SINUSTAR Nebuliser Instructions Rev May 2006

6. Replace the nebulizer insert (Fig. B). The semi-circle should face the nebulizer outlet. The two alignment rings should now be lined up with each other (See page 3). 7. Insert the nasal adapter into the mouthpiece. Attach the mouthpiece with the nasal adapter into the nebulizer outlet (Fig. B). Then attach the inspiratory valve cap by pressing firmly into the nebulizer insert. The inspiratory valve cap is designed to fit snugly. Refer to PARI SinuStarTM Reusable Nebulizer with nasal adapter illustration on page 3. 8. Firmly press the other end of the tubing onto the air intake on the bottom of the PARI SinuStarTM Reusable Nebulizer (Fig. B). The tubing is designed to fit tightly.

WARNING Check PARI SinuStarTM Reusable Nebulizer with nasal adapter for proper assembly. All parts should be seated firmly in place. Use of an improperly assembled nebulizer could prevent adequate delivery of medication.

III. AEROSOL NASAL TREATMENT 1. Take your treatment as directed by your physician. 2. Treatment with the PARI SinuStarTM Aerosol Delivery System is most effective when the nasal passages are not blocked. Before starting therapy with the SinuStarTM Aerosol Delivery System please make sure the nasal passages are clear by rinsing with a nasal irrigator according to the manufacturer’s instructions for use. 3. Sit in a relaxed, upright position and turn the compressor on. 4. Place the PARI SinuStarTM Reusable Nebulizer with nasal adapter comfortably but firmly under the nose. Inhale and exhale normally through your nose. Do NOT inhale deeply. Breathe normally with the nasal adapter under the nose during the entire treatment. 5. Continue step 3 until the medication is gone or you hear a “sputtering.”

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IV. CLEANING THE PARI SINUSTARTM REUSABLE NEBULIZER WITH NASAL ADAPTER 1. Disconnect the tubing from the air intake on the bottom of the nebulizer cup. 2. If there is any moisture (condensation) in the tubing, let the compressor run with only the tubing attached for 2-3 minutes. The warm air from the compressor will dry out the tubing. Alternatively, you can dry the tubing by removing it from the compressor and hanging it up with the "ends down" to allow any moisture (condensation) to drain out and evaporate. Use a clean damp cloth to wipe the exterior of the tubing. 3. Disassemble the PARI SinuStarTM Reusable Nebulizer with nasal adapter parts as illustrated on page 3. 4. Wash all parts with warm water and liquid dish soap. DO NOT WASH THE TUBING. 5. Rinse the PARI SinuStarTM Reusable Nebulizer with nasal adapter parts thoroughly with warm water and shake out water. 6. Air dry or hand dry PARI SinuStarTM Reusable Nebulizer with nasal adapter parts on a clean, lint-free cloth. Reassemble nebulizer with nasal adapter when parts are dry and store. 7. You can also wash all parts of the PARI SinuStarTM Reusable Nebulizer with nasal adapter on the top shelf of a dishwasher. DO NOT WASH TUBING. Place the PARI SinuStarTM Reusable Nebulizer with nasal adapter parts in a dishwasher basket, then place the basket on the top rack of the dishwasher. Remove and dry the parts when the dishwasher cycle is complete.

WARNING, TO REDUCE RISK OF INFECTION: 1. Nebulizer for single patient use (one person) only. Do not share your nebulizer with other patients. 2. You must regularly disinfect or sterilize the PARI SinuStarTM Reusable Nebulizer with nasal adapter between treatments. Failure to do so could lead to serious or fatal illness.

PARI SINUSTARTM REUSABLE NEBULIZER WITH NASAL ADAPTER INSTRUCTIONS FOR USE

PART# 22F59

FOR SINGLE PATIENT USE (ONE PERSON) ONLY

For patients with Cystic Fibrosis, the CF Foundation recommends boiling for a full 10 minutes to disinfect.

V. DISINFECTING AND STERILIZING THE PARI SINUSTARTM REUSABLE NEBULIZER WITH NASAL ADAPTER 1. Clean the PARI SinuStarTM Reusable Nebulizer with nasal adapter as described in section IV. Every other treatment day, soak all parts of the PARI SinuStarTM Reusable Nebulizer with nasal adapter (except tubing) in a solution of 1 part distilled white vinegar and 3 parts hot tap water for 1 hour. You can substitute respiratory equipment disinfectant (like Control III®) for distilled white vinegar (follow manufacturer’s instructions for mixing). 2. Rinse all parts of the PARI SinuStarTM Reusable Nebulizer with nasal adapter thoroughly with warm tap water and dry with a clean, lint-free cloth. Discard the vinegar solution when disinfection is complete. 3. The PARI SinuStarTM Reusable Nebulizer with nasal adapter parts (except tubing) may also be disinfected by boiling them in a clean pot of water for a full 10 minutes. 4. Hospitals and clinics can sterilize the PARI SinuStarTM Reusable Nebulizer with nasal adapter parts (except tubing) by autoclaving (a maximum of 277° F or 126° C), follow autoclave manufacturer’s instructions. 5. Dry parts on a clean, lint-free cloth. CONTROL III® IS A REGISTERED TRADEMARK OF MARIL PRODUCTS, INC.

THE PARI SINUSTARTM REUSABLE NEBULIZER WITH NASAL ADAPTER INCLUDES A 6 MONTH LIMITED WARRANTY FOR HOME CARE USE

VI. PROCEDURE FOR RETURNING THE PARI SINUSTARTM REUSABLE NEBULIZER WITH NASAL ADAPTER 1. Contact PARI Patient Connection at 1.800.FAST.NEB, then press 2 for shipping instructions. 2. Clean, disinfect and/or sterilize the PARI SinuStarTM Reusable Nebulizer with nasal adapter as indicated on the previous page. Dry the PARI SinuStarTM Reusable Nebulizer with nasal adapter and place in a plastic bag. 3. In writing, describe the malfunction or symptoms of the PARI SinuStarTM Reusable Nebulizer with nasal adapter. Include your full name, address and daytime telephone number. 4. Send written description and PARI SinuStarTM Reusable Nebulizer with nasal adapter in a protected box to the address provided by Patient Connection.

DS-22-660 Rev 5/06

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WARNING CAUTION: U.S. Federal Law restricts this device to sale by or on the order by a physician. Read all warnings and instructions before use. Improper use can result in serious or fatal illness or injury. Nebulizer is not sterile. The PARI SinuStarTM is a handheld nebulizer designed to aerosolize medication approved for nebulization and prescribed by a physician. The nasal adaptor facilitates delivery to the upper airways. The PARI SinuStarTM Reusable Nebulizer with nasal adapter is intended for adult and pediatric patients consistent with the indications for aerosol medication.