using same saline vial across multiple nebulizing sessions

I store opened vials upright in a cleaned prescription bottle in the refrigerator for later use. According to the RT in the hospital, this is safe for 24 hours. So, if you neb twice a day, you can use each vial 3 times, morning-evening-morning or evening-morning-evening. If you only neb once a day, neb twice and throw the rest away.
I have done this for years, depending on what is available, and haven't had a problem in over 6 years.

Sue,
This is useful! Thanks,
Sarah

@yardsend This was the advice from the respiratory therapist at my pulmonologist's office. They are very conscientios there, but also sensitive to cost issues.

@sueinmn thank you. Did they explain why it should be refrigerated after opening and why only safe for 24 hrs? I can't imagine how the opened vial could get exposure to NTM if it's stored in a closed, sterilized container.

@sueinmn @six5532one Also, should the vial be at room temperature before using? When I started Arikayce, the trainer told me to make sure vial was at room temperature because using cold solution would cause broncho spasms.

For the 2 or 3 years I have been nebulising hypertonic saline I have been using the 10ml sachets by cutting them open, using half, folding sachet over and paperclipping it down till I do the next neb either that day or the next, keeping them at room temperature. I can't understand how that could be a problem, although at a recent webinare in Australia it was recommended not to use half vials and to keep refrigerated. I have continued to do as I have been.

@mjb24 I don't have the answer, will ask my pharmacist tomorrow if she knows. If I take it out of the refrig as I prep, that tiny amount is just fine by the time I sit down to neb.

After a bit of looking, I found a resource that seems a good source from Australia addressing this.
https://buyauracle.com/products/saline-sachets-20-pack
I looked because I also put the vial with half the hypertonic saline in an alcohol wiped med bottle for 24 hours when it is a 5ml vial. The 2.5 takes about 20" with Proneb Max now and since I'm using it for prevention and rarely produce sputum, I think that's enough. When I got a 4ml vial, half didn't last long enough and I just put all solution in. (Btw, my ProNeb uses virtually all solution in cup). I have not been keeping it in refrig, but should and will.

The reason for discarding after 24 and keeping in refrig is because bacteria takes time to multiply and they prefer warm temps. Bacterial load is a factor in a pathogen's ability to cause infection, therefore refrigerating and limiting the time an accidental contaminate has to grow decreases risk of infection.

@six5532one my preference is to use single use vials. As others have pointed out there are contamination concerns with storing open saline. My pharmacist discourages it.

@pacathy thanks for explaining the reason for those precautions. That's helpful!