Can anyone tell me how to properly use a brown preventer inhaler with a spacer for a 7year old?

[Nochristmasbreak]

My son was diagnosed with asthma in October and given a blue inhaler to use if he needed it.

He got really wheezy and struggled to breath recently so the GP gave us a prescription for a brown one to use morning and night.

But we haven't been given instructions/guidance on how to use it.

So he has to have two puffs, but how far apart? Does he have to hold his breath? How long between each puff? Can he breath in and out between the puffs?

I have googled til I'm blue in the face and there is guidance for adults, videos from Australia, videos from Finland, some without spacers, some with different spacers. But not a clear video or instructions on what a 7 year old should be doing.

He doesn't has an asthma review until February yet we are doing this twice a day. Only in my recent googling we discovered he has to tilt his chin up so we could have been doing this wrong the whole time!

Can anyone help?

Have you looked at the videos & information on asthma.uk? They are a charity & full of lots of information regarding asthma, they've been a help with my (also 7 year old) asthmatic son & have lots of videos or you can call & speak to the asthma nurses. But generally (I do work with asthma/allergy drs) they say to do one puff, then wait 30 seconds/1 min shake the inhaler again & do the second puff.

Do you have a chamber to use with it? An orange or yellow one? If so, hold the chamber over his mouth with the inhaler in the other end. One puff of the inhaler while your child takes breaths. I usually count to ten. If 2 puffs are required, just do another puff and count to 10 again. My kids use a chamber with their inhalers.

I'm an adult, and find the pumps really difficult so I have Accuhalers, much easier. I suck in, wait ten seconds and then repeat if I need 2 doses.

The instructions for ours are:

1 puff into the spacer, child takes 4 normal breaths in and out.
Take a break from the spacer and breathe normal air for another 4 breaths
2nd puff into the spacer and breath in and out 4 times again.

Child does not need to hold their breath, normal breathing is preferred when using a spacer. If he breaths too heavily and too quickly the valve will usually whistle which is a sign to slow down

We got our instructions from the spacer box rather than the inhalers. So if you don't have the box try ringing the chemist and ask if they can tell you what the directions are on the side.

Also rinse mouth out after using to avoid thrush

Rinse the spacer out every couple of weeks or so with washing up liquid and leave to dry before using again. It stops the static build up,which causes the medicine to cling to the sides and reduces the amount your child breathes in so this is quite important.

You don't have to wait for his asthma review, phone up and ask for an appointment with an asthma nurse - they are always happy to see people and it is something that can probably be done over a video consultation.

Make sure he rinses his mouth out afterwards, as well as brushes his teeth as well.

I think the asthma uk website is terrible. It is not clear, it shows dozens of pictures of different inhalers with codes but which one is it? You then click on 'watch video to help your child with their inhaler' and it takes yo straight back to the page with all the pictures again!! Whoever designed that needs sacking

I just want to see a video that shows a brown inhaler with a spacer for a child under 10. I don't understand why it isn't clearly shown in there. All I see is this.

1 puff into the spacer, child takes 4 normal breaths in and out.
Take a break from the spacer and breathe normal air for another 4 breaths
2nd puff into the spacer and breath in and out 4 times again.
This is the advice we were given when my son started his brown inhaler.

The pharmacist should go through how to use it with you, especially if it's a first time prescription. I would go back and ask.
I shake the inhaler, do one puff into the spacer, breathe normally through the mouthpiece for about ten seconds, then repeat.

@RoomForMore our spacer is a big clear one, no colour on it, you have to put it together with two sections.

@LadyPenelope68 @NannyR thank you I think I will use that advice, 4 breaths/10 seconds is probably the same amount of time.

is this any good? It looks like it's not the same shape spacer as yours but the technique is the same.

Here’s the Asthma UK advice on how to help a child use a spacer. As a PP said, the instructions that come with the spacer might be the most helpful thing - different brands work slightly differently. If you’ve not the instructions, you’ll be able to find them by googling - for example, instructions for an aerochamber are here.

Sorry, crossed posts with you - that’ll be a volumatic spacer.

Ask the pharmacist. They will be able to demonstrate with the actual inhaler and spacer.

We do spray and count to ten too.

I think this is the video you’re looking for - the spacer videos are under the ones about the different sorts of inhaler.

For the volumatic spacer we were told one puff, breathe in and out normally for 10 seconds then take a break and do it again for the second puff.

Aerochambers are better; Volumatics are so large that one puff tends to get lost in them.

This leaflet with pictures might help?

I'm pretty sure the leaflet hasn't changed since I had my first one at about that age!

(Aero chambers are a bit easier, but I'd always have a Volumatic in the house. Ten puffs of ventolin in a Volumatic spacer can be used as a DIY nebuliser in an emergency, until you can get to a medic.)

With a volumatic spacer. One spray count ten seconds normal breathing. Then repeat.
Our children’s ward always uses volumatics.

Off to google aerochamber chamber and volumetric chamber, not sure which one we have.

@sueelleker

Aerochambers are better; Volumatics are so large that one puff tends to get lost in them.

I have always been told the exact opposite but respiratory consultants from two hospitals. Ds is 11 and we use the volumatic spacer every day and are only allowed to use the areochamber when out and about (because it is easier to transport)

There was a BIG trend for Aerochambers Are Better in the early-mid noughties; but volumatics seem to be making a comeback...

Trying to uncover how much is to do with medic’s personal preference, mind you, is an interesting one - one of the articles linked to in the footnotes of of a discussion of inhaler-related myths suggests that using a large-volume spacer like a volumatic is effective with long-acting bronchodilators; & it’s not a leap to it having near-parity with inhaled steroids (I’m assuming amount “lost” will vary very slightly - as in, the sort of numbers you’d report For Science, not as Normal Human Doing Normal Human Things). That study was done in 1992 though, when volumatics may’ve been the only spacer on the UK market (the only one I remember seeing) so the choice shouldn’t be taken as meaningful even if the results are good, iyswim? That said, there’s also an article from 2000 where they compared a couple of spacers & something they’d improvised from a 500ml drinks bottle (as people typically do in countries where spacers are unavailable) & the latter was actually most effective, which suggests large volume spacers might be better (for paeds patients, at least). Why they didn’t include an actual large volume spacer is a bit of a mystery, but there we are

(Sorry if that seems like a huge derail OP - the TL;DR is basically that volumatics are grand, if a wee bit awkward for small hands to manage, but as you’re overseeing things there’s no need to worry. And that washing the spacer as directed, as well as the obvious keeping it clean, “primes” it to help reduce loss of medication - but any such loss is absolutely minuscule; & factored in when doses are considered: people who don’t use spacers generally end up “losing” some of their medication to the back of their throat rather than it reaching their lungs, & it’s vastly preferable it stick to the sides of a spacer... I just didn’t want you to feel you’d now another worry re: which sort of spacer is actually better.)