A Cleaning Schedule for Breathing Equipment

Principles for all equipment

• Wash your hands before handling anything that goes in the nose or mouth.
• One person, one set. Never share masks, mouthpieces, cannulas, spacers or nebuliser cups.
• Clean, rinse, dry. Damp equipment grows germs and mould; drying fully is as important as washing.
• Use mild washing-up liquid and warm water, unless the maker recommends something else. Avoid harsh cleaners, bleach or strong disinfectants on parts that touch the face or airway unless the maker says they are suitable.
• Never put electrical parts in water: compressors, concentrators, CPAP machines and purifiers are wiped, not washed.
• Air-dry on a clean cloth or paper towel, not on a damp towel, and cover to keep dust off.
• Replace parts on schedule or when worn, cracked, cloudy or smelly.
• Keep a simple log with dates; see keeping a health record at home.
• Fire safety applies to everything oxygen-related: no smoking, flames, oil or grease.

The schedule at a glance

After every use - Nebuliser cup, mask or mouthpiece: rinse and air-dry. - Spacer: after steroid inhalers, rinse the mouth; wipe the mouthpiece. - Mask or cannula: wipe the face-contact parts.

Daily - Nebuliser parts: wash in warm soapy water, rinse, dry. - Oxygen humidifier bottle: empty, wash, refill with fresh water. - Cannula or mask: wipe. - Check tubing for kinks and moisture. - CPAP mask and humidifier chamber: wipe or wash.

Weekly - Concentrator intake filter: wash and dry. - Spacer: wash in warm soapy water and let drip dry. - Mask and tubing: wash if the maker allows. - Pre-filter of air purifier: vacuum or wash if washable. - Nebuliser: disinfect parts as the maker allows. - Peak flow mouthpiece: wash.

Monthly or as advised - Replace cannula, mask and nebuliser tubing and cups at the maker's interval. - Check and replace concentrator and compressor filters. - Wipe the exterior of machines.

Every few months - Replace humidifier bottles, CPAP masks and cushions, air purifier main filters, as instructed.

The details follow.

Nebulisers

See nebulisers: types, use and cleaning and how to use a nebuliser step by step.

After each treatment 1. Disconnect the cup, mask or mouthpiece from the tubing; leave the tubing attached to the compressor. 2. Take the cup apart. 3. Rinse the parts in warm running water, shake off water and put on a clean cloth or paper towel to dry. 4. Run the compressor for a minute with the tubing attached and nothing in the cup to dry the tubing. 5. When dry, reassemble and store in a clean, covered container.

Daily - Wash the parts in warm water with mild liquid soap, rinse well and air-dry.

Weekly (or as the maker advises) - Disinfect heat-safe parts by boiling, or soak in a diluted solution recommended by the maker, such as a vinegar and water mix. Rinse and dry. Do not boil parts that are not heat-safe, and do not soak the tubing unless the manual permits.

Monthly or as advised - Replace the cup, mask or mouthpiece and tubing at the supplier's interval, and the compressor filter. Replace sooner if cloudy, cracked or sticky.

Never wash or immerse the compressor. Wipe with a damp cloth.

Inhalers and spacers

See inhaler technique and spacers for older adults.

• Inhaler mouthpiece: wipe the outside with a clean dry cloth weekly, and follow the leaflet to clean pressurised inhalers, which may involve rinsing the plastic holder (not the canister) and drying fully. Dry powder inhalers are usually wiped, not washed.
• Spacer: wash weekly, or as the maker says, in warm water with a drop of washing-up liquid, do not rub the inside dry, and let it drip dry in the air, because wiping creates static that makes medicine stick to the walls. Rinse well and replace it as the maker advises, commonly every six to twelve months, or sooner if cracked.
• Mask on a spacer: wipe and wash like the spacer.

Oxygen cannulas, masks and tubing

See nasal cannulas and oxygen masks: choosing and caring for them.

• Daily: wipe the prongs and the face contact areas with a damp cloth and mild soap, rinse and dry. Check the skin.
• Weekly: wash masks in warm, soapy water, rinse and air-dry. Tubing is usually wiped, not washed; follow the supplier's advice.
• Replace cannulas about every two to four weeks, tubing every one to three months, and masks as advised, or at once after a cold, flu or chest infection, or if dirty, stiff or damaged.
• Never use oil, grease or alcohol-based products on parts or the face while oxygen is in use.
• Keep spares in a clean, closed bag.

Humidifier bottles for oxygen

See using an oxygen concentrator safely at home.

• Daily: empty any remaining water, wash with warm soapy water, rinse thoroughly and let dry, then refill with fresh water of the type advised, commonly distilled or boiled and cooled water, up to the marked level. Do not top up old water.
• Weekly: disinfect as the maker advises, such as with a diluted vinegar solution, then rinse well.
• Replace the bottle as the supplier advises, and sooner if cloudy, cracked or smelly.
• Do not run a dirty bottle; contaminated vapour can cause chest infection.

Concentrator and compressor filters

• Concentrator intake filter: wash weekly in warm soapy water, rinse, squeeze gently, dry completely and replace. Clean more often in dusty or smoky conditions. Never run without it.
• Machine exterior: wipe with a damp cloth, keep vents clear.
• Service as the maker or supplier advises, and ask about internal filter replacement.
• Oxygen cylinders need no cleaning inside; wipe the outside with a dry cloth, and keep oil and grease away. See oxygen cylinder safety at home.

CPAP equipment

See sleep apnoea in older adults: signs and next steps.

• Daily: wipe the mask cushion and wash the humidifier chamber; empty water after use and let it dry.
• Weekly: wash the mask, headgear and tubing in warm soapy water; rinse; air-dry out of direct sunlight.
• Filters: rinse or replace as the maker says.
• Replace mask cushions, masks, tubing and chambers at the recommended intervals.
• Do not use scented products or harsh cleaners that leave residue.

Peak flow meters, oximeters and thermometers

• Peak flow mouthpiece: wash weekly in warm soapy water, rinse and dry, and keep clean. Never share. See peak flow meters: tracking asthma and breathing at home.
• Oximeter clip: wipe the inner surfaces with an alcohol wipe, allow to dry; do not immerse. See pulse oximeters: how they work and how to use one.

Air purifiers and humidifiers

• Air purifier: clean the pre-filter every one to two weeks; replace HEPA and carbon filters as the maker advises. See air purifier filters: replacement, costs and maintenance.
• Room humidifiers, if used: empty, wash and dry daily and descale weekly, as dirty humidifiers spread germs and mould. Avoid them in damp weather.

Humidity, heat and dust in Indian homes

• Dry thoroughly in the monsoon: use a clean, dry cloth, place parts in a well-ventilated spot out of the damp, and avoid sealed boxes with wet parts.
• Store in clean, dry containers with lids, away from the bathroom and kitchen steam.
• Watch for mould, pink or black spots, or a musty smell; replace affected parts and clean the storage area.
• Dust: cover equipment when not in use.
• Insects: keep tubing and masks in closed containers, away from cockroaches and ants.
• Water quality: if tap water is hard or unclean, use distilled or boiled and cooled water for humidifiers and rinsing parts that contact the airway.
• Power cuts: a nebuliser or humidifier may be left half cleaned; clean when power returns.

See pest, damp and mould at home and infection control for home caregivers.

During and after infection

When your parent has a chest infection, a cold, flu, COVID-19 or other illness:

• Clean equipment more often.
• Replace cannulas, masks, tubing and nebuliser parts when recovered.
• Wear gloves or wash hands carefully when handling equipment used by an infected person.
• Do not allow others to use the equipment.

A simple chart

Make a small table, with columns for the item, how often and the last date, and keep it near the equipment. Mark it each time. Share the chart with family and helpers, and brief them on safe handling. See training a new attendant: first week.

When to ask a professional

Ask the supplier or nurse to show how to clean each item and how often to replace it. Ask the doctor if your parent has frequent chest infections, as equipment hygiene may be part of the reason, and a review of treatment may help. Call the doctor for fever, increased cough, breathlessness or a change in sputum. Call 112 for severe breathlessness, blue lips, confusion or chest pain.