was used in the medication studies for FDA approval will often be listed in that drug’s prescribing information. The nebulizer system that was used in those studies is often the best system, and may be the only recommended system to deliver your prescribed medication.
Q. Can my children share one nebulizer handset?
A. Nebulizer handsets are labeled as single patient (one person) use only. To reduce the risk of spreading infection, please do not share nebulizer handsets with others.
Q. What is better to use with my nebulizer set, a mouthpiece or a mask?
A. Ideally, a mouthpiece should be used, when appropriate. However, mouthpieces cannot be used for infants, small children, and in some elderly or special needs populations. Also, the use of a mouthpiece may be uncomfortable with longer nebulizer treatments. In these cases, nebulizer treatments with a face mask are often recommended. For the best treatment, be sure that the mask covers the nose and mouth and has a good fit. Whether a mouthpiece or a face mask is used, it is important to inhale through the mouth during nebulizer therapy. Proper mask fit can optimize the delivery of the nebulizer medications and reduce the chance of getting some of the medication in the eyes or depositing on the face. Special pediatric and adult face masks are available that were specially designed to improve aerosol medication delivery and reduce medication getting into the eyes or depositing on the face. The Bubbles the Fish Mask and PARI’s Adult Aerosol Mask are two examples of these types of masks.
Q. What is asthma?
A. Asthma is a chronic disease of the airways that makes breathing difficult. The underlying cause of asthma is inflammation of the air passages that result in a temporary narrowing of the airways that carry oxygen to the lungs. Also, the airways can go into spasm referred to as “bronchospasm” by contracting the muscle tissue that surrounds the airways. Inflammation and airway spasm result in asthma symptoms, including coughing, wheezing, shortness of breath, and chest tightness. Some people refer to asthma as "bronchial asthma."

Even though there are excellent treatments for asthma, it is still a serious disease that affects more than 25 million Americans and causes nearly 2 million emergency room visits ever year. With proper asthma treatment, most people with asthma can enjoy a full and active lifestyle. Yet inadequate asthma treatment limits the ability to exercise and be active. Poorly controlled asthma can lead to multiple visits to the emergency room and even hospital admission, which can affect quality of life and performance at home, school, and work.
Q. Are nebulizer sets sterile?
A. Nebulizer handsets are not sterile. Therefore it is important that prior to its first use the nebulizer handset is cleaned and disinfected. Please follow to the manufacturer’s instructions for use for more detail.
Q. How often should I wash my nebulizer handset?
A. Nebulizer handsets should be cleaned after each treatment and before disinfection. Please refer to the manufacturer’s instructions for use for specific details on cleaning your nebulizer handset.
Q. Can I use a baby bottle sterilizer to disinfect my nebulizer handset?
A. Although a baby bottle pasteurizer is not included as a disinfection method in the manufacturer’s instructions, a small number of small studies concluded that this method of disinfection is effective in killing common pathogens or germs found in respiratory equipment. However, it is important to speak with your healthcare provider first to determine if using this method is suitable for your particular health condition.
Q. Why do nebulizer handsets need to be disinfected?
A. It is essential to clean and disinfect nebulizer handsets and other respiratory equipment that has been in contact with mucous membranes and sputum to prevent lung infections. Bacterial contamination can be reduced by regular cleaning and following the manufacturer’s instructions on when to replace the nebulizer.
Q. How often should Nebulizer Handsets be disinfected?
A. All nebulizers should be disinfected regularly to prevent getting lung infections. It is important to follow the manufacturer’s specific instructions on disinfection. Most nebulizers should be disinfected at the end of each treatment day or every other treatment day. Please refer to the manufacturer’s instructions for frequency and specific disinfection methods.
Q. What is the best way to clean the nebulizer tubing?
A. The nebulizer tubing should not be submerged in water or cleaned with harsh chemicals. The outside of the tubing can be wiped down with a clean damp cloth or paper towel. If you feel your tubing needs a more thorough cleaning, then it should probably be replaced.
Q. How long will the nebulizer handset last before replacement?
A. Like anything else, the longevity of the nebulizer handset depends on how often it is used and how well it is cared for. With proper care, cleaning and disinfection, a reusable nebulizer handset will last approximately 6 months. The nebulizer should be replaced more often for those that take frequent nebulizer treatments. Frequent use is considered more than 3 times daily.
Q. Why do I need to replace my nebulizer handset?
A. Many do not realize that nebulizer handsets need to be replaced on a regular basis to maintain optimal performance.
Q. Do I need a recommendation from my physician to purchase a nebulizer system or nebulizer handset?
A. A physician recommendation is not required, but it may be a good idea to ask your healthcare provider because nebulizer efficiency varies widely between different brands and certain medications require the use of a specific nebulizer system or handset. For example, the LC Plus Reusable Nebulizer is the only nebulizer that should be used to deliver the medication tobramycin.
Q. What must I do if my nebulizer no longer makes an aerosol or mist?
A. See instructions for use. This may be due to any of the following reasons:

  1. The nozzle insert in the nebulizer is missing.
  2. Nozzle blocked (also possible with the LC SPRINT Nebulizer). Check the nozzle first. If there are crystalline deposits (e.g. lime residue) in the nozzle, it may be possible to remove them simply by squeezing the flexible nozzle with your thumb (however, this only works with the LC SPRINT nozzle because it is flexible). For more stubborn blockage, it often helps to clean the nozzle again by boiling the nebulizer.
  3. Not enough medication in the nebulizer. Make sure that the medication in the nebulizer reaches the fill mark. Minimum: 2ml, Maximum: 8ml.
Q. What should I do if moisture condenses in the nebulizer connection tubing?
A. Small amounts of condensation can form in the connection tubing as a result of air humidity and temperature fluctuations. After each treatment, switch the compressor on again and blow the tubing dry with the nebulizer disconnected. The instructions for use contain a detailed description of this procedure.
Q. Are nebulizer products latex-free?
A. Due to the latex sensitivities many people have, all nebulizer parts and products that we carry are latex-free. If you have questions about a specific product's specifications, please contact our team.
Q. What medications can be nebulized?
A. Always follow your physician’s advice on what medication is suitable for inhalation. He or she will prescribe the right medications and dosage that you need. Your pharmacist can also answer questions about your medications.
Q. How can I tell when my child has breathed in all the medication from the Vortex Holding Chamber?
A. If the child is using a mask, apply the face mask over the nose and mouth creating a good seal between the mask and the child’s face. Depress the MDI (inhaler) and watch the child breathe in and out for 10 seconds before removing the mask. Repeat the same procedure with each subsequent puff of medication. Do not activate multiple doses into the chamber at once. Each medication dose or puff should be administered separately.

If the child is able to use the mouthpiece (by age 4 or 5):

  1. Have the child exhale; place the mouthpiece into the child’s mouth. Be sure that the lips seal around the mouthpiece;
  2. Depress MDI, and then instruct the child to breathe in slowly and deeply through their mouth (not through the nose);
  3. To confirm inhalation watch or place your hand on the child’s chest to feel the child’s chest rise.
  4. If possible, instruct the child to hold their breath for 10 seconds or for as long as is comfortable.
  5. Repeat steps a through d with each MDI puff of medication.
Q. What are holding chambers or spacers?
A. Valved holding chambers (VHC) and spacers are add-on devices used with metered dose inhalers (MDI’s). Both are designed to overcome the problems associated with MDI use and can be used by anyone that has trouble using MDIs correctly. VHC and spacers work by holding large aerosol medication particles that are too large to enter the lungs, inside the chamber or tube, thus enhancing the amount of smaller medication particles entering the lungs. Larger aerosol particles are too big to enter the lungs, and are more likely to deposit in the back of the throat and mouth, which may lead to local side effects like yeast infections of the throat and mouth.
Q. What is the difference between a valved holding chamber (VHC) and a spacer?
A. Both terms are often used interchangeably; a spacer is an open extension tube that is placed on the mouthpiece of an MDI to increase the “space” between the person and MDI. A spacer slows the speed of the aerosol medication exiting the MDI and decreases medication from depositing in the mouth and throat. However, spacers do not solve MDI technique issues.

The key difference between a spacer and valved holding chamber (VHC) is a VHC uses a valve, which allows aerosol medication to stay suspended inside the chamber for a short time period. The valve only opens on inhalation and does not allow one to exhale into the device. A VHC also slows the speed of the MDI aerosol. In addition, the need for coordinating pressing the MDI and inhalation is no longer necessary because the aerosol medication stays suspended in the chamber. VHCs are preferred over spacers for this reason. The VORTEX Non-electrostatic Valved Holding Chamber is a commonly used valved holding chamber.
Q. Who should use a valved holding chamber (VHC)?
A. A valved holding chamber can be used by anyone that has difficulty using their metered dose inhaler correctly. Ask your healthcare provider to observe you using your MDI to ensure that you are using it correctly. Many individuals, particularly the very young and seniors, find it challenging to use a metered dose inhaler. Correct inhaler technique is important because the efficacy of the drug relies on its ability to get into the lungs. Timing the pressing of the metered dose inhaler with inhalation is a frequent error with MDI use.
Q. What if my child cannot use the VHC with mouthpiece?
A. Children that are too young to use an MDI alone can use a valved holding chamber and face mask to take their MDI medication. It is important to have a good face mask seal with the child’s face to ensure that an adequate medication dose is achieved. PARI’s VORTEX offers a face mask for both adult and pediatric use. For children, VORTEX comes with a frog or ladybug face mask, which can help encourage cooperation with MDI therapy.
Q. Why is the Vortex made from materials that are non-electrostatic?
A. Plastic chambers and spacers carry a static charge that causes medication to be attracted and stick to the walls of the chamber. This can make less medication available for inhalation to the lungs where it needs to go to be effective. VORTEX is a valved non-electrostatic holding chamber made from lightweight aluminum which does not carry a static charge. Non-static results in more consistent dosing and delivery of MDI medications.
Q. How do I care for my valved holding chamber?
A. As with all respiratory equipment, cleaning your spacer or chamber is important to prevent lung infections. Some valved holding chambers like VORTEX can be cleaned in the dishwasher. Please follow the product instructions for proper cleaning and disinfection methods.
Q. Does Nebology accept insurance for nebulizers?
A. We do not accept insurance reimbursements directly. If your insurance company reimburses you for durable medical equipment (DME), submitting your sales receipt with a copy of your credit card payment is usually what is necessary. You can check with your own insurer for the specific documentation that is needed.
Q. Are nebulizers covered by Flexible Spending Accounts?
A. Yes! Flexible Spending Accounts allow consumers to deduct pre-tax dollars from their paycheck in employer sponsored accounts to pay for medical expenses. You can submit your expense receipts to your healthcare administrator for reimbursement.
Q. How often do I need to replace masks, hoses, filters, etc?
A. Each nebulizer system comes with explicit instructions on care and cleaning. Systems last longer and work more efficiently when the maintenance schedules are followed. Most accessories can be ordered directly from our site
Q. Educational Resources
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To navigate the maze of mobile health apps, check out iMedicalApps (http://www.imedicalapps.com), an online publication written by a team of health care professionals that provides reviews on mobile health technology and apps.

  • Asthma Buddy
  • Asthma MD
  • Asthma Pulse
  • AsthmaCheck
  • Asthmapolis
  • AsthmaSense
  • AsthmaTrack
Q. COPD Resources
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