How to Choose the Best Nebulizer

A nebulizer is a drug delivery device that uses compressed air to convert liquid medication into a breathable mist. Available in both electric and battery-operated versions, nebulizers are most commonly used to treat asthma and other breathing conditions. 

How does a nebulizer work? 

When using a nebulizer, medication is delivered via a facemask or mouthpiece. A pre-measured amount of the user’s liquid medicine is placed into the nebulizer’s reservoir, and a compressor tube is connected to the nebulizer at one end with the mask or mouthpiece at the other. 

The medication is then delivered through the tube and into a mask or mouthpiece using either compression or vibration to convert the medication into a fine mist. The user breathes deeply, and the medication is inhaled directly into the lungs, providing relief from breathing difficulties.  Most treatments take no more than ten minutes!

Features to consider when purchasing a nebulizer 

Size: pediatric or adult model?

Pediatric nebulizers are designed to deliver breathing medication quickly and efficiently, but also make the experience of using a nebulizer less anxiety-provoking for young children. 

Many pediatric nebulizers come in fun shapes and patterns - some in the shape of a friendly animal, others with bright colours the child can interact with while receiving their medication. 

Adult nebulizers are more standard in appearance, although some may contain unique features which distinguish one from another. 

Design: tabletop or handheld device? 

The choice of nebulizer design is a matter of convenience, and of knowing where and how you are planning to use the nebulizer. Some nebulizers contain compressors which weigh several pounds, while others are small enough to fit in the palm of your hand! 

To choose the best product size, first determine if you will be using the nebulizer primarily at home, or if you want the option of being able to take it with you to a friend’s home or on a trip. 

Some users with severe asthma find that traveling with a nebulizer is a necessity. If this is the case for you, selecting a nebulizer capable of being carried on active adventures will direct you toward portable models. 

Helpful tip: When traveling by airplane, remember to inform TSA of your nebulizer and medication, which you are legally allowed to carry on so long as the device is packed appropriately and all liquid medications are stored in 3 oz. containers.

Medication delivery system: atomizer, ultrasonic wave, or vibrating mesh? 

Nebulizers are designed to deliver medication using several different mechanisms. Here are the three most common designs: 

  • Nebulizers that deliver medication by use of a compressor are the most common models. Known as atomizers, the nebulizer’s compressor sends a jet of air directly into the attached liquid medication, creating a fine, breathable mist. 
  • Nebulizers which utilize compressors are generally heavier and louder than ultrasonic models. That said, as time goes on, many more atomizer models are being developed which work more quietly while also being compact. An ultrasonic wave nebulizer uses high-frequency vibrations to vaporize medicine. 
  • Since 2005, many nebulizers feature a vibrating mesh delivery system. A screen with several thousand laser-drilled holes is placed across the reservoir holding the medicine, causing a cool mist for inhalation. The mesh also makes delivery more efficient, since it prevents the waste of medication commonly seen in atomizer models. 

Speed of medication delivery

When you are in the midst of an asthma attack, the speed and efficiency with which you receive your medication is crucial. A nebulizer’s capacity to deliver medication can range anywhere from four to eight liters per minute, and specific airflow rates can be found in any nebulizer product description. 

Helpful tip: You can enhance this speed by keeping the nebulizer filter clean!

Noise level

Less of a logistical necessity, and more of a personal preference, is the nebulizer’s noise level.

If you are planning on using your nebulizer at night, perhaps while falling asleep (and particularly with a child), be aware of how the larger the compressor, the louder the sound. For optimal comfort, factor your nebulizer’s noise level in amongst the other considerations you’ll be making as you choose the best nebulizer. 

Standout brands worth mentioning

While Rehabmart has a broad selection of top-of-the-line nebulizers, three of them stand out and are worth mentioning here:

  • Independence Medical produces the Omron Micro-Air Electronic Nebulizer, the smallest and lightest nebulizer available on the market! This portable unit weighs just six ounces, and fits snugly in the palm of your hand. The Omron Micro-Air makes use of a patented metal alloy system, which creates a compressed therapeutic aerosol as it moves medication through the mesh. This nebulizer has been highly praised by many, many users.

 

  • Roscoe Medical makes the Pediatric Neb Dog, a nebulizer for children that looks just like Snoopy! Created from durable plastic, this tool delivers up to eight liters of breathable medicine per minute. Children are comforted by the Neb Dog’s friendly face, and parents rave about the way it’s helped their children comply with their breathing treatments.

 

  • Finally, Drive Medical has created two standout nebulizer products. First, the MedNeb Plus Compressor Nebulizer is a cost-effective, piston-driven compressor that users have reported to be both durable and efficient. It includes batteries that will last far longer than your treatment time. Secondly, the Traveler Portable Compressor is a powerful machine that’s only about the size of a postcard! It runs quietly, and has a backup battery option, making it great for long trips.

What else do I need to know about choosing the best nebulizer?

Sterilization and cleaning of nebulizer components is very important to ensure user’s get the most out of their products while receiving the best level of treatment. Make sure to follow the manufacturer’s guidelines on how to store items between uses!

Although nebulizer parts are created to last a long time, individuals should always replace any mouthpieces, hoses, or high-contact pieces which are worn down, bent, discolored, or cracked in any way. 

Helpful tip: When replacement parts are needed, be sure you’re purchasing them from the same manufacturer, or from one who makes parts that are compatible with your nebulizer unit! 

Who needs a nebulizer? 

Children and adults with a range of diseases and conditions which impair respiration depend on the breathing treatments they receive via a nebulizer. This includes (but isn’t limited to) adults and children who have the following medical conditions:

  • Asthma
  • Emphysema
  • Cystic fibrosis
  • Muscular dystrophy 
  • COPD 

For someone living with one the aforementioned conditions, using an inhaler may be beyond their capability, particularly if these user’s lack strength and dexterity in their hands. In these cases, a nebulizer ensures medication is given when needed - even if it’s needed in a hurry, as with a rescue inhaler. 

Doctors will often prescribe a nebulizer for young children with frequent colds and upper respiratory illness. This is usually a short-term remedy, unless you and your doctor determine that other problems may be contributing (such as asthma)

Did you know that even babies and toddlers can need a nebulizer? While it’s hard to diagnose an infant with asthma, there are certainly cases where a baby or toddler will need breathing treatment. Many, though, will fight a mask, and not want to use a mouthpiece.

In these unique situations, pacifier nebulizers may be the answer! The pacifier attachment fits onto the mouthpiece, causing infants to naturally close their mouth around the device breathe through their nose. This way, medication is naturally inhaled and carried to the lungs.

What kind of medicine can be used with a nebulizer?

Nebulizers may be used to vaporize both long-acting medication and short-acting rescue medication. 

Common medications paired with a nebulizer are:

  • Corticosteroids - used to open constricted airways, and most commonly used to treat asthma. (Albuterol is a common one.) 
  • Ipratropium bromide – also opens airways, but is a long-acting drug.
  • Cromolyn sodium – a long-term medication which relaxes muscles as well as airways
  • Budesonide formoterol – a combined anti-inflammatory and bronchodilator used long-term.

Does Medicare cover the cost of a nebulizer?

Yes, Medicare Part B covers nebulizers and nebulizer medications as Durable Medical Equipment (DME), provided they have been prescribed by your doctor as medically necessary. 

In fact, you cannot purchase a nebulizer without a physician’s prescription! Getting a prescription is important not only to complete a purchase, but to submit for Medicare coverage of your device.

Talk to your doctor about questions you have regarding the process of purchasing a nebulizer, and how to ensure proper Medicare coverage. 

Does private insurance typically pay for nebulizers? 

Nebulizers are typically covered under the Durable Medical Equipment portion of health insurance policies. 

However, most insurance companies will require that you purchase your equipment from a particular medical equipment supplier to receive coverage. 

Check with your health insurance company to avoid misunderstandings!

For a full range of nebulizer options, visit RehabMart's category page

Want to learn even more? Keep reading with our article The 5 Best Nebulizers!

Author:

Co-Founder of Rehabmart and an Occupational Therapist since 1993. Mike has spent his professional career working in multiple areas of Occupational Therapy, including pediatrics, geriatrics, hand therapy, ergonomics and inpatient / outpatient rehabilitation. Mike enjoys writing articles that help people solve complex therapeutic problems and make better product choices.

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