@sarahlynn1960 Well, maybe not sterile - but has anyone ever seen a respiratory therapist open a sealed bag containing a nebulizer and tubing, in the hospital or a rehab setting, and clean it before setting it up and treating the patient?
I haven't, and my daughter, and ER nurse, says they never do it either. So for me, I take this as my cue that it is "good enough", so I have always used my nebulizers straight from the (sealed) package.