1. Nebuliser & compressor use in NZ Cystic Fibrosis clinics
Jan Tate
CFNS
STARSHIP
MAY, 2016

2. Total 17 / 23 clinics analysed
Questionnaires
14 paediatric clinics returned
9 adult clinics 4 returned
Total 17 / 23 clinics analysed

3. Total number of CF Patients
Paediatric pts 191
Nebulising %
Adult pts 184
Nebulising %
TOTAL 239 / 375 CF pts

4. Pari products used
100% (x 1 clinic used x 1 Respironic side stream disposable)
17 / 17 clinics replied:
Pari Turbo boy compressors used: pts
Pari e-flow used: pts
Other: (Respironic) pt

5. Who supplies ? Pari Turbo Boy compressors (217) CFA 189 DHB 28
E-flow (41)
CFA 31
DHB
Other

6. Who services compressors?
Most do annually
x 2 clinics unknown
x 1 clinic not done
Responsibility:
NS / physio / Fieldworker / DHB / Hospital aide / parent or on patient request

7. Consumerables: who provides ?
Pari nebuliser, tubing, filter attachments, mouthpieces, filter pads, masks:
17 clinics
DHB 100%
CFA provide e-flow parts for x 2 clinics
Self funding for e-flow parts x 2 clinics
Physiotherapy devices:
DHB x 17 & CFA x 2 (some consumerables)

8. Consumerables changed
Annually
3 – 6mthly
Monthly
PRN
Unknown
Nebuliser & filter set 7 10
+ all
Tubing 2 6 1
Annually
3 – 6mthly
N/A
Unknown
Masks 6 2 7
Annually
3 – 6mthly
PRN
Not done
Unknown
Physio
devices 3 4 1 5

9. Cleaning of equipment
Nebulisers, mouthpieces, filter / valve sets, masks:
wash & leave to dry BD
Sterilise daily / BD / weekly
Boil for 10 mins weekly
Tubing:
blow through compressor & leave to dry
wash weekly
boil weekly
Physio devices:
as per nebulisers
wash weekly
Unknown

10. Filter / valve set used with antibiotics:
16 / 17 clinics used filter/valve set
Steriliser used for cleaning:
15 / 17 clinics used & supplied mostly by CFA, some self funded
Replacement compressors (may have been used by another person with CF:
No 7
Yes 10

11. DO NOT USE NEBULISER IF WET
What is nebulised in CF?
Hypertonic Saline
Antibiotics (TOBI, Amikacin, Meropenem)
Pulmozyme
Require separate nebuliser for each medication
DO NOT USE NEBULISER IF WET

12. Pari products for CF pts
Recommendations
Pari products for CF pts
Compressor: medium output (Pari Turbo Boy or Pari mobile S)
Nebuliser: Pari LC Sprint (red nozzle insert for smallest droplet size, blue nozzle insert for older children & adults)
Filter/Valve Set: when antibiotics are nebulised
Mask: Pari Baby mask with baby bend for infants or Starfish mask for older children (cannot filter)
Sinus nebuliser: for acute & chronic sinusitis

13. Equipment change recommendations
Nebuliser, filter/valve set (for antibiotics), mouthpiece, baby or Starfish mask, sinus nebuliser: annually or PRN
Mouthpiece may need to changed more frequently
Filter pads: company state after each use, in practice use x2 filter pads weekly (x1 morning & x1 evenings then discard after week)
Tubing: company state annually, in practice change 1 – 3 monthly
Physio device: annually or PRN
E-flow device: handset – annually
aerosol head – 6mthly

14. Cleaning recommendations
Nebuliser, antibiotic filter/valve set, mouthpiece, baby or Starfish mask, Pari PEP device: wash in hot soapy water, rinse, sterilise (“baby bottle” steriliser) & leave to dry in covered container
Filter pads: leave to dry for 24hrs then discard after 1 week
Tubing: leave tubing on compressor, remove nebuliser & blow air through for a few mins