To be utterly confused as to how DS is supposed to be taking his asthma inhaler correctly

[Squarepebbles]

So DS newly diagnosed by nurse.He has the small spacer.

First time she said breath out and then breath in through the inhaler,take it away then breath out.Repeat.

Went back and got her to watch DS but she said he was doing it wrong.She then said breath in and out with the inhaler attached to his mouth.

Looked on the asthma site and there is a video saying the first way.

So which is it?

She told us off for not waiting 10 mins to do the brown which she never told us to do first time.

She isn't the most patient of nurses tbh.

Help!

Sorry to post here but need the traffic.

We do

inhaler in spacer
over mouth/face
puff of inhaler
keep over face and count 5 Mississippi
take inhaler off

repeat with blue as required, then do brown about 5 mins later.

Should add that we've seen several GP, several hospital consultants and never had anyone say it should be breath out and then breath in through the inhaler,take it away then breath out, never seen anyone ever do it that way.

We do (the way shown to us by our asthma nurse)

• shake inhaler
• put inhaler in spacer
• put spacer over mouth and nose
• start breathing in/out in deliberate fashion
• one press on inhaler
• breathe in/out for at least 6 breaths
• remove inhaler and shake again
• repeat as above for 2nd puff

That's just for the preventative (brown) one.

Oh jeez I'm utterly confused now.

She is quite snappy so can't go back and ask again.

We do the same as the two previous posters. Last appointment got us to demonstrate what we did and she said it was right.

But red is breathing in and out with inhaler attached.

Sophia what are you doing when saying Mississippi?

Mississippi means count like this '1 Mississippi, 2 Mississippi, 3 Mississippi... and so on. It means you get a good long count to 5 rather than just quick counting.

The inhaler stays in the end of the spacer the whole time

How old is he? I found the large spacer much easier when ds was little and still use it when he's having a bad attack as it's requires less breath control to do it properly.

I've never been told to do it the first way and we've seen nurses, gps and paediatrians.

He's 9

So during Mississippi the inhaler is attached to child's mouth?

That is different to asthma site video?

we just stick it over her face an count to 10. she can hold her breath that long so we have to cajole her into taking a few breaths from time to time

Sorry no Sophia you take it off so it is like the asthma site video.

Should I just go by the video and disregard nurse?

This describes how we were told ds should use his. HTH

I have always done the breath out first because that helps you to breathe in properly (reflex breathing). However after the breath in I've always closed my mouth for 5 secs to make sure the spray goes into my lungs not back out of my mouth.

Web that was how she said to do it last time but it is different to the asthma site video which is how she told us to do it the first time.

I think.

Do you think it matters?

I've had asthma 26 years and I do

Empty lungs of breath
Inhaler in mouth and spray
As soon as it sprays I breath in.
Hold breath for 5long secs
Repeat if need to.

Sorry, not sure if I was clear, will try to describe again

inhaler fitted into end of spacer
inhaler&spacer as a unit put over face
puff the inhaler
whole unit (inhaler&spacer) stays on face for a count of 5
then whole unit is taken off face

repeat whole process for however many blue puffs required, wait 5 mins before repeating whole process with the brown.

Thanks for your patience,just to clarify during count of 5 whilst pacer is over face is he breathing in and out?

Spacer and inhaler as a unit over the face for a count of 5, whilst it is on the face child just breathing in and out as normal.

Follow the Asthma UK video, it's excellent. (Am an asthma nurse) Useful for children to watch, too. Remember to rinse and spit after the preventer inhaler to avoid oral thrush/hoarse voice.

Also she is incorrect saying wait 10 mins after using the blue before using the brown - thats outdated advice - you can do them after each other. But you shouldn't be using the blu routinely, only if symptomatic, does that make sense?

I think the breathing in and out of for very young ones who can't understand to inhale slowly and deeply and hold their breath? I babysay a 2 year old who had to do it that way. Your son is 9, so he probably doesn't need one that covers his nose. I use an areo chamber myself as my dr prefers his patients do, even adults.
He said it works best if you stand, as your lungs can expand more.
Exhale, place chamber at your mouth, then puff the inhaler into the chamber and slowly inhale, slowly and deeply. If I do it too fast my chamber "whistles".
Hold for about 5 seconds, then exhale.
Wait 5 minutes, then repeat.
Then repeat with the brown inhaler.
Now this is me, I know there are different inhalers out there, but all of them you slowly and deeply inhale and hold for 5 seconds.
The reason you wait before using the brown one is it takes a few minutes to open up airways, once they open, you get more benefit from the medicine in the brown one.
Hope your son feels better soon. :)

Oh yeah, give it about 40 shakes before using.