Nebulizer Maintenance in College Dorms

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Ekm

Guest
I have CF and will be living in a college dorm starting in the fall. I use 3 nebulizers/day, and need to boil them after each use. Hot plates aren't allowed in dorms, and some research has showed me that using a baby bottle sterilizer may be able to replace boiling the nebulizers. Has anyone had experience with these? Any other suggestions would be very welcome as well. Thanks!

Emma
 
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Aboveallislove

Super Moderator
Emma,
a few thoughts....talk to your college office for students with disabilities...think of ideas that might work, such as you having access to a stove to boil am s maybe take ten sets so you can do every few days. Maybe the have dorms where rectors have kitchenettes. Or a similar space. Also I'd strongly suggest you try to save for or ask as a present a box of disposable nebs for midterm and finals week so you can use and toss. Re your question do a search for baby sterilizers as several great threads! Best of luck...how so exciting!
 
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stephen

Guest
Emma;

If you have a microwave oven, Medela Quick Clean Micro-Steam Bags should work well. They cost about $1 each.

After rinsing the nebulizers, I put 3 -6 nebulizers in a bag, add about 6 ounces of water, and microwave the bag for 10 minutes. Each bag lasts me for more than 30 uses.

There are a lot of people who use a baby bottle sterilizer. My CF center actually gave me one. However, I find the Microwave Steam bags much more convenient.

Good luck and enjoy college.
 
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Patti Rowland

Guest
My daughter is using a baby bottle sterilizer that she loves. It has a dry setting so when she goes to use them they are sterile and dry! We bought it on Amazon - its called Wabi Baby - big enough to sterilize everything at once. Its good bc they are in clean, dry storage till use - as opposed to setting them out to dry.
 
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Patti Rowland

Guest
Added note - she does have to keep distilled water on hand for its use. We just stock up at the beginning of the year.
 
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mommy w/ cf

Guest
hi!
i graduated from college a few years ago, & used a baby bottle sterilizer. it works great, but does need distilled water…
the last part of school i actually just put my nebs in a medium sized glass bowl with water completely covering then & microwave them for 10min. this was the easiest way i found to sterilize them @ college :)
i wish you well, & hope this helps!!
 
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Gammaw

Super Moderator
Ekm, please be ever so careful about using baby bottle sterilizers. There's a lot of debate over their ability to adequately sterilize nebs for you. There are a slew of threads on this forum about them, just do a search. Here's a link to the latest one of which I'm aware.

http://forum.cysticfibrosis.com/thr...ce-on-Keeping-them-Clean?highlight=Sterilizer

I would first simply call your Respiratory Therapist at your CF Center. They should have good suggestions and can tell you what they think of baby bottle sterilizers. If you have microwave access, you can always put them in water and boil for 10 minutes as suggested. But it takes 10 minutes of actual boiling. you can also go to www.cff.org and search for sterilizing nebulizers too. I believe they have the stock handouts with instructions on that site. Please don't just use baby bottle sterilizers or you could be leaving behind nasty things to breathe into your lungs. Your lungs are much too important for that kind of risk. Obviously you know that or you wouldn't be asking! And college is too much fun to be sick!
 
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Gammaw

Super Moderator
Ditto, Aboveall. Your suggestion to check with the university is a great idea. They surely have a whole department to help with medical disabilities. If you contact your CF Center Respiratory Therapist to find out what you really need to ensure your nebs are sterilized, the University should be able to find a way to accomodate. And your CF Center likely has people who work with schools - from daycares to colleges and everything in between - to help you with communicating adequately with the University - especially if your CF Center is at a pediatric hospital. At our Center, there is an Education Department that does everything from help hospitalized children keep up with schoolwork, to visiting educational institutions to evaluate changes they need to accomodate kids with disabilities. They will even help draft 504 plans or IEPs.
 
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Gammaw

Super Moderator
Hi QTPie. Yes, the link has been discussed in previous posts. It is specific to the e-flow and another nebulizer - they can't be sterilized in the microwave because they contain a metal part. There are suggestions that they can be sterilized with alcohol or hydrogen peroxide. There was a time they thought using vinegar was sufficient too! But I have personally received specific instructions from the CF Team to not use those methods. I suspect the confusion or perhaps just the changes in recommendations is a result of various studies and the ever growing complexity of various "bugs." There has also been some reported testing of the baby bottle sterilizers that question whether they can reach the required temperatures for sterilization. Again, these issues have been discussed in many previous posts, but I do not want to suggest they don't need to be repeated. Here's another link to a post specifically discussing the baby bottle sterilizers - http://forum.cysticfibrosis.com/thr...m-sterilizer?highlight=Baby+bottle+sterilizer I would also suggest you read the last link I posted as well - http://forum.cysticfibrosis.com/thr...Keeping-them-Clean/page4?highlight=Sterilizer The debate seems to persist . . . .

The best way to handle the question in my humble opinion is to ask your respiratory therapist and pulmonologist at your CF Center. I have no doubt they will be happy to give you their recommended protocols. I would also suggest you talk with the manufacturer of your nebulizer, making sure they understand you are a CF patient, and do not want to simply "clean" your nebulizer. Most occasional nebulizer users seem to be advised to simply wash them - but the lungs of a CFer are much more fragile and susceptible to bacteria. Your lungs aren't going to fight off the average bug that might be left on a nebulizer in the usual way.

My own round and round on this issue led me to conclude that the safest and surest way to sterilize a plastic reusable nebulizer, like the Pari LCPlus typically used for TOBI or Hypertonic Saline, was to wash it in soap and water, rinse it, boil it for 10 minutes, and then let it air dry, protected from the environment by placing it in a clean covered tub or covered with a clean paper towel.
 
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mom24dodd

New member
I have researched this for a while - because it is very difficult to go on vacation as a family without staying in a place with a kitchen. My next attempt was to use a fry daddy - it will keep the water boilng for the recommended 10 minutes.

10 minutes in a microwave does not keep the water boiling for 10 minutes - and I am afraid of what the micro wave radiation may be doing to the plastic of the nebulizer - so I am always afraid to use it.

They also make those portable induction burners that are cool to the touch - which our pulmonologist suggested. Read the reviews on Amazon: http://www.amazon.com/Cooktop-Singl...0-Volt/dp/B005TLMBHK/ref=cm_cr_pr_product_top

Good luck with whatever you are able to use.
 
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Gammaw

Super Moderator
Well here's the latest that I've found . . . As I stand here waiting for my boiling nebi soup to finish! This is copied and pasted from updated infection prevention control guidelines published on www.cff.org, and the link to those guidelines from the cff.org site is: http://www.jstor.org/stable/10.1086/676882. I don't know if these are any different from the2003 guidelines.
Heres the link to the introductory article, which interestingly enough contains an email address to use if you have questions about the updated infection control guidelines themselves : http://www.cff.org/aboutCFFoundation/NewsEvents/7-2-CF-Infection-Prevention-Control-Guidelines.cfm. The email address is infectioncontrol@cff.org. If anyone sends them questions, I'd love to see the answers!

"Nebulizers: Cleaning and Disinfecting
59. The CF Foundation recommends that the following steps be performed for nebulizers used in the home as soon as possible after each use:

  • a. Clean the nebulizer parts with dish detergent soap and water
  • b. Disinfect the nebulizer parts using one of the following methods:
Heat methods:

  • a. Place in boiling water and boil for 5 minutes
  • b. Place in a microwave-safe receptacle submerged in water and microwave for 5 minutes
  • c. Use a dishwasher if the water is more than or equal to 70°C or 158°F for 30 minutes
  • d. Use an electric steam sterilizer
Cold methods:

  • a. Soak in 70% isopropyl alcohol for 5 minutes
  • b. Soak in 3% hydrogen peroxide for 30 minutes
    • i. Rinse off the cold-method disinfectant using sterile water, not tap water; the final rinsemust be with sterile or filtered (less than or equal to 0.2-micron filter) water
    • ii. Air dry the nebulizer parts before storage
Source of supporting evidence: 2003 CF IP&C guideline, Category II
2013 CF IP&C guideline consensus: 100%
Sections in the text: III.D.1; IV.E.3

60. The CF Foundation recommends that nebulizers used in the home should not be disinfected with acetic acid (vinegar), bleach solutions, or benzalkonium chloride (eg, “Control III”).
2013 CF IP&C guideline consensus: 100%
Sections in the text: IV.E.3".
 
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