Transcript Cleaning Your Equipment-Power Point

Cleaning Equipment 101
CF Education Day 2009
Kristin Shelton, CPFT, RRT
Cystic Fibrosis Center
Lucille Packard Children’s Hospital at Stanford
Cleaning Your Respiratory
Equipment
Germs can get on respiratory equipment
and cause lung infections.
 It is important to clean and disinfect
equipment that has been in contact with
mucous membranes, or secretions.
 Clean and disinfect all equipment used for
inhaled medicines or airway clearance
using the manufacturer’s instructions.

To clean and disinfect your
nebulizer, follow these steps:
1 Clean your hands.
Disassembled nebulizer
Disassembled nebulizer
Disassembled nebulizer
2 Clean and rinse the nebulizer parts.
3 Disinfect nebulizer parts using one of
these options:
Boiling for 5 minutes
Dishwasher, if the water is hotter than
158° F for 30 minutes
The CFF has approved the electric Avent
iQ24 steam sterilizer as an option for
disinfection.
Soaking in a solution of 1 part
household bleach and 50 parts water for 3
minutes
1 Part
50 Parts
+
4. Rinse the nebulizer parts.
If you disinfect using bleach, rinse all parts
thoroughly using sterile water. You can make
water sterile by boiling it for 5 minutes.
5. Air-dry the nebulizer parts.
Drain the parts on a clean surface covered
with new paper towels. Remember, germs will
grow on anything that stays wet, so store the
dry nebulizer in a clean, dry bag in a clean, dry
place.
Maintaining your compressor
Remember to change your
filter every 6 months
Which nebulizer for which drug?

Pari LC Plus:
Tobi
 Colistin (Colistimethate,
Colymycin)
 Albuterol
 Hypertonic Saline (Hypersal)
 Pulmozyme (Dornase
Alpha)
 Mucomyst (Acetylcystine)
 Pulmocort Respules
(Budesonide)

Which Nebulizer for which drug

Pari Sprint:
Use with Albuterol
 Hypertonic Saline
 Mucomyst (Acetylcystine)
 Pulmozyme (Dornase Alfa)
 Pulmicort Respules

*Replace every six months
Which nebulizer for which drug?

Pari LC Star

Colistin
(Colistimethate,
Colymycin)
Which nebulizer for which drug?
Side Stream
nebulizer:
Use with Pulmozyme
(Dornase Alfa) or Albuterol
Replace once a year
Which nebulizer for which drug?
E-flow nebulizer:
Use with Colistin
(Colistimethate sodium),
Hypertonic saline
Replace aerosol head every
ninety days
Which nebulizer for which drug?
Disposable nebulizer:
use if you have no other
nebulizer available.
Replace each month
Nebulizing for a child
The bubble’s the fish mask
will melt if boiled.
Nebulizing for an infant
Recommended order of
nebulized medications
1.
2.
3.
4.
5.
6.
7.
Bronchodilators: (Albuterol, Xopenex, Atrovent,
Combivent) to open the airways.
Mucomyst: (10%) (20%) to break up mucous.
Hypertonic Saline: (7%) (available now in premixed
vial manufactured by Pari called Hypersal) to mobilize
mucus and improve airway clearance.
Pulmozyme: (Dornase Alfa) to thin mucus.
Airway Clearance
Antibiotics: (TOBI, Colistin) the previous therapies
open and clear the airways thereby improving the
distribution and effect of these antibiotics.
Steroids: (Flovent, Pulmicort, QVAR, Symbicort,
Advair) to relieve inflammation.
Special Considerations

Do not mix medications in the same nebulizer unless proven to be
compatible.

Use a mouthpiece whenever possible (moving the mask just 2 cm away
from the face may reduce the delivery of nebulized drug by up to 85%; in
addition, nasal deposition further reduces airway deposition).

Learn how each medication should be stored (e.g., refrigerator, room
temperature, travel considerations) and any special mixing concerns.

Be aware of possible side effects for each medication (e.g., bronchospasm,
hoarseness/voice changes, increased cough and/or secretions, sore
throat, loss of taste or hearing).