Hold it! Correct use of inhalers in children with asthma

• Published in: The Western journal of medicine Vol. 175; no. 5; pp. 303 - 304
• Main Authors: Abrolat, Marla Law, Nguyen, Lan-Phuong, Saca, Luis F
• Format: Journal Article
• Language: English
• Published: United States Copyright 2001 BMJ Publishing Group 01-11-2001; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Anti-Asthmatic Agents - administration & dosage; Antiasthmatic agents; Asthma; Asthma - drug therapy; Asthma in children; Child; Chlorofluorocarbons; Dosage and administration; Drug dosages; Drug therapy; Humans; Information services; Information services industry; Medical errors; Nebulizers and Vaporizers; Patients; Respiratory agents; Respiratory therapy; United States
• ISSN: 0093-0415; 1476-2978
• DOI: 10.1136/ewjm.175.5.303

Spacers are accessory devices that permit inhaler use in a patient who has difficulty with hand-mouth coordination, and they enhance the efficacy and efficiency of drug delivery to the lungs. Because children often are unable to time their inhalation with the activation of the inhaler, many experts recommend that children routinely use spacer devices with a metered-dose inhaler. 2 The metered-dose inhaler is engineered to deliver aerosolized medication to the respiratory tract. When activated, a liquid spray is ejected from the inhaler at about 15 meters per second. [...]when a patient uses the "closed-mouth" technique, as demonstrated by our young model, a high-velocity jet propels onto her oropharynx, and approximately 80% of the dose deposits locally. 5 (pp409-417) Some practitioners have advocated holding the inhaler's mouthpiece 4 cm from a wide-open mouth to increase the chance that particles could decelerate enough to be entrained into a lowflow inspiration.