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SUBJECT: Nebulizers

Statement of Purpose:

To sterilize or high level disinfect nebulizer devices between treatments to make

them safe for patient care.

NB. Nebulizers are known to harbour hydrophilic bacteria e.g. pseudomonas

aeruginosa and other gram-negative organisms that can nebulized during use
increasing a patient’s risk of acquiring Pneumonia.

1. Policy

1.1. The Registered Nurse shall be Knowledgeable on types of nebulizer


1.2. All aerosolized treatment shall be prescribed by a Doctor.

1.3. The registered Nurse must ensure that all multi dose vials must have date
and time indicated on vials to check for expiry.

1.4. Multi-dose medication bottles must be labeled with patient’s name to

indicate for particulars patient use only. Use single use ampoules if not

1.5. All patient receiving nebulizers treatment shall have their own

1.6. All in line and handheld nebulizers must be cleaned, disinfected and rinsed
with sterile water and dried between treatment of the same patient.

1.7. For all multi-dose nebulizers treatment use new ampoule of sterile
fluid and
new sterile syringes each time.

1.8. The nurse shall ensure that patient and family education is carried
out prior
to treatment.

1.9. For cleaning/disinfection of nebulizers, please refer to guidelines.

manufactures instruction concerning length of use of nebulizer set.

© Cassidy Rabong 2010 Prepared by: SN. CaR

2.0 Cleaning/Disinfection of Nebulizers – Use Any of the Following Disinfectants:
• Clean with soap and water, and rinse.
• Place in 3% hydrogen peroxide for a minimum 20 minutes soak.
• Next, thoroughly rinse with sterile water.
• Air dry and store in a plastic bag.
• Peroxide solution should be changed every shift and labeled with date and

2.1. Methylated Spirit (Isopropyl Alcohol)

• Wash nebulizer with saop and water, rinse.
• Place in 70% isopropyl alcohol for a minimum 20 minutes soak; thoroughly
rinse with sterile water.
• Dry with forced air or air dry.

2.2. Cidex Orthophalaldehyde (Cidex OPA) – Only ICU & Endoscopy

• Wash nebulizer with soap and water, rinse
• Place in Cidex OPA following manufacturer’s instructions.

3.0 References

Walker J, Fell B (2005). Respiratory care. Association for professionals in

infection control and Epidemiology, Inc.
Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R (2003). Guidelines for
Preventing Health-care-Associated pneumonia. Centres for Disease Control,
53(RR03); 1-36

© Cassidy Rabong 2010 Prepared by: SN. CaR