We recommend you have normal saline through a nebuliser every four to six hours while you are awake. Your treating medical team will tell you whether to change the amount of saline or how often you have it. This will help keep your secretions thin and easier to cough up.

Equipment you will need:

You can buy this equipment from your local pharmacy

• laryngectomy/tracheostomy masks x 2 will be supplied by the hospital
• nebuliser (bowl) canister
• 5mL syringe - clean
• 5mL normal saline – sterile plastic ampoule (this type of saline has the right concentration of salt and water for you to use)
• nebuliser unit and tubing
• tissues.

How to use the nebuliser:

1. Wash your hands with soap and water and dry your hands with a clean towel. If you prefer, instead of washing your hands, you can use hand sanitiser following the instructions on the bottle. Make sure you let the hand sanitiser dry before moving to the next step.
2. Set out all the equipment on a clean bench or work space in your home.
3. Draw up 5mL of normal saline from the vial into a clean syringe.
4. Remove the top of the nebuliser canister and place the normal saline into the collection chamber. Replace the top of the nebuliser canister.
5. Connect the nebuliser canister to your laryngectomy/tracheostomy mask. Place the mask over your stoma and secure it around your neck firmly with the elastic. Do not make the elastic too tight. If you are uncomfortable, loosen the elastic a little.
6. Turn on the nebuliser unit at the switch.
7. Breathe slowly.
8. After 5 to 10 minutes, or as long as your doctor or your health care professional has advised you, turn off the nebuliser unit. Take off the mask. There could be a small amount of normal saline left in the canister after your treatment. This is normal.
9. Cough up phlegm into a tissue if you need to. Put used tissues in the bin. Don’t put tissues down the toilet as they can block your plumbing.
10. Wash your hands with soap and water. Dry your hands with a clean towel. Or you can use hand sanistiser.
11. Remove the top of the nebuliser canister and discard any unused normal saline. Also discard the ampoule you have used, including any saline left in it.
12. Wash your hands with soap and water. Dry your hands with a clean towel.

Looking after your nebuliser and mask

• At the end of each day wash the nebuliser canister, mask and syringe (after removing the plunger from the barrel) in warm soapy water. Rinse with tap water and allow to air dry on clean paper towel. Once dry store the equipment in a clean covered container.
• It is a good idea to have two reusable nebuliser canisters, masks and spare syringes. This way you can use one each day while the other is drying.
• Check the nebuliser canister and mask each day for signs of wear and tear.
• The nebuliser canister and mask can be used for as long as they are in good condition.
• Always refer to the manufacturer’s instructions regarding your nebuliser machine.
• Please contact your local pharmacy, or where you purchased the nebuliser from, if you need any further information.