Airway clearance order of devices?

Hi, welcome to the group. Generally speaking, the order of things is two puffs of albuterol (wait 5-10minutes) -> 7% saline via nebulizer -> aerobika for an allotted amount of time.

Some people nebulize 7% saline and use the Aerobika at the same time. This cuts down on time spent as it combines the two. Do you need assistance figuring out what type of compressor and nebulizer to use?

That would be helpful. I have heard that there’s a way to hook the Aerobika to the nebulizer but don’t know the details or where to get that. Also, I always have nebulized the entire vial of Albuterol before moving to the saline. Are you suggesting I don’t need to do that much Albuterol? Thanks!

I think Scoop is using 2 puffs of an Albuterol inhaler rather than nebbing it. I usually neb the Alberto and the entire vial gives the dose the doctor ordered. You're doing it correctly.

My pulmonologist OK'd using an inhaler just for trips or rushed days.

@johnwpatrick To further clarify: the nebulized version of the "puffer" albuterol is called levalbuterol (link below). To get started with nebulizing you'll need:

1. compressor: tried and true is the Ombra compressor, which is a jet compressor. This plugs into the wall. There are other options but this one is the most popular. Does not require a prescription.
2. nebulizer handset, which "plugs and plays" with the Ombra, called Aeroeclipse breath activated. Does not require a prescription.
3. aerobika - oscillatory PEP (Positive Expiratory Pressure). Does not require a prescription.

The aerobika slides onto the end of the nebulizer handset, so that you can nebulize saline and use the aerobika PEP device at the same time.

Many people use hypertonic saline, either 3% or 7%, which requires a prescription, but is not covered by insurance.

Here's a video by one of our members showing how it all works together:
https://connect.mayoclinic.org/discussion/short-video-on-nebbing-saline/
Here are a few links to one vendor who I have purchased from before but there are others. Let us know if you have follow-up questions.
https://www.saveritemedical.com/products/aerobika-opep-oscillating-positive-expiratory-pressure-therapy-system
https://www.saveritemedical.com/products/ombra-120v-table-top-nebulizer-compressor-system
https://www.saveritemedical.com/products/monaghan-aeroeclipse-xl-breath-actuated-nebulizer-ban?variant=33232366633046
https://www.drugs.com/mtm/levalbuterol-inhalation.html (requires a prescription).

On the chance that you have Kaiser Permanente insurance, you should know that Kaiser does cover 7% hypertonic saline. I pay $12. for a month supply.

@scoop Albuterol and Levabuterol are not the same. I have both. Both are available as inhaler and nebulizer vials

I have BCBS and they cover the 7% saline. You can buy it online without a prescription but you will pay more . I was buying it from Base Laboratories before I got my prescription. https://baselaboratories.com/products/base-labs-nebulizer-saline-solution-vials-25pk

Thanks for the advice!

@reneemc Thanks for the clarification. I am among the few who have a paradoxical reaction to levalbuterol. It's supposed to eliminate jitteriness but instead increases them in me. Sadly, I have a whole closet filled with levalbuterol ampules.

I have a surplus of Albuterol due to jitters. My insurance doesn’t pay for the Levabuterol but it makes me less shaky