The last winter was unusually quiet for us in the paediatric department. This was most likely due to social isolating preventing the spread of other respiratory viruses. We are now seeing a bit more of a surge since children have gone back to school.
One of the areas we frequently provide parental education on is inhaler use. Below is a quick reminder, which should prove helpful.
Children can need inhalers for a few conditions, the most common being viral induced wheeze (usually in the preschool population) and asthma. Your doctor will have told you which one your child has. Children will, in general, use two types of inhalers:
PREVENTER: these include Clenil (brown) Seretide (purple)
These are steroid-containing inhalers, which are prescribed to be used every day (usually morning and evening) – regardless of how well your child might feel. The aim is to prevent any acute episodes of wheeziness by reducing the inflammation and sensitivity of the airways. The dosage and inhaler type will vary depending on your child’s need and age. You should not stop this inhaler unless advised to by your clinician.
RELIEVER: these are commonly Ventolin/ Salbutamol (blue)
These are inhalers to relax the airways for quick relief during an acute wheeze attack. They should not be needed regularly. If you find your child needing these on a regular basis, or needing to get a repeat prescription more than every couple of months, then ask for a GP or asthma nurse review. After an acute wheeze you will be advised to follow a daily weaning plan for the reliever inhaler. Your child should have this inhaler with them at all times.
Inhaler technique with spacer
(This is for the metered dose inhaler. Powder based/accuhaler technique will be different)
1) Hold inhaler upright, take off cap and check mouthpiece is clear.
2) Ask child to put mouth around mouthpiece – or use facemask for a young child or toddler – creating a seal. Sit child upright, or slightly tilting backwards on your lap.
3) Shake inhaler well and place on end of spacer.
4) Press canister once and encourage deep breaths in and out 5 times.
5) If your child needs another dose, take off the inhaler and shake again – repeat.
Your child should have their own individual asthma/wheeze plan – please see your GP or nurse specialist if you are unsure or do not have one.
Additional resources and videos:
Dr. Yuheng Zhou
Teddington Resident & Paediatric Consultant