7% Hypertonic Saline for Nebulization HF#6355



Use of this Medicine

 

Hypertonic saline is used by nebulization twice daily in people with Cystic Fibrosis (CF) to help increase their lung function and decrease the number of lung infections by decreasing the thickness of mucus in the airways.

 

 

Dose

 

The usual dose is 4 mL of 7% salt solution nebulized via air compressor twice daily.  A bronchodilator such as albuterol is often used before the hypertonic saline to avoid any shortness of breath which may occur.  Bronchodilators also help to improve the deposition of the hypertonic saline in the lung.

 

 

What is a small volume nebulizer?

 

A small volume nebulizer (neb-U-lie-zer) is a device that holds liquid medicine.  The medicine is turned into a fine mist by a small air compressor.  The mist of medicine is deeply inhaled into the airways and lungs.  A nebulizer treatment of one dose of medicine will take about 10 to 20 minutes to finish. 

 

 

How do I prepare the 7% hypertonic saline solution?

 

The 7% hypertonic saline solution comes in a single dose vial called Hyper-Sal 7%.  It is preservative free.

 

1. Wash your hands well with soap and water.
2. Place clean, nebulizer cup on preparation surface.
3. Snap off the top of a single dose vial and squirt it in the nebulizer cup.
4. Plug the air compressor into an electrical outlet.  Make sure the compressor is on hard surface such as a table.
5. Attach one end of the smooth tubing to the air compressor and the opposite end to the nebulizer cup containing the 4 mL of 7% saline solution.  Turn the air compressor on.  A fine mist should be visible.  If not, make sure the compressor is working by disconnecting the smooth tubing.  Feel for air coming from the compressor.  If the compressor is working properly, check all connections. If the nebulizer is still not misting, use a different small volume nebulizer kit. 
6. Place the mouthpiece in your mouth.  Some children may use a mask over their mouth and nose rather than a mouthpiece. 
7. Take slow, deep, even breaths through your mouth. 
8. Make sure the medicine cup is kept upright.
9. Stop the treatment if you notice any side effects or reactions to the nebulized therapy.
10. Be aware of any coughing that occurs.  Note the color and amount of any secretions.
11. Continue the treatment until the medicine is finished (no medicine is coming out, or the sound of sputtering occurs). 
12. After the treatment is over, take the medicine cup apart.  Follow the cleaning instructions below for cleaning the equipment. Your nebulizer cup should be rinsed after each use. 

 

How often are treatments done?

 

Treatments are generally done twice daily.  Do not combine the 7% hypertonic saline solution with any other nebulized medications.  If you use a bronchodilator inhaler, use it about 10 minutes before you do the therapy.  Your symptoms may improve or remain stable as you continue the therapy.

 

 

Are there any side effects?

 

Some people have increased coughing while nebulizing the 7% saline solution, a sore throat and perhaps some chest tightness.  It is known that hypertonic saline can irritate the airways.  Your CF center care team may want you to take your first dose while at the clinic to make sure that your lungs will not have problems from 7% hypertonic saline therapy.

 

 

How Do I Clean and Disinfect My Nebulizer?

 

Twice weekly cleaning and disinfecting of your nebulizer is extremely important in preventing infection and keeping the nebulizer working well.

 

Dishwasher Cleaning

1. Take the nebulizer apart.
2. Place the pieces in a dishwasher basket on the top rack of the dishwasher.
3. After the dishwasher cycle is done, remove the pieces and shake out the

    extra water.
4. Air-dry the nebulizer pieces on a dry paper towel. 
 

 

Hand Cleaning

If you would prefer not to clean and disinfect your nebulizer using the dishwasher, select one of the choices below.

 

The reservoir tubing (pleated tube) cannot be placed in the dishwasher.  This piece needs to be cleaned according to the “hand cleaning” directions.

 

Rubbing Alcohol

1. Take the nebulizer apart and wash the pieces in warm soapy water.
2. Rinse with hot tap water.
3. Place the nebulizer pieces in a bowl and add enough rubbing alcohol

    (isopropyl alcohol) to completely cover the equipment.
4. Soak the nebulizer for 5 minutes.
5. Rinse all of the parts of the nebulizer with sterile water.  Do not use water

    from the faucet, bottled, or distilled water.  You can make water sterile

    by boiling it for 5 minutes.  Use this water once, and then throw it out.
6. Place the pieces on a paper towel to dry.
 

Microwaving

1. Take the nebulizer apart and wash the pieces in warm soapy water.
2. Rinse with hot water.
3. Place nebulizer pieces in a bowl, add water to cover.
4. Microwave for 5 minutes.
5. Air dry on a clean paper towel.
 

 

Equipment

 

If you have questions or need more supplies, contact UW Home Health at (608) 203-2273.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 12/18/2012

Copyright © 12/18/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6355

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