This leaflet provides a reminder of the steps you need to take to administer the nebulised hypertonic saline for bronchiectasis. If you would like further information, or have any worries, please do not hesitate to ask your doctor, nurse, or physiotherapist.

In all cases, your respiratory team will provide training on how to administer the nebulised hypertonic saline and answer any questions you might have.

The nebuliser drives air into the liquid which is then inhaled as a fine mist: this mist is to make the mucus less sticky which will make it easier to cough up. This treatment is recommended by the British Thoracic Society (BTS) for the management of bronchiectasis in adults who have difficulty with airway clearance alone.

Preparing the equipment

Always start with washing your hands. You will need:

  • Nebuliser machine.
  • Nebuliser pot.
  • Tubing.
  • Mouthpiece/mask.
  • Vial of 7% hypertonic saline.

How to administer the nebulised hypertonic saline:

  1. Assemble the nebuliser pot and mouthpiece by squirting the hypertonic saline into the nebuliser pot and screwing the lid on. Then, attach the tubing to the bottom of the nebuliser pot (see fig 1).
  2. Ensure that the nebuliser machine is plugged into a mains supply. Connect the nebuliser tubing to the machine and switch on the machine.
  3. Seal your lips around the mouthpiece and slowly breathe in and out through your mouth, sitting in an upright position (see fig 2).
  4. Breathe at a rate that is comfortable for you and try not to talk.
  5. If you need to stop for a break, switch off the machine and restart when you are ready.
  6. When the nebuliser has finished, detach the tubing from the nebuliser pot, then switch off the machine. This removes moisture from the tubing. You will be able to tell when the nebuliser has finished because it starts to ‘spit’ and there will be almost no liquid left in the pot.
  7. Clean your nebuliser (as detailed below), wash your hands, and rinse out your mouth with water.
Figure one: Assembled nebuliser pot, tubing, and mouthpiece.
Figure one: Assembled nebuliser pot, tubing, and mouthpiece.
Figure two: Showing the correct administration of the nebuliser.
Figure two: Showing the correct administration of the nebuliser.

Cleaning the nebuliser

It is important to clean your equipment carefully after every use to prevent bacteria from growing on it. If small amounts of the drug remain in the equipment, it can harden and block the nebuliser; keeping it clean and dry will prevent this.

After every use:

  1. Disassemble the nebuliser pot: remove the mouthpiece and lid from the pot.
  2. Wash the nebuliser pot and mouthpiece in warm soapy water.
  3. Rinse the pot and mouthpiece under hot running water before leaving to air dry. Ensure all components have dried completely before re-using.

For periodic cleaning and maintenance of the machine, please see the instruction booklet for your specific machine.

Side effects

As you have had a supervised trial and assessment prior to commencing this treatment, we do not expect you to have significant side effects. If you experience chest tightness or shortness of breath whilst using the hypertonic saline, stop the nebuliser immediately. If you have one, take your reliever inhaler/nebuliser (Salbutamol/Ventolin) as prescribed.

If your symptoms do not improve, go to your nearest emergency department for medical review.

Let your medical team know as soon as it is safe to do so. If you have other side effects whilst inhaling the hypertonic saline, stop and ask your medical team for advice.