Choosing a nebuliser for home use

A nebuliser turns liquid medication into a fine mist that can be breathed into the lungs. It is prescribed for asthma, COPD, bronchiolitis in children, and a range of other respiratory conditions.

Because they are inexpensive, they tend to be bought quickly. Two decisions are worth slowing down for.

The three types

Compressor (jet) nebuliser

An air compressor forces air through the medication cup, breaking liquid into aerosol. Reliable, works with essentially all prescribed nebuliser medications including suspensions like budesonide, and the least expensive. Downsides: it is noisy, mains-powered, and takes longer per treatment.

This is the right default for most households.

Mesh nebuliser

Medication is pushed through a vibrating mesh. Very quiet, battery-powered, portable, and faster. More expensive, the mesh needs careful cleaning and eventual replacement, and not every medication is compatible. Good where portability genuinely matters — school, travel, work.

Ultrasonic nebuliser

Uses high-frequency vibration. Quiet and fast, but the vibration heats the medication and it should not be used with suspensions such as budesonide, or with some antibiotics. Check compatibility with the prescribed medication before considering one.

Particle size is the specification that matters

Look for the mass median aerodynamic diameter (MMAD), stated in microns. The useful range is roughly 1–5 microns — small enough to reach the lower airways. Larger particles deposit in the mouth and throat, which delivers the taste of the medication without the therapeutic effect.

If the specification sheet does not state MMAD, ask. A manufacturer that does not publish it has not tested it.

Mask or mouthpiece

• Under about five years: a correctly sized mask that seals against the face. Masks come in infant, child and adult sizes — a loose mask, or one held a few centimetres away, wastes the majority of the dose.
• Older children and adults: a mouthpiece gives better lung deposition, because it bypasses the nose.

Buy the size that fits now, and expect to replace it as a child grows.

Practical factors

• Noise: Compressors run 55–65 dB. If treatments are given to a frightened child, or at night, quieter is worth paying for.
• Treatment time: Typically 5–15 minutes for a compressor. With a distressed toddler, the difference between 6 and 14 minutes is significant.
• Duty cycle: Check how long the unit can run continuously before it needs to rest. Cheap compressors overheat with repeated back-to-back treatments.
• Spare kit availability: Cups, tubing and masks are consumables and need periodic replacement. Confirm they are available locally.

Cleaning — the part that gets skipped

A nebuliser delivers whatever is in the cup directly to the lungs. A damp, uncleaned cup grows bacteria.

• After every use: disassemble, rinse the cup and mouthpiece or mask in warm water, shake off, and air-dry fully on a clean cloth. Do not put a damp cup back together.
• Weekly, or per manufacturer instructions: disinfect using the stated method.
• Do not wash the tubing. Moisture inside tubing cannot be dried and should be replaced instead.
• Replace consumables at the manufacturer’s interval — cups and masks degrade.
• Check the compressor air filter and replace when discoloured.

Before you buy, confirm

1. Type — compressor, mesh or ultrasonic — and compatibility with the prescribed medication
2. MMAD particle size
3. Noise level and typical treatment time
4. Mask sizes supplied, and correct size for the user
5. Warranty on the compressor
6. Local availability of cups, masks and tubing

Available in Kottayam

Cosmic Surgicals stocks compressor and mesh nebulisers with adult, child and infant masks, plus replacement cups, tubing and filters. Bring the prescription — medication compatibility decides the type.

See respiratory and home-care equipment or ask for a quotation.