These instructions from Children’s Hospital of Philadelphia describe how to clean home respiratory equipment. Specific instructions are included for patients with cystic fibrosis.

Important information:

Patients with cystic fibrosis need to follow different cleaning protocols.  Proceed to the bottom of the page for these specialized instructions.

Cleaning instructions for the child without cystic fibrosis

Supplies needed for cleaning your breathing equipment:

• Mild dish detergent
• Boiled tap water. Only use tap water that has been boiled for 5 minutes. Change the water after 24 hours.
• Re-sealable plastic bags
• Soft brushes
• Cloth or paper towels
• Plastic containers with lid (2)

Instructions for cleaning equipment after each treatment:

1. Wash hands.
2. Take apart equipment and rinse with warm water.
3. Shake off excess water.
4. Allow to air dry on a clean towel.

Instructions for daily cleaning of equipment:

Perform the following steps daily or if mucus is visible on the equipment

1. Wash all the parts in warm water with mild dish detergent.
2. Use soft brushes to remove dried secretions. Do not use any brushes on the tracheostomy speaking valves (Passy-Muir valves).
3. Rinse well with boiled water.
4. Place all parts on a clean towel to air dry. Cover with another clean towel.
5. When completely dry, put the parts back together and store in plastic bags.

Equipment to clean:

• Medication nebulizer, mask/t-piece
• Tracheostomy Speaking Valve
• CPAP/BiPAP interface
• Aerochamber and mask
• Trach collar
• Oral suction devices
• Cough Assist interface/tubing if secretions are present

Instructions for weekly disinfection:

1. Wash all the parts in warm water with mild dish detergent.
2. Use soft brushes to remove dried secretions. Do not use any brushes on the tracheostomy speaking valves (Passy-Muir valves).
3. Soak the parts in a large container to completely cover the pieces with a solution of:
   • 1-part white vinegar (1 cup) and 3 parts water (3 cups)
   • Soak for 30 minutes
4. Rinse the parts well with boiled water.
5. Air dry on a clean towel on a clean table or counter. Cover with another clean towel.
6. When completely dry, put the parts back together and store in a clean airtight container.

Equipment to clean:

• CPAP/BiPAP interface
• Cough Assist interface and tubing adapters
• PEEP Valves
• Medication nebulizer, mask/t-piece
• Aerochamber mask
• Humidifier canisters for heaters
• Suction Canister
• All tubing adapters or “Y’s”
• Oral suction devices

Helpful hints:

• Do not wash equipment parts in a dishwasher using the heated dry cycle.
• Do not reuse the water/vinegar solution. Make it fresh each time.
• Certain tracheostomy tubes are made to be reused, but they come with separate cleaning and disinfecting instructions.
• Tracheostomy speaking valves cannot be placed in vinegar. See instructions that come with the speaking valve.
• Only air-dry equipment. Do not dry with paper towels or cloth.

Instructions for cleaning suction machines:

1. At the end of each shift, empty the contents in canister into the toilet and flush.
2. Rinse the canister with water.
3. The outside of the machine may be wiped with a damp cloth and mild detergent.
4. Replace the canister and tubing as per your durable medical equipment company (DME).
5. Replace the filter when it becomes gray colored or as per DME.

Instructions for cleaning suction catheters:

At home, suction catheters may be reused unless your child has an active infection or is at higher risk for infections, for instance a patient receiving certain treatments for cancer. You will get a limited supply of suction catheters at home, so you will need to reuse them if your child requires frequent suctioning. This can be done safely according to guidelines set for the home. Your DME company will tell you which method to use to clean the catheters.

Option 1

• Only partially open the suction catheter wrapper.
• After clearing the airway, rinse the catheter with distilled or boiled water.
• “Suction” air into the catheter to help dry it.
• Return the catheter to the plastic wrapper and reuse it if more suctioning is needed within 4 hours.

OR

Option 2

• After suctioning, rinse the catheter with distilled or boiled water.
• Remove the catheter from the suction tubing and place in a small container, which has 1 part vinegar (1/4 cup) and 3 parts distilled or boiled tap water (3/4 cup).
• Allow the catheter to soak for 30 minutes in vinegar solution.
• Remove the catheter, rinse with distilled or boiled water.
• Place catheter in dry container lined with paper towels to air dry (usually dry within 8-12 hours) and then reuse.

Instructions for cleaning of oral and nasal suction devices:

If you are using a suction catheter for oral/nasal suctioning, use it for 24 hours.

Keep it separate from catheters used for the tracheostomy.

• Catheters are made to be re-used.
• Rinse catheter between uses and “suction” air into device to help dry.
• You may wipe the outside area of the device with alcohol to help it dry.
• Keep in clean area while waiting for next use.
• Clean daily, following instructions above.
• Disinfect weekly, following instructions above.

Cleaning instructions for the child with cystic fibrosis

Instructions for daily cleaning of equipment:

Perform the following steps daily or if mucus is visible on the equipment

1. Clean and disinfect all equipment that touches mucus membranes after each use.
2. Wash all the parts in warm sterile water with mild dish detergent.
3. Use soft brushes to remove dried secretions. Do not use any brushes on the tracheostomy speaking valves (Passy-Muir valves).
4. Rinse well with sterile water only.
5. Place all parts on a clean towel to air dry. Cover with another clean towel.
6. When completely dry, put the parts back together and store in plastic bags.

Instructions for disinfecting equipment:

Follow manufacturer guidelines. If the equipment does not come with cleaning instructions, you may use one of the methods below:

1. Soak in boiling water for 5 minutes. Use a standard cycle dishwasher.
2. Microwave for 5 minutes.
3. Soak in either:
   • Household bleach diluted 1 part bleach (5 mL) and 50 parts water (250 mL) for 3 minutes.
   • Soak in 70%-90% ethyl or isopropyl alcohol for 5 minutes.
4. Air dry all equipment. Do not dry with a towel.

If you have any questions about your child’s health, please contact your child’s healthcare provider. This document is intended only to provide general educational information and is not intended as medical advice or treatment. Please consult with your healthcare provider prior to use, as some of this information may need to be adapted for your child’s specific needs. It is the responsibility of your healthcare provider to advise you on the appropriate use of this information. If you/your child are not already a CHOP patient, this document does not create a doctor-patient relationship between you/your child and CHOP. CHOP is not responsible for any outcomes you/your child might experience from your use of this document. This document is provided "AS IS", WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, express or implied. If this document refers to any drugs or medical devices, it is the responsibility of your healthcare provider to check the FDA status prior to use. If this document includes references to drug dosing, please do not rely on this document. Your healthcare provider should check the package insert for each drug before use. Hyperlinks used within this document may not be translated into other languages.

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