Nasal Wash Treatment
The Centers for Disease Control (CDC) recently updated the guidelines for preparing the water used in a nasal wash. These updates are listed below.
Many people with asthma or other lung problems also have nasal and sinus symptoms. Drainage from your nose and sinuses can make asthma worse, especially at night. A saltwater nasal wash, or nasal irrigation, can help reduce this.
A nasal wash:
Cleans mucus from the nose, so medication can be more effective
Cleans allergens and irritants from the nose, reducing their impact
Cleans bacteria and viruses from the nose, decreasing infections
Decreases swelling in the nose and increases airflow
Watch How to Perform a Nasal Wash
CDC Water Preparation Guidelines
Wash your hands.
Make the nasal wash solution.
Do not use tap water for the nasal wash (unless boiled or filtered as described below). Do not use well water.
You may use:
Tap water that has been boiled for 1 minute (at elevations above 6,500 ft., boil for 3 minutes) and cooled, or tap water that is filtered using a filter with an absolute pore size of 1 micron or smaller
Whichever water you use to make the saline solution, replace container or water at least weekly.
To make the saltwater solution, mix one-half teaspoon noniodized salt in an 8-ounce glass of water (described above). Noniodized salt is used because iodized salt may be irritating when used over a long period of time. Add a pinch of baking soda. A pinch is a small amount you can pick up between two fingers. If you are congested, use the entire 8 ounces of saltwater during the nasal wash; otherwise, 4 ounces should be enough.
Discard any unused saltwater and prepare a new saltwater solution before the next nasal wash.
Position for the Nasal Wash
Adults and older children - Lean far over the sink with your head down.
Younger children - If possible, have your child lean as far over the sink as possible. A small child may have trouble cooperating with a nasal wash, and may need to be held and assisted. Ask your health care provider about ways to hold a small child when doing a nasal wash.
Perform the Nasal Wash
Ask your health care provider to discuss which of these techniques may be best for you.
Techniques for Adults and Older Children
Sinus Rinse Kit Technique (preferred technique) —
The Sinus Rinse Kit comes with a Sinus Rinse bottle and mixture packets. When using the Sinus Rinse Kit, you can use the prepared mixture packets that come with the kit or you can make your own nasal wash solution described above. The Sinus Rinse bottle is filled with saltwater. The bottle is placed against the nostril. After the bottle is squeezed, saltwater comes out the opposite nostril and may come out the mouth. The nose is then blown gently. The procedure is then repeated with the other nostril.
Bulb Syringe Technique (alternate technique) — Use a large all-rubber ear syringe. An ear bulb syringe can be purchased at most pharmacies. Fill the syringe completely with the saltwater. Insert the syringe tip just inside your nostril, and pinch your nostril around the tip of the bulb syringe to keep the solution from running out your nose. Gently squeeze the bulb to swish the solution around in your nose; then blow your nose lightly. Repeat the procedure with the other nostril.
Waterpik® Technique (alternate technique) — Use a Waterpik with a Sinus Irrigator Tip. Pour the saltwater into the water reservoir and set the Waterpik at the lowest possible pressure. Insert the tip just inside your nostril, and allow the fluid to run out of your mouth or other nostril. Blow your nose lightly. Repeat the procedure with the other nostril.
Hand Technique (alternate technique) — Use your hands for this technique. Pour some saltwater into your palm. Sniff the liquid up your nose, one nostril at a time. Blow your nose lightly. This technique may not be as effective, but may be used in some situations.
Techniques for Babies
Babies — Use Nasadrops™ or a saline spray for doing a nasal wash with a baby. Place a small amount of the saltwater in your baby's nostril. Use a bulb syringe to suction the mucus from your baby's nose. Repeat the procedure with the other nostril. Ask your health care provider to show you how to do this.
With any technique, the saltwater solution may get into the mouth during the nasal wash and leave a salty taste. You may want to rinse the mouth with water after the nasal wash.
Cleaning the Equipment
To prevent the growth of bacteria, you must thoroughly clean the equipment used for a nasal wash. It is important for each family member to have his/her own bulb syringe or nasal adaptor.
Cleaning the Sinus Rinse Bottle
After each use, put a small amount of dishwashing detergent in the bottle. Add water (described above). Secure the cap with the tube onto the bottle. Shake the bottle. Rinse the bottle, tubing and cap with water. Shake off any excess water and allow the pieces to dry on a clean towel.
If you feel the system is discolored or contaminated, clean the bottle, cap and tubing with rubbing (70 percent isopropyl) alcohol or white, distilled vinegar (1 part vinegar to 3 parts water). After the use of either solution, rinse the pieces well with water and shake off the excess water. Again, allow the pieces to dry on a clean towel. You may also place the bottle tubing and cap in the microwave for 1.5 – 2 minutes.
The Sinus Rinse bottle is not cleaned well using the dishwasher.
Replace the Sinus Rinse bottle every 3 months or if it becomes discolored.
Cleaning The Bulb Syringe (dropper, syringe or nasal spray bottle)
After each use (which may be several times a day), fill the bulb syringe with water (described above), swish the water around, and empty the bulb syringe completely. Always suspend the bulb syringe tip-down in a clean glass to allow the bulb syringe to drain completely. Do not allow the bulb tip to sit in a puddle of water.
In addition to rinsing the bulb after each use, clean the bulb daily with rubbing (70 percent isopropyl) alcohol. Draw the rubbing alcohol into the bulb syringe. Swish the liquid around, and empty the bulb syringe. Again, suspend the bulb syringe tip-down in a clean glass to allow it to drain completely.
If you have any questions about these nasal wash techniques, please ask your health care provider. Your health care provider can discuss which technique is best for you.
This information has been approved by Ann Mullen, RN, MSN, AE-C (February 2012).