Respiratory Solutions: Work with caretakers

A. Children are at the highest risk for serious complications from asthma. Providers can help improve quality of life for young patients by educating them on proper inhaler technique and suggesting tools to maximize treatment.

A recent study in the Journal of Hospital Medicine reported that almost half of participants ages 2 to 16 used their inhalers incorrectly during treatment. Nearly 18& of patients in the group did not incorporate a spacer device.

A spacer is a large tube that fits onto mouthpiece of the MDI and helps patients fully breathe in medication to reach the bronchial tubes. While appropriate for all ages, spacers are particularly effective for children and adolescents who are still learning proper inhalation technique.

Spacer devices are also commonly used to prevent medication loss during treatment: Research shows they can increase the amount of medication a patient takes in from 34% to 83%.

To further these benefits, patients may upgrade to a valved holding chamber, an updated version of the spacer.

Valved holding chambers feature a one-way valve that opens when patients breathe in the aerosol cloud and closes to prevent oxygen from entering the medication chamber. They also commonly feature an antistatic coating that improves drug delivery by preventing medication from clinging to the chamber wall.

Since spacers and holding chambers help prevent the aerosol spray from settling in the mouth, throat and stomach, they also decrease the risk of side effects such as thrush.

Providers can work with caretakers to select an appropriate spacer or holding chamber, as well as an inhalation mask for patients under six.

Providers may also consider issuing a small reminder sheet for caretakers and patients to reinforce proper technique. For example, doctors recommend pushing just one spray into the spacer at a time and inhaling within the first few seconds.

These practices could significantly improve treatment for your youngest patients!